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 /> N J <br /> N <br /> C <br /> p d <br /> ONMER �,� / J`�� I,. �� TELEPHONE �f 3 - �� g- 2! <br /> J f/ ���/ 7— �� �c� /I �° 1 l-. L� �j/ 'E � f�0 4� r5 /��N .f.S39 r O <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS j G(1� l Q it- Ala d'e r /(�d I <br /> Com/ , ) / / <br /> LEGAL DESCRIPTION(see tax receipt) O �?� s M ,3 7 L I <br /> CD <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ rn <br /> TYPE OF PERMIT(S): v ' <br /> FILLING/GRADING ❑ CAMPING UNIT SUBDIVISI N ❑ a <br /> 06, <br /> STRUCTURE/ADDITION USE: <br /> Home/ in; Commercial Business;Bedroom; Deck;etc.) rn <br /> d <br /> BUILDING CONTRACTOR: <br /> M <br /> M <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR Om 3 � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> XI m 1J� M <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a W <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m �° ( • <br /> NORTH(N). C W <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF C>tJZ <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 9 <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, CONTROR, ETC., THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. CC o ) <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICA ON A a o <br /> NEEDED. n <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. A4y/ r o O I I <br /> CONDITIONS OF PERMIT: 7� 3 O <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMITRNE I , L'Q 7-�� <br /> ISSUANCE. zpNINGi UNr <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 <br /> SETBACK AREA. <br /> m m ori > O a O <br /> 6. / / , 3 'nm 10 F ° m <br /> S CN o 3 <br /> 7. Z p, mo <br /> o -n`< : M <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o, 0 <n C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o v <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. I further accept all liability which may be a result of the County of Burnett relying on this information I am oOi <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> 6 m : <br /> SIGN HEREt)te'� ;r- � <br /> a : <br /> (signature of r or building co a tor) (date) � <br /> ZONING ADMINISTRATOR <br /> O <br /> N) 0V/N ON <br /> N N N O O <br /> NO (T (TOO <br /> TOWN HIP PERMITS MAY BE REQUIRED <br />