Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No.102,Siren,WI 54872 Office of Zoning AdministratorGD o <br /> APPLICATION FOR LAND USE PERMITS �. <br /> o <br /> N <br /> C <br /> OWNER CC ei r- ! 2TELEPHONE 1 O _ <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS 2 DQ'"► 'RCLj1 q E�, L-(Y)e- GV"mb6a4-a t vi I I V�) <br /> QJ <br /> LEGAL DESCRIPTION(see tax receipt) 4,/S 1,q 41 F6�5 4)J f m <br /> DWELLING/BUILDING 0 GARAGE/ACCESSORYSTRUCTURE ADDITIONEI c 0 <br /> TYPE OF PERMIT(S): <br /> CL <br /> FILLING/GRADING ❑ CAMPING S. <br /> -�-� UNIIT ❑ SUBDIIVISION ❑ <br /> (-TP <br /> L <br /> STRUCTURE/ADDITIONUSE: <br /> 0 <br /> /� <br /> ��77 -til (Home/Cabin;Commercial Business;Bedrdpm; Deck;etc.) w <br /> BUILDING CONTRACTOR: A-C /fl <br /> , u I dt'(LTJ Mu i ltiil Civ eV d <br /> CD <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> M <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) On <br /> T v z D <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 _ <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m OG P - <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 Q <br /> MUST BE SIGNED AND DATED BY THE OWNER. ° 1 , , <br /> Pd <br /> o W <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERI �Q�� Jt <br /> EN o �. <br /> NEEDED. � 7ai, <br /> jT{{�S PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. ' Ap i o <br /> �INQdIONS OF PERMIT: R 6 A <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OFISSUANCE. / <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORE).101V//V GUN]"/ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY' G <br /> PERMITTED. <br /> 4. NO STRUCTURE§-,-tNGLUPING RETAINING WALLS, ETC.,ALLOWED WITHIN THE .REQUIRED WATER <br /> SETBACK AREA. <br /> 5. -_....... D 0r- D0D0 'a <br /> This structure to be used as private residential 3 a m F a <br /> 6' garage/storage only. Not to be used for human m c y o ; <br /> Z y � o : <br /> 7, habitation. o ;,,< m <br /> _U): rn <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my L7 c C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a N : y <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize �'. m O G <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CD� <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 d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other (o <br /> m : u)i <br /> authorized perso have access to the above described premises at any reasonable time for the purpose of Inspection. : Zr <br /> CD <br /> SIGN HERE �� _y a <br /> (sign of 0w Ver or building contractor) (date) <br /> ZONING ADMINISTRATOR �)O1 <br /> J f fA Cn N3 fA 0 N <br /> I_IJ�, N(Ji N N O O <br /> -r✓nom TOWNSHIP PERMITS MAY BE REQUIRED (T O(T U1 O O <br /> eSW T1�PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE —�� <br />