Laserfiche WebLink
Burnett County 7410 Co.Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator m o 0 <br /> APPLICATION FOR LAND USE PERMITS <br /> r <br /> N O <br /> OWNER TELEPHONEC7 �Vt�/�L / wm <br /> 00 <br /> 2 /'^ l� <br /> MAILING ADDRESS 60 �0 7-A( ST T7�/V 0,$0,V W/ <br /> r m <br /> S ��r <br /> PROPERTY ADDRESS y30 ,�s a'1 <br /> / <br /> LEGAL DESCRIPTION(see tax receipt) 40'r ztiL � <br /> 3 Mf Sa�dld/�JO�/ d�rxr TW � <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE 9 ADDITION ❑ N U) <br /> C <br /> TYPE OF PERMIT(S): C <br /> FILLING/GRADING ElCAMPINGUNIT ❑ SUBDIVISION Elw a �,; <br /> STRUCTURE/ADDITION USE: C7 A 2 AG�� /STD�/t 1��—� r Id' LI&n 3o x 3-s-' ° V <br /> Q (Homee/�n; C mercial Business; Bedroom; Dec •etc.) m <br /> BUILDING CONTRACTOR: lI D f/I`l7G� � w Q <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR m B. <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> 3I w i-'i <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a 1 <br /> In Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. A m �o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m <br /> NORTH(N). y o <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 (� Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO (�p� <br /> BUILDINGS,ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <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. 5 m <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN q o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c O <br /> CONDITIONS OF PERMIT: i <br /> Q <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> y IN 0 CL M <br /> 6. m3 'om �c � $ m <br /> v m C <br /> 7. y <br /> ° n m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m r^: Q <br /> PP ( 9 Y ) Y Y t7 C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> a u, . <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m $ : o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- 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 `• m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other E <br /> CD <br /> : to <br /> authorized person to h ccess to the above de ed premises at any reasonable time for the purpose of Inspection. cCD <br /> , <br /> CD <br /> SIGN HERE rY ����✓"! <br /> (slgnatu caner or uildi ontractor) (date) � ` a <br /> ' ` <br /> ZONING ADMINISTRATOR <br /> Y� EA M frA�fA 0 N <br /> a, (ill (NP0 "W 01 OO <br /> ��� a2� PERMITS ALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE J) <br />