Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator v c) Z <br /> N <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> Sf P*td —4,51-48y- -USy <br /> OWNER 2j�/ �L S/70 -�Z TELEPHONE (.11i - ZS9--74.5'rf n <br /> o W <br /> 'i Z/AV40 /Z44 1) n <br /> MAILINGADDRESS p <br /> �N S-Sf•L7 <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION(see tax receipt)C� r7 / / � C'c� ��, <br /> L) J / <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE 1:1ADDITION ❑ o <br /> TYPE OF PERMIT(S): O <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ or <br /> STRUCTURE/ADDITION USE: YS QQ� o <br /> ,✓//� ,/ - '(Home/Cabin;Commercial Business;Bedroom;"Deck;etc.) pp <br /> BUILDING CONTRACTOR: �[!to, / /4#E ?1,40-6 F53 <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 17 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 3 <br /> O N c � <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 N <br /> In O- <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE n �; <br /> iF A <br /> M <br /> NORTH(N). C 11 <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 (�.� <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. I I 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 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. v � 0 1 <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. Z <br /> CONDITIONS OF PERMIT: P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. J Q <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 /> /6 77� <br /> 6. T� l �— C�1 2R SCJ (67YL &ff0j 7) ) D C COj_e_.�r— 'd! U) 1 ° a f p <br /> 3n� c LI <br /> �. cv2y Shu%rs Cher mat, 7Qn 6F / " N ' y 3 <br /> O <br /> yiL O T� in <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my w 10 (^ <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 p 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- 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 vl} <br /> authorized person to have acces to the above described premises at any reasonable time for the purpose of inspection. <br /> T <br /> O <br /> SIGN HERE 03 <br /> ignature of building contrac ° [ (� <br /> / (date) <br /> ZONING ADMINISTRATOR (/ i rA ( (4 <br /> O O <br /> (VU (n O (r O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> g <br />