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 3. <br /> - r <br /> m o <br /> N <br /> C <br /> N <br /> OWNER TELEPHONE o <br /> m <br /> HOME ADDRESS IISLI * ���f 5� 3 o CD <br /> EMERGENCY/FIRE NUMBER Z I ROAD NAME <br /> oC) <br /> LEGAL DESCRIPTION (see tax receipt) m <br /> DWELLING/BUILDING ElGARAGE/ACCESSORY STRUCTURE ❑ ADDITION El PRIVY v1- o PRIVY � <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) m <br /> .111.1&4W46 CONTRACTOR:�C Wly�7 fir <br /> v <br /> 1 <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR � 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> /n N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) OT o <br /> ,n o z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m v <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C n <br /> NORTH(N). y o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> a <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. P <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. <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. �'c�j0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN 0 <br /> NEEDED. ) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c <br /> CONDITIONS OF PERMIT: Id k—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. <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 ( nabn�eSsO��l//j����emr�• h�uh hS �c L,a¢,cle o�S%�SeeGf Qce`tGo�r/yru�lc�l� QS CD <br /> MCLW� ; d o <br /> R om 9 3 <br /> zE m 79 -f <br /> 7 <br /> speJl� (iS cn : m <br /> I declare that this application (including any accompAnying schedule) has been examined by me and to the best of my 6' C <br /> C <br /> and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of ' a B ; <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m : m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am <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 the above described premises at any reasonable time for the purpose of inspection. <br /> m <br /> SIGN HERE <br /> ( gnature of ow r build) o (date) <br /> 4117 - <br /> ZONING ADMINISTRATOR _ 00 <br /> vs cn ui f»f»to� <br /> N NfT NN P <br /> (T fI� OCTP <br /> N <br /> TO <br /> 0 <br /> NSHIP PERMITS MAY BE REQUIRED 0000000 0 0 0 <br /> o0 <br />