Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r_ <br /> C <br /> t� l _ <br /> a <br /> OWNER 1 TELEPHONE '� S ' <br /> d <br /> MAILING ADDRESS //V l.ii ,� <br /> 0 <br /> PROPERTY ADDRESS <br /> ( P) <br /> LEGAL DESCRIPTION see tax receipt) m � <br /> m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESS RY STRUCTURE ❑ ADDITION ❑ U <br /> TYPE OF PERMIT(S): D 1 Q <br /> FILLINGIGRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ �Q <br /> STRUCTURE/ADDITION USE: C L 'l� / r 1 0 0 C7 <br /> (Home(Cabin; Commercial Business; Bedroom; Deck; c.) U <br /> BUILDING CONTRACTOR: jatQUM <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 " \\\) <br /> y ^ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 (D ' <br /> n <br /> T1 Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C _ o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m 3 <br /> a <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 /> 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 2 <br /> MUST BE SIGNED AND DATED BY THE OWNER. O <br /> Cl <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. oO <br /> CONDITIONS OF PERMIT: 0 <br /> I <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. 7� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY I v C <br /> PERMITTED. `w <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> X co O r D O n 0 -0 <br /> 7W3 <br /> m x. 3 nm � �' � <br /> -o p m C y o �+ <br /> Z C to COD 0 O O <br /> 7. O (D -n <br /> = rn : m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m 0 <br /> PP ( 9 Y ) Y Y G) - : C <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of a <br /> all information contained in this application (including any accompanying schedule)and I further declare that 1 recognize D m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- fD Cn o <br /> sue a permi rther accept all liability which may be suit of the County of Burnett relying on this information I am m O <br /> providin in this pplicati, n. ee to permit ou ials charged with ad i rdinances or other ° m <br /> O d <br /> author' ed perso to ve to the above es i ed emises at any reaso I r r ti m a <br /> m <br /> N Di <br /> CD o <br /> SIGN ER <br /> IS a ure of owne or uIg contractor) I (date) o <br /> JUN 22M <br /> ZONING ADMINISTRATOR <br /> O (T O Ut Ut Ut O <br /> TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY <br /> Q <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANNNNLNG <br />