Laserfiche WebLink
T <br /> BuFnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> N 0 <br /> N <br /> OWNER John M. Wardell TELEPHONE 715-349-2635 <br /> m <br /> HOMEADDRESS 4848 Bertram Road, Webster, WI 54893 v ° <br /> EMERGENCY/FIRE NUMBER 4848 ROAD NAME Bertram <br /> LEGAL DESCRIPTION(see tax receipt) SW 1 /4, SE 1 /4, Sec. 4, T 38 N-R 15W LaFol let e <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ® ADDITION ❑ PRIVY ❑ y <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ 5 <br /> N <br /> STRUCTURE/ADDITION USE: f?xbsa Garage 4 X C <br /> (Home/Cabin; Commereial Business; Bedroom;Deck; etc.) v) <br /> d <br /> BUILDING CONTRACTOR: lir <br /> v <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. m <br /> M N \ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m � 'o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m n <br /> NORTH(N). N O <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> M <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. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO � Q <br /> BUILDINGS,ROADS,LAKE, LOT LINES. I - <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 41- <br /> ^ ) <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. m o <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN a <br /> NEEDED. 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c <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, <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY -7•j <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER 00 <br /> SETBACK AREA. / 1 <br /> i cc1(ura uS� 9 a1 oh��/ A 4-/70 � q Tal-kts e�/,, X 'a ° r ° ° m <br /> 6. $ � � ayo • 3 <br /> Z " m o ` 7,p q <br /> 7. <br /> =y m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my \ i S C C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of '• m ': E <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- Io <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' <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. m <br /> CD <br /> m <br /> SIGN HER = .77 <br /> �` <br /> (sign tur of ow r b Id acto f q (date)O' n i <br /> ZONING ADMI IS TOR "- fO� 98 <br /> ��A40 4� <br /> N N M N(T <br /> !T (rO OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED 000 oa <br />