Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o o <br /> APPLICATION FOR LAND USE PERMITS <br /> r <br /> y O <br /> N <br /> OWNER /t A L 6 TELEPHONE "! f _ y/ �_a Qr-) <br /> b v � <br /> T� m <br /> MAILINGADDRESS U C� SG `� K ^/ O�� <br /> [ , t/1 0 <br /> 0 <br /> PROPERTYADDRESS S // ti4-C J�/s � � 7/ , r N 1 <br /> S. 3a -r.3& <br /> p. �q <br /> LEGAL DESCRIPTION(see tax receipt) Np— WV t7K Pcl V,23& P o <br /> } m <br /> DWELLING/BUILDING� GARAGE/ACCESSORY STRUCTURE 1:1ADDITION ❑ <br /> o <br /> TYPE OF PERMIT(S): / C <br /> FILLING/G I G CAMPING UNIT 1-1SUBDIVISION ❑ <br /> W n <br /> STRUCTUREIADDITION USE: o <br /> (Home/Cabin; Commercial Business;Bedroom; Deck;etc.) (n <br /> 0 <br /> BUILDING CONTRACTOR: <br /> '- <br /> m <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY IN OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> M <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p uU <br /> 11 <br /> Q. 11� <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. A o A lU� <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 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF P <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. y o <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO ;t o <br /> BUILDINGS, ROADS, LAKE, LOT LINES. XJ <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N /J <br /> 6 IF MUST BE SEPATE GNED AND DATED BY THE OWNER.PLANS ARE SUBMITTED BY AN HE ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS o C>Q <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o � <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT j Q <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 O <br /> PERMITTED. 0 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 6. m W - '0i 0, m <br /> 0 3 a0 w n <br /> m m x — <br /> 7. Z N m o N =n 3 <br /> o :ji ;u <br /> 1 declare that this application (Including any accompanying schedule) has been examined by me and to the best of my C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of @ n d, <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m ; o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- V m <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am nO <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection s <br /> SIGN HERE i " `� •s I Y �.�1`Y`�_ ����j�'© J <br /> Cl <br /> (signature of owner or building contractor (date) <br /> ZONING ADMINISTRATOR <br /> \J b9 fRMfA�N <br /> N U t N N O O <br /> U O N N O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />