Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Sir@W@NMTER/SCAME0f Zoning Administrator � C � <br /> APPLICATION FOR LAND USE PERMITS 2< ° <br /> N 0 <br /> OWNER TELEPHONE 3 -7 � �E <br /> HOME ADDRESS <br /> `rt r \ a <br /> EMERGENCY/FIRE NUMBER ROAD NAME P/ <br /> LEGAL DESCRIPTION(see tax receipt) ti <br /> TYPE OF PERMIT(S): DWELLING/BUILDING G AGE/ACCESSORY STRUCTURE^/ ADDITION- <br /> or y V' <br /> n <br /> N 1 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 'oCn <br /> ' 11J <br /> STRUCTURE/ADDITION USE: <br /> �rJ <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> T <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m <br /> DIRECTIONSFOR PLOT PL6N DRAWING- (AERIAL OR TOP VIEW) 0 <br /> O � <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m j <br /> NORTH(N). <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 LAKE, <br /> STREAM OR RIVER. z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- G <br /> INGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS S I h <br /> MUST BE SIGNED AND DATED BY THE OWNER. c �/ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CANBE 3 <br /> ISSUED. Cr ° <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF FERMI :: c <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 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. =md co � <br /> Z 3 as T <br /> 7. Z <br /> o <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my C ' �j <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of ) C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize C m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- p <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information 1 am d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> CD <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> T <br /> SIGN HERE <br /> (signature of owner or building contractor) (date) . <br /> ZONING ADMINISTRATOR Im 't/�R1' ' `• ': <br /> "fnwwfnfnw� <br /> N NfTNNfJI Ut <br /> fT N O U1 UI 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />