Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator T o 0 <br /> APPLICATION FOR LAND USE PERMITS . <br /> r <br /> y O <br /> N <br /> N <br /> OWNERt7 R �LN Q �� TELEPHONE <br /> F CD O <br /> MAILING ADDRESS jp�8 g L tJ LNoe LV.SSa <br /> A <br /> ' l� <br /> PROPERTY ADDRESS � L ( I ' Cy�(� p Lj fry V'=► <br /> W � <br /> LEGAL DESCRIPTION(see tax receipt) 0 Z0 �(43 ra - 0I- q/u C <br /> U <br /> CD <br /> DWELLING/BUILDING ® GARAGE/ACCESSORY STRUCTURE El ADDITION ❑ © � <br /> TYPE OF PERMIT(S): n <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <. <br /> STRUCTURE/ADDITION USE: S� <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN SY:X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O — <br /> ZI Ul <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) n n <br /> T <br /> ?1 O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m R ;b2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). C 3 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m 3 <br /> f 70 <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 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS S Q <br /> MUST BE SIGNED AND DATED BY THE OWNER. f t <br /> O D <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. r`1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o �I <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT r`r <br /> ISSUANCE. r� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLYCVJ <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED W#ATER <br /> SETBACK AREA. /� J / / ��r� �" Mn <br /> 5. //P ��Jt✓S �af5 leu !�f (J� G� �/ �` (� <br /> c� nOima <br /> 0M :E M <br /> m F3m � am � <br /> 6. o m cy i o o 3 <br /> Z c rn o M� <br /> 7. o m � '< <br /> In <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j a : O <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m' 51 i : c <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m 0 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> d <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 o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonabl r enable tion. m <br /> T a <br /> il.. L;�1 m i a : <br /> SIGN HERE 1 a <br /> si at a oo er or building contractor) ,.i.I (date) <br /> ZONING ADMINISTRATO ��%?f1� i7T L 2UlR f` <br /> IURNETT COUNTY � O N o W cn N <br /> TOWNSHIP PERMITS MAY BE REQUIRED C>� N u N u <br /> ISSU7A� <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF � <br />