Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Adrninistr�&r� bt <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> OWNERiJ f UIt / \ . NC:� �y <br /> TELEPHONE ..' <br /> HOME ADDRESS J �I ►t L ��N�L_ �D UU �-Cl5 w•L J ' 0 <br /> (P <br /> CD <br /> ° <br /> EMERGENCY/FIRE NUMBER ROAD NAME �e„ Arlo'/L IIIIf p <br /> (�D <br /> " LEGAL DESCRIPTION(see tax receipt) -3� ,// w <br /> I� (o m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ , Cn o <br /> TYPE OF PERMIT(S): a <br /> FILLING/ RADINS. <br /> -}G�❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: L' l K"(�I�1� W af-4 i 1 I f-ts TL rV <br /> (H a/Cabin; Co erclal Busi ess; Bedwom; Deck;etc.) Cn <br /> BUILDING CONTRACTOR: ,�iA <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> O — W <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> n <br /> in 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m o <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. <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o ` <br /> o � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHENq 0 CAI <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. a <br /> CONDITIONS OF PERMIT: I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. I <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 /> MOM <br /> M <br /> 6. ml 3 va <br /> cD L1 <br /> Cwrn & <br /> m in , � <br /> 7. Z m ID A <br /> o <br /> I declare that this application (including any accompanying sch has been examined by me and to the best of my �j p <br /> knowledge and belief it is true, correct and complete. I ackno am responsible for the detail and accuracy of e <br /> all information contained in this application(including any a I gftatqt"county <br /> I further declare that I recognize m 'm m <br /> that this information I am providing will be relied upon by ounsin in determining whether to is- p <br /> sue a permit. I further accept all liability which may be a r� It of the Coging on this information I am m <br /> providing in this application. I agree to permit county offi Is ch d ordinances or other m <br /> authorized person to have access to the above described p miser rpasonable t he purpose of inspection. m <br /> cn <br /> UCD <br /> SIGN HERE � <br /> (slgnatur of Vr or building ntr for O / o'o (date) <br /> ZONING ADMINISTRATOR v <br /> w w w w to to <br /> N N N N N N En <br /> �-y Ut Ut O N pl O O <br /> TO NSHIP PERMITS MAY BE REQUIRED XJ <br /> 0000000 <br />