Laserfiche WebLink
Bu nett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator T o 0 <br /> APPLICATION FOR LAND USE PERMITS 3: <br /> N <br /> OVNJER Oa 1^ a /,aL/Ann l l r iota a TELEPHONE ?�`-3`(� `l7_ l o <br /> O <br /> MAILINGADDRESS ~ aEtA /� M <br /> r m <br /> o <br /> PROPERTY ADDRESS A).5 ( \1tC7(,j n <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE I� ADDITION ❑ 0 <br /> TYPE OF PERMIT(S): Cr <br /> FILLING/GRADING ❑ CAMPING UNIT 1:1 SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: Pn 1/P l(�U b tl:1 /' S tbra C, P 0 <br /> J (Home/Cabin; mmercial usines ;Bedroom;Deck;etc.) C pV <br /> BUILDING CONTRACTOR: /l V lY1�t n h,t..t.m kbe r /'>00 Wes fier-n <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> Tl i°o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 0 <br /> -n o Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C <br /> NORTH(N). y t 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <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 O <br /> BUILDINGS,ROADS, LAKE, LOT LINES. p <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N �1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONT TO%B,,j�iEIT��C..,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. � ' D o F <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICA ION = °, Jj <br /> NEEDED. `-� RjR <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. PR / o <br /> CONDITIONS OF PERMIT: sUR t^' <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT N N�`,ff 7'y ( W <br /> ISSUANCE. p C� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. r+ /vl, <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 <br /> SETBACK AREA. <br /> 5. Bp(� i This structure to be used as private residential <br /> A nrDODO 'V <br /> garage/storage <br /> 6 onl . Not to be used for human m d g M a m <br /> Y 2 3a2 % <br /> habitation. z y o N 3 <br /> 7. o i� <br /> declare that this application (including any accompanying schedule) has been examined by me and to the best of my 'c c <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m 0 : to: <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize E o M <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CDsue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 1 N <br /> authorized pers n to have access to the above described premises at any reasonable time for the purpose of inspection. -n o <br /> m m <br /> SIGN HERE #htC /c5 © n <br /> (sign a of owner or buil ng cony for) (d e) <br /> ZONING ADMINISTRATOR Ca i v,d, <br /> �r N)fA r)fA 0 N <br /> N <br /> (vy (T N O O <br /> 4O C T N 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />