Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 731 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> N � <br /> ^� C <br /> OWNER TELEPHONE 'ft <br /> m <br /> MAILINGADDRESS / yj 6i,vG y�j�J/j.s R_B74-D 'L_r�D/}C L�j Z __0 <br /> PROPERTY ADDRESS Q Sico <br /> y)e Z-A 'eb <br /> LEGAL DESCRIPTION(see tax receipt) l6eLSC N� S— z Al l�C'w <br /> O m <br /> DWELLING/BUILDING <br /> ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ N o <br /> TYPE OF PERMIT(S): <br /> FILLINGIGRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ J��yr z D 5 �� a <br /> STRUCTURE/ADDITION USE: re'gk h6✓F/Srt'w4e® 0 <br /> :) I <br /> (Ho e/Cabin; Commercial Business; Bedroom; Deck; etc.) N <br /> BUILDING CONTRACTOR: [ - _ 047 <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. m <br /> O N <br /> �I N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p � <br /> T n <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n W A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m <br /> NORTH(N). C n <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. <br /> o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO Q, 1, <br /> W <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 j o /I� <br /> MUST BE SIGNED AND DATED BY THE OWNER. 1O f lJ <br /> O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. oZ 14 <br /> I <br /> CONDITIONS OF PERMIT: <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 THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. T b e > �s ' -fr <br /> A W O r D O D 0 <br /> M c m m 0 m o. f M6. m x 3 'n m x a 'D A <br /> 0 om C �0 `" o 3 <br /> 7. Z cB0, o ; 1 <br /> o m <br /> declare that this application (including an accompanyingschedule has been examined b me and to the best of my <br /> PP ( 9 Y ) y <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m n C <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> G) E s : <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 : o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other �' m <br /> m <br /> authorized person to have access t the above described premises at any reasonable time for the purpose of inspection. �D <br /> Ci D : <br /> SIGN HERE L_ /1� (j��� 6 �) a n <br /> rek? <br /> ( ' nat 16 A caner .b 'thing contractor) (date) trVl^I` a j <br /> ZONING ADMINISTRATOR 1 <br /> �fA fA bi EA�N <br /> O N N W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED o u o u v N o <br /> S PERMIT SHALL EXPIRE ONE YEAR FRO <br /> _tD D OF ISSUANCE <br /> 1�errrut L rSem ISUu CEE <br />