Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> OWNER : e� gr g�y�i4s/e�i�� /C/J`H�i TELEPHONE (�'(O W/ -� <br /> i//tQ � <br /> MAILING ADDRESS /Zo �J��qs / Z O <br /> !E GL// � d'9� f <br /> PROPERTY ADDRESS <br /> C s� [� O <br /> LEGAL DESCRIPTION(see tax receipt) ✓�fT1D �? TuJAJ 39 y,,m/T� �[� ,{/E-,¢��C i� N <br /> m <br /> I';�� 0 .� <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION 0 <br /> L7 !1 <br /> TYPE OF PERMIT(S): � � <br /> c <br /> FILLING/GRADI G CAMPING UNIT El SUBDIVISION ❑ <br /> a <br /> STRUCTURE/ADDITION USE: t-fi o�--� � k;4Z It C2 0 <br /> ¢¢�� N4omCommercial BuslWSS;1 d9&00m; Deck; etc.) <br /> BUILDING CONTRACTOR: <br /> W <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> O — <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING- (AERIAL OR TOP VIEW) O m�I <br /> T a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. -n ? <br /> o p <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NEI) n)AND INDICATE 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 (n3 <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. n , 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. I _ <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N pO <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS I r <br /> MUST BE SIGNED AND DATED BY THE OWNER. , o <br /> o 0 w <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN g <br /> NEEDED. W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z <br /> CONDITIONS OF PERMIT: .0 �. <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT O <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. V 3' <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY �9 <br /> PERMITTED. W <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> 6. m c° M <br /> W ori Da0 � <br /> na m n * m <br /> a O <br /> 7. N y N N 0 3 <br /> Z C N p O O <br /> O m <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my <br /> € <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of iu C : C <br /> all information contained in this application(including any accompanying schedule)and 1 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 /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this Information 1 am G) <br /> : m : 0 : <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other ` '^ <br /> o : n <br /> authorized person to ccess to thea escr' d remises at any reasonable time for the purpose of inspection. <br /> T G <br /> D ; <br /> SIGN HERE <br /> ( na re of ner or ui ing contractor) (date) J� [ o I <br /> ZONING ADMINISTRATOR ^' <br /> o �69 fA fA EA�+N <br /> O N N W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED Q O N O 0 N ti O <br /> THIS PERMIT SHALL EXPI E ONE YEAR FR M DAT OF ISSUANCE� <br /> r a-4; -fv m2?Y4Ils 1t y'Oil' Ari S1 kdi o �F-a4� (� <br />