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 . <br /> 0 <br /> m � <br /> N <br /> c <br /> OWNERGTELEPHONE 105 gga-/-7s3 vm <br /> "j <br /> Im <br /> MAILINGADDRESS A- At 0 <br /> 155/a 41 � <br /> � 0 <br /> n 0 <br /> PROPERTY ADDRESS a 9 316 NY4 wry le 15 b V r0b 4 t t� W 2 d`cld 3 0 <br /> /Fj C) I <br /> LEGAL DESCRIPTION(see tax receipt) PIQ,+ of- At ersi(4c {¢omn& tyf- 7 <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE 1:1ADDITION O c <br /> TYPE OF PERMIT(S): Q <br /> FILLING/G8RADING 1:1 CAMPING UNIT ❑ SUBDIVISION ❑ m <br /> �7 <br /> ) <br /> STRUCTURE/ADDITIONUSE: Act ttfilow tNk !a'x <br /> (Home/Cabin, Commercial Business;Bedroom:Deck;e (ntc.) n <br /> BUILDING CONTRACTOR: aU_r c� tS IiONs� [x��tO�v 933/ Alr -r11 /l CIRS d <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN BY.X 11 SHEET OF PAPER. ANY INCOMPLETE OR In 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. �� Q�'+/ N <br /> 'Iv O w <br /> c <. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) SyL� O <br /> T n <br /> J lr. Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> v <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. 0 <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO ) d, <br /> BUILDINGS, ROADS,LAKE, LOT LINES. Li su <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N G <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 /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o �J O <br /> CONDITIONS OF PERMIT: <br /> 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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 /> SETBACK AREA. <br /> 5. <br /> m Wr- cDi ODa0 -0 <br /> WCD, <br /> Ox LL <br /> rn <br /> 6. ��-°' 0 C: <br /> ZN '. O <br /> 7. o ' '' i i i m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m 0 : <» <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m O mo <br /> that this information 1 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 J d <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 reason ec'on. ID o <br /> CD n m : <br /> SIGN HERE 6e <br /> isiure of own building c ntractor) hi date) <br /> SEP 1 5 2004 ,n <br /> ZONING ADMINISTRATOR � V I <br /> pq(0!S-CJ6(n E IPURNETT COUNTY <br /> /W-I�_ 5he� TOVI(NSHIP PERMITS MAY BE REQUIRE ZONING <br />