Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o 0 <br /> APPLICATION FOR LAND USE PERMITS . 4 <br /> OWNER�,/�/' �g,L �(G� / Hc< TELEPHONE 8'&(, <br /> HOME ADDRESS a�6.Z_� � � �` —�- � I/V��✓ST� ( -'7 <br /> (� 0 <br /> vY <br /> EMERGENCY/FIRE NUMBER 5444 t'✓ ROAD NAME SA-A4 C, <br /> LEGAL DESCRIPTION(see tax receipt) y ` <br /> � a <br /> TYPE OF PERMIT(S):DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION `v <br /> a <br /> H. I <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION (I <br /> J�J <br /> 1 <br /> STRUCTURE/ADDITION USE: f�t�� !�� o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR m <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 70 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m ® I <br /> n n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m jp <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE c <br /> NORTH(N). <br /> cc 0 <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, <br /> STREAM OR RIVER. o <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. <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 kj <br /> MUST BE SIGNED AND DATED BY THE OWNER. m o <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 41 <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: c <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT V <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 1 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. /-ee-l-"0 ;a -00r GC11�. m m <br /> 3 u �I ;M06. a 'aCwwos3 <br /> Sit 0,7. p ; F MQ i ,mo i <br /> N 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 c <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a <br /> all information contained in this application(including any accompanying schedule)and I further declare that Irecognize pp ,I (s m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Is- ; m E O <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information 1 am m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. T <br /> SIGN HERE - �// !�[ �✓{s�� (�' l��/ H <br /> (signature ofe r building contrac r (date) Q <br /> ZONING ADMINISTRATOR <br /> HNN(�NNlA� <br /> o'\ tN7� fNJ�O,tNJ�N 0 0 <br /> �(oW 0000000 <br /> TO SHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 <br />