Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v ci Z <br /> APPLICATION FOR LAND USE PERMITS 3 E <br /> Z7 <br /> Z7 <br /> OWNER 4+ d <br /> TELEPHONE <br /> HOME ADDRESS <br /> /89401 /61 /r/,�r�er��f.,► / S` s�— 0 <br /> r o <br /> EMERGENCY/FIRE NUMBER ROAD NAME t, 1`I L C_k <br /> !? / <br /> .!�— <br /> S <br /> LEGAL DESCRIPTION(see tax receipt) y f I/l ` e5m V to Q ) <br /> �1 J' e <br /> TYPE OF PERMIT(S): DWELLING/BUILDING_ 0 <br /> GARAGE/ACCESSORY STRUCTURE ADDITION c = --) <br /> Cr <br /> _a <br /> SANITARY5• <br /> PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o <br /> Cn <br /> STRUCTURE/ADDITION USE: AJG'W i0uie,�InR �� ' X!�/y e1 <br /> Er <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -I <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR C <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> GNSI�d - - 9� 0 <br /> PDRAWING: N CT` <br /> DIRECTIONS FOR PLOT N AERIAL OR TOP VIEW) 1 G <br /> 0 � . <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> W BUILDINGS(NB)AND INDICATE 7x UT n m Q� Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEm M <br /> NORTH(N). C ` n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES, (B)BUILDINGS)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- <br /> INGS, 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 I <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> -2)(Q o W <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 0 � <br /> ISSUED. a T <br /> T <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z � <br /> CONDITIONS OF PERMIT: o <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 75 FEET OF THE OH <br /> 5. WM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 6. zv0rm �� vv <br /> m �. m <br /> 3 & -- ;M0ea; <br /> 7. ` o 0m 3 <br /> NCUD,•� 1 <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my o <br /> y A <br /> Cr . m <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 i �m E m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- G3 <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 i �' '• <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other 03 <br /> authorized person to have access to the above described premises at any reasonable time for the moose of inspection: <br /> m <br /> SIGN HERE et"- <br /> n ureofowne �d/ing contrac r) <br /> /7 _ r (date) <br /> ZONING ADMINISTRATOR g G 6 7� J j 91997 <br /> wwwwen <br /> I' II N N Ut N N N <br /> TOWNSHIP PERMITS MAY BE REQUIRED V `'J o <br /> 00000 <br /> 00000 <br />