Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v 0 Z <br /> APPLICATION FOR LAND USE PERMITS _ 0UT - <br /> r <br /> c o <br /> OWNER L -kA 7-N /1'1'ANA./ TELEPHONE (1(Z-- <br /> '1 X18 � I I Farm � ��y, <br /> HOME ADDRESS (� e ) S D O�`v <br /> EMERGENCY/FIRE NUMBER �363QADNAME C�m� <br /> 7! - \ <br /> LEGAL DESCRIPTION (see tax receipt) I I �— , 17 <br /> wv T m <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE I ADDITION ❑ PRIVY ❑ W o <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING CAMPING UNIT El SUBDIVISION ❑ G a <br /> l N <br /> STRUCTURE/ADDITION USE: A�ACiE ayxa� /, , <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) U) <br /> BUILDING CONTRACTOR: S'A TN Z�7lL CO Aj SU 4LVF2� ! � m2' <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/z X 11 SHEET OF PAPER. ANY INCOMPLETE OR CD3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 'n r. <br /> O <br /> ;l N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p m <br /> T a <br /> -n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. � <br /> (� 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 /> CD <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO <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. Zo <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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> F <br /> o � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: ° <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT OC' <br /> ISSUANCE. <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 /> SETBAC AREA. '7 CD <br /> Pr_ -5. : c: y . 0 <br /> 7. o : 0 CD O . _ -1 <br /> - (n : A <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 0 c C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o <br /> all information contained in this application(including any accompanying schedule)and I further declare that IErecognize m <br /> CD <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin D <br /> sconsin in determining whether to is- ' <br /> sue a permit. I further accept all liability which may be a result of the Coun I i n I am <br /> providing in this application. I agree to permit county officials charged witft g�_+ ,I t nn u i other <br /> authorized person to have access to the above described premises at any re4j 'p tion. D <br /> m <br /> ID <br /> SIGN HERE J © <br /> (signature of r or b di r ctor) a <br /> ZONING ADMINISTRATOR I 9T <br /> ZONING <br /> TOW SHIP PERMITS MAY BE REQUIRED <br />