Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - 0 <br /> o <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> ; O <br /> a <br /> OWNER ( n <br /> h +- pVl,��0. �C� TELEPHONE 6O� o O� <br /> HOME ADDRESS E 141 3 b j„L S /} DD W 53 / /� e <br /> EMERGENCY/FIRE NUMBER ROAD NAME C i}JZSoN �D/FrJ <br /> LEGAL DESCRIPTION(see tax receipt) SCG DZ$ _41/2--04-740co <br /> a <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> a <br /> N <br /> SANITARY PRIVY FILLING/GRADING// CAMPING UNIT SUBDIVISION 0 <br /> CD <br /> STRUCTURE/ADDITION USE: <br /> Cab; p0 <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) 3 <br /> (D <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR r 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o. <br /> ,n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n W -1) ;a2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m C? <br /> NORTH(N). y o <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 LAKE, Z <br /> STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS, ROADS, LAKE, LOT LINES. I J <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 i 0. <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> oc,v, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q <br /> ISSUED. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o �J <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. r7ET <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALO3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPPERMITTED. I4. NO STRUCTURES, INCLUDiF(G RETAININGWALLS,ETC'-AiLOWED WITHIHE O V <br /> PONDS, RIVE"CESS SPECIFICALLY PER TIED. �y, <br /> 5. <br /> dd f m <br /> 6. <br /> Cl M a O f0 <br /> MECO N Z : y �, <br /> 7. - --- 0 /y V TY o <br /> I declare that this application (including any accompanying schedule) has been examined by me a�d to the best of my (j� p <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of h c Er — <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize <br /> CD m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- 0 <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 m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to hqve access to the above described premises at any reasonable time for the purpose of inspection. CD <br /> T <br /> m <br /> SIGN HERE e <br /> (signa r bf own or <br /> ui I onVactor) (date) <br /> ZONING ADMINISTRATOR G v+ <br /> fn fn fn to to to <br /> N <br /> (A0Cn V t N 0O N0 <br /> N O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 <br /> 0000Oo <br />