Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator T 0 0 <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER �IS� TELEPHONE <br /> MAILINGADDRESSsgq? '51"a4e & /�7 7 '&46ttr <br /> PROPERTYADDRESS 5agr7 5—� led '7_ A �GI/LI m <br /> LEGAL DESCRIPTION(see tax receipt) I <br /> DWELLING/BUILDING ❑ GARAGEIACCESSORY STRUCTURE ❑ ADDITION ❑ fn Q <br /> TYPE OF PERMIT(S): g <br /> FII L INGIGRADING ❑ CAMPING UNIT [-] SU11ON ❑l� r1 <br /> STRUCTURE/ADDITIONUSE: (�5/����e�W� /D /VELE o <br /> (HomelC in; Commercial BusIrI Bedroom; Deck; etc.) m <br /> m <br /> BUILDING CONTRACTOR: <br /> - T 3 <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN fl'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. I� <br /> DIRECTIONS FOR PLOT PLAN DRAWING' (AERIAL OR TOP VIEW) O � <br /> T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. () m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> m z <br /> NORTH(NI. ro V <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGIS)TO ALL LOT LINES,(B)BUILDINGS)TO re 0 1 a3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF �'" 51 <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 1 0 <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. .` F Q <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I o <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. �oa o <br /> C` o <br /> NOTE: NGISTRUGTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN <br /> NEEDED. <br /> NEEDED. R <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 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. r <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 /> 6. C)K pima LWcp req u, reauq-ft <br /> A m O r D O D O on <br /> 6. � T.3 gym " ='FD-- on <br /> ZI <br /> T. <br /> D <br /> ,lam . m <br /> declare that this application (including any accompanying schedule) has been examined by me and to the best of my to w O <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of "' C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize /(y�NJ $ i m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is. w f O <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 <br /> providing In this appliegtion. I agree t county officials charged with administering county ordinances or other — <br /> authorized perso t ecce to e a ova d cribed premises at any reasonable time for the purpose of inspection. <br /> SIGN HERE <br /> (si �}{ in//9��c t1r�acTtor) (date) <br /> ZONING ADMINISTRATOR \ 0 1 rf <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />