Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator T 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> - r <br /> UT O <br /> N <br /> C <br /> OWNER � 5 j,I T! � TELEPHONE 76CD <br /> �- 7 0113 <br /> _- <br /> HOME ADDRESS J <br /> zs�6 �s /Val — Af X 36 <br /> r <br /> 0 <br /> EMERGENCY/FIRE NUMBER ROAD NAME 1/A0%t,7,Wp tp <br /> LEGAL DESCRIPTION (see tax receipt) <br /> DWELLING/BUILDING TO GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ 7TVI�J <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING EI CAMPING UNIT 9 SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: f7��/ ("� <br /> 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) 2cn <br /> BUILDING CONTRACTOR: S�zF <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> 0 y "�l:� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> n o- <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m T <br /> O <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. A <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. I <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS Q 1 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> _o (� <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN C <br /> NEEDED. Vv <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT x/ <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY qj <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. A <br /> 5. NO <br /> ,II l�{y,iO�+ V t�GL✓+ ccr 't�jOfi O C� �+ Oi - � 3 <br /> cs m <br /> ac _ -0- n �oCL6. rD LA-1 0- 5U� OFh I-ligQim 1 m <br /> -a M <br /> C'm " > > 3 <br /> 7. SeeS�►tA� �YB� Z <br /> P . <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my tj c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m c <br /> all information contained in this application(including any accompanying schedule)and I further declare that ICLrecognize m m <br /> that this information I am providing will be relied upon by tWela' <br /> f Burnett Wisconsin in determining whether to is- O <br /> sue a permit. I further accept all liability which may l: a reurnett relying on this information I am m <br /> providing in this application. I agree to permit county offiwi i t ty ordinances or other m <br /> authorized person to have access to the above described prI urpose ofinspection. m <br /> LJ <br /> m : <br /> Q /) m <br /> SIGN HERE /n� <br /> (si a of own r ilding co tor) -� ,UQ1 (date) <br /> ZONING ADMINISTRATOR • • • • . y, <br /> ������� <br /> NN (IINNM <br /> TOWNSHIP PERMITS MAY BER Q1UIRED 0 0 0 0 0 0 <br />