Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> iT o <br /> OWNER W <br /> r� e (� `I�VV , �Q�YSQ�) TELEPHONE <br /> HOME ADDRESS L. j1 Jy7q A Y ke-- y v ML <br /> EMERGENCY/FIRE NUMBER 2 �g ROAD NAMEEx s `O WS LA�e /y 1 `o <br /> LEGAL DESCRIPTION(see tax receipt) Loi' Lf Vo� lT 1 p z% CSM Lm ,4..( Gov Laf(Sj S'4- 07 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE X ADDITION ❑ PRIVY ❑ 40N Rw se ) m o <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> N <br /> STRUCTURE/ADDITION USE: .S oy c-, q P_ /C► A cfy^020 <br /> (Ho /Ca mercial iness; edroom; Deck;etc.) �— ro <br /> IU <br /> BUILDING CONTRACTOR: CD w tc" <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> O — <br /> �I in <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. v <br /> Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m n <br /> NORTH(N). N 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. P <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 0 GG <br /> MUST BE SIGNED AND DATED BY THE OWNER. 0 1 <br /> o � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHENa S <br /> NEEDED. T <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z i <br /> CONDITIONS OF PERMIT: P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. I <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 /> 5. Q—'S"- <br /> This structure to be used as private residential m 3 n 1 m <br /> 6. garage/storage only. Not to be used for human -53' : m e 8 y o T 3 <br /> 7. habitation. Z € a <br /> 0 <br /> 1c, : j jm <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my L7 c 10 <br /> knowledge and belief it is true, correct and complete: thatl din responsible for the detail and accuracy of n <br /> all information contained in this application(includin Od urther declare that I recognize <br /> that this information I am providing will be relied up hr �o _¢/�u, s In determining whether to is- G <br /> sue a permit. I further accept all liability which may a result of the Coun oflying on this information I am ( m <br /> providing in this application. I agree to permit coulr ter officials char ed with admini rg county ordinances or other m <br /> t <br /> authorized person to have access to the above des d pre , a ny r able or the purpose of inspection. m <br /> I m <br /> SIGN HERE Z O® . <br /> (signaWfi wneror building contractZbN)NG (da)6) <br /> ZONING ADMINISTRATOR L (n <br /> N fnNN(nM <br /> 17\Vn N 0 �n iVn O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 9� 000 $!000 <br /> ` 0001000 <br /> I' <br />