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 /> N <br /> N <br /> C <br /> (D <br /> OWNER TELEPHONE 6 ,S 731 910 o <br /> MAILING ADDRESS /,,,I /L W00,0"Y 41 S 12-.5' <br /> r m <br /> 0 <br /> PROPERTY ADDRESS 27235 N e—LSooi Ro" SSU Q <br /> c� w \moo <br /> LEGAL DESCRIPTION(see tax receipt) C01-ferS U Cl h D P Lot Q Lot a7°L,Q R ��kCn <br /> TYPE OF PERMIT(S): <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE 10 ADDITION ❑ <br /> Q <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION,, //❑ <br /> STRUCTUREIADDITION USE: SZi t_2 X `7 D 0 CN <br /> (H a/Cabin; Commercial Business; Bedroom;Deck;etc.) cn <br /> v <br /> BUILDING CONTRACTOR: SEL- P <br /> w <br /> z � _ <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> n <br /> -n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. f7 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). N >11 o <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 a <br /> LAKE,STREAM OR RIVER 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 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BEG �R FILLED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,/ �74GTOfi,ETC., THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. �"' - o <br /> / o Z <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE V ICATION MAY I9igO1� �IVF1EN <br /> NEEDED. Q11 <br /> COINS PERMDIT ONIS OFSPEBRJECM TT TO ALL CONDITIONS LISTED BELOW. e(JRNF , 9200 .0 n" O <br /> IS ,Vnn j l .' r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERAAI VC'0(Jjr `N <br /> ISSUANCE. Q Y <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Q <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY 0 <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> CD Wm <br /> a mC00 51 <br /> 7. Z ;neo : � � 1 <br /> o it'2 ;a <br /> _ �: m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m ; 0 0 <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 further accept all liability which may be a result of the County of Burnett relying on this information I am 0 <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m C <br /> - o : <br /> m m <br /> SIGN HERE r <br /> n : <br /> (signature of owner building contractor) (date) <br /> ZONING ADMINISTRATOR �// Can l Gell Q N <br /> N NC1 N NOO <br /> �J V 1 O N N O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED �p <br />