Laserfiche WebLink
But-nott County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator - o ' Z 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> C <br /> OWNER r S TELEPHON 7'� � � /3 n <br /> o �A;�J <br /> HOME ADDRESCD <br /> S W SZ/930 <br /> 1 <br /> CD <br /> CD <br /> EMERGENCY/FIRE NUMBER (�3 39 ROAD NAME r^ C <br /> 1 <br /> LEGAL DESCRIPTION (see tax receipt) C h Gov <br /> CD <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE �I ADDITION ❑ PRIVY ❑ CO 0 <br /> TYPE OF PERMIT(S): Q c <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> a <br /> STRUCTURE/ADDITION USE: OLk I C'E f o_ <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) Cl) <br /> BUILDING CONTRACTOR: S91DZ. A S <br /> iu <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> �I N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p m <br /> n <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n o A O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m AS <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m B <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. o <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 /> 0 O ly <br /> O � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN o <br /> NEEDED. <br /> \. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60/ SOF PS IT P <br /> ISSUANCE. J2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALO�jj��HORELINE.6 1 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNPERLESS SPE>rIF1Ili1 <br /> 4. NO STI STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE ��cc 9Q&M _ }d <br /> SETBACK AREA. Y U <br /> 5. <br /> 6. ID COD -a 20 <br /> v � IDCymO7. _ �' 3 <br /> o : -n � m <br /> — ' A <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 0E c <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize <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 <br /> providing in this applicatio I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to h*e ccessAp the above clescribopproises at any reasonable time for the purpose of inspection. m <br /> -n <br /> �^ <br /> CD <br /> CD <br /> SIGN HERE <br /> ignat a of owner building ontractor) (date) <br /> ZONING ADMINISTRATOR JI �f O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />