Laserfiche WebLink
Burnett,County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> � 0 <br /> y 0 <br /> H <br /> OWNER1�__JA!;XUCL Ne ELEPHONE o <br /> p• F� 71S 16a-3y67 <br /> HOME ADDRESS L15A <br /> .. <br /> ^ r <br /> EMERGENCY/FIRE NUMBER ,�J� ROAD NAME � <br /> LEGAL DESCRIPTION(see tax receipt) <br /> / <br /> `r 3-7 4- 1(�` i 8w s i (,f m <br /> DWELLING/BUILDING Y,I GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ m ° 1 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING WAMPING UNIT ❑ SUBDIVISION ❑ o: <br /> STRUCTURE/ADDITION USE: C Ab J N 4Y /1 &`1 ° <br /> (Home/Cabin; mercial Business; Bedroom;Deck; <br /> rettc)+ m <br /> BUILDING CONTRACTOR: 7Zm Ge,,s FAJ <br /> FLD Co�SUN ✓S[ D L_ Eker-C 1.)1IU <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR n � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. n <br /> � in I(JU <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> In <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. t) m '� <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS,ROADS,LAKE,LOT LINES. (� <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q (� <br /> NEEDED. Q I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z° <br /> CONDITIONS OF PERMIT: I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT + Q <br /> ISSUANCE. `Tp 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY p <br /> PERMITTED. <1rIJJ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> AM0� kvv <br /> 3 <br /> a n ° m <br /> 6. � R- = z <br /> N <br /> co, 0' 7z <br /> 7 <br /> 7. P <br /> - rn E E m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of 0,i? S <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize to . . . <br /> M <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m l7 <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am m' <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other m <br /> authorized to have a ess to the above described premises at any reasonable time for the purpose of Inspection. -n <br /> CD <br /> to <br /> 5 � <br /> SIGN HERE 9 � • • <br /> ( ure of owner or building o act rof (date) <br /> ZONING ADMI RATOR �j` ' ` 4 w <br /> wwwwww-� <br /> Nin NNtn to <br /> (T (n Oto N O O <br /> TOWNSHIP PE ITS MAY BE REQUIRED <br /> 0000000 N <br />