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 _3. (^ <br /> r v / 9-) <br /> N O <br /> CD IG7- <br /> N <br /> C <br /> OWNER IYl ( ') 1 I�5 TELEPHONE (� �jCj 1 q1 n <br /> {{ o <br /> m <br /> MAILING ADDRESS f <br /> PROPERTY ADDRESS <br /> Sa.LA/TLio/ Is w �crmi.-w <br /> LEGAL DESCRIPTION(see tax receipt) S N C �lt S bb01 A r (,��/ % m <br /> DWELLING/BUILDING LTJ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION G� rn o <br /> �7I <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ CAMPING UNITSUBDIVISION ❑ n <br /> ' I 1 { \ N. <br /> STRUCTURE/ADDITION USE: '+"16 M e— AU n a h ryV\<C'k <br /> (Home/Cabin; Commercial Business;Bedroom; Deck,etc.) Cl) <br /> m <br /> 0 <br /> BUILDING CONTRACTOR: m. <br /> C <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8Y:X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T Ul <br /> O <br /> A NJ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O c <br /> m Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m A <br /> ,.Y' SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). y o <br /> lx8 SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD,(P BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF 1 <br /> LAKE,STREAM OR RIVE AND MEASUREMENT TO WETLAND AREAS. ) o <br /> ✓4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO t <br /> BUILDINGS, ROADS, LAKE, LOT LINES. J 1j Cr. <br /> INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED.W %II 1 ?\ <br /> t 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 /> op pp v, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN - o <br /> NEEDED. 40 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. S� <br /> CONDITIONS OF PERMIT: �J ��/ / <br /> t <br /> ISSUANCE. <br /> MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 D S OF 6l�dDtlT� <br /> l% w( <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALO1017 ,R�ELINE✓20 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICA7� <br /> PERMITTED. Zn,./ c <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE RIAtRE� R <br /> SETBACK AREA. �/ <br /> 5. D / / <br /> m W 0 MO a E m <br /> 6. m am xa� <br /> m C N �' o 5. 9 <br /> 7. Z rn � o <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) ID <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m c : o mt7 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> sue a permit. I f rther accept all liability which may be a result of the County of Burnett relying on this information I am o0 <br /> providing in th ppli I agree to pe c my off' ials charged with administering county ordinances or other <br /> authorized pe have access to th b e es ibe emises at ny reasonable time for the purpose of inspection. m o <br /> CID <br /> SIGN HERE <br /> 3,20,01-1a <br /> CL : <br /> (signature of ow r' b 1 I ate) <br /> ZONING ADMINISTRATOR 6� <br /> viF»viE» <br /> ` r1Ar <br /> N (TNN <br /> TOW SHIP PERMITS MAY BE REQUIRED I (f <br /> ►g16o AcC- T <br /> 90 10 6 . --, <br />