Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v G) Z <br /> APPLICATION FOR LAND USE PERMITS03. <br /> _ r <br /> c <br /> OWNER fDa,,j 4_ C� L_0CA rLt44a-- TELEPHONE 0 <br /> v / L� ) <br /> MAILINGADDRESS g9 �pir'r {- L-k `gc(' ^' I—Y 4YICiE��1 Syg31 <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) If iow_q.-7 R4rwG 12 6C L G v V I O+ a o <br /> ff''XXII m 4 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORYR�TURE IN ADDITION ❑ Cn o `' <br /> TYPE OF PERMIT(S): C <br /> Cr <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: tlilg \7 OUt mal G� o <br /> (Home/Cabin; Commercial Busi4e�ss; Bedroom; Deck; etc.) <br /> 1 � <br /> BUILDING CONTRACTOR: _ <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/2X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T 3 <br /> o (D J <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p a <br /> T <br /> T Z / <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <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 Od 0 <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. 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. Cjq <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. (il N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS v' 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. a <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN n o �} <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z Q> <br /> CONDITIONS OF PERMIT: <br /> W ) <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 U' <br /> 5 SETBACK AREA. This structure to be used as private residential <br /> garage/storage only. Not to be used for human M m h r n 0 D o v <br /> N C m W 0 M d F m <br /> s. habitation. 0 3 a ; ; a p <br /> p W C y N O �+ <br /> 7. <br /> P m m <br /> I declare that this application (including ally dbbVlllpolly1111) acneuulei IIdb ween ezammeu oy me ano to me nest of my 1D <br /> J rr <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of v C <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is. Cn : O <br /> G): <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relyin on this infor � o 0 <br /> o <br /> providing in this application. I agree to permit county officials charged with adm!n i s r `D <br /> authorized person to have access to the above described premises at any reasonab h e i ID [ <br /> T 6 : <br /> SIGN HERE 7—�Z—0 S' CD a ' <br /> ,(� i Fn a <br /> (sign ture of owner or building contractor) JUL 1 (7' W: : 0 <br /> ZONING ADMINISTRATOR VI(Yl f7bo6 {1 i <br /> BURvO N C��J�J N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING O N O M N N O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE F I UANCE <br /> RfM;+ -4- le 'fe�mal�led 4D Ve k�,ncy <br />