Laserfiche WebLink
Barnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator ' o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 �n <br /> F o <br /> t a SU <br /> OWNER vsii//5 � TELEPHONE '3,p 0 <br /> HOME ADDRESS fit) 6'a 3 if G /p 74" ,F7 4�"VeA)c ,*7 OA/ r C fV f , <br /> EMERGENCY/FIRE NUMBER ROAD NAME C„ 7,?C.d <br /> LEGAL DESCRIPTION (see tax receipt) � <br /> DWELLING/BUILDING ® GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY <br /> TYPE OF PERMIT(S): a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ S ]VISION 1:15. \ <br /> STRUCTURE/ADDITION USE: '4 UB A/ r-'ilo <br /> (Home/Cabin; Com ercial Business; Bedroo ; Deck;etc.) C <br /> BUILDING CONTRACTOR: D W Al P V S Er ” 1 <br /> N � <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR "n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) c <br /> In <br /> In <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. U <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDIdATE m m n <br /> 111. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 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. ° <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 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT VC <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I <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 (y <br /> �SETBACK AREA. /� <br /> c4bi ) `� h� r�is,�C C' � ssu� syS ems-► z -0 0o O <br /> 7 jai m <br /> 6. .5 N C I r 0 7 F. <br /> 7. C �N � =j <br /> n A <br /> C <br /> A <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my Z3 2 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 I recognize !" m <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 m E <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to a above described prergises at any reasonable time for the purpose of inspection. -n <br /> N <br /> N <br /> 59 <br /> SIGN HERE <br /> (signature o er Ildi (date) ; <br /> ZONING ADMINISTRATOR 6 oZ02— <br /> hH,nwwuN <br /> N N N N P 9 <br /> ut NP <br /> O P !11 O O <br /> T WNSHIP PERMITS MAY BE REQUIRED 0 0000000 <br /> 00 0 0 0 0 <br /> & <br />