Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v ci z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> - r <br /> N .°s <br /> N <br /> C <br /> CD <br /> OWNER / /� �" p / CL <br /> LQiNAit ( irJr OL2�o,v/- ' �A{i �p� 6 TE <br /> EPHONE 71 -yoorP-Z�z� O <br /> m <br /> HOME ADDRESS <br /> EMERGENCY/FIRE NUMBER �� SePlj ROAD NAME Poi f G~ <br /> l <br /> LEGAL DESCRIPTION(see tax receipt) <br /> L L �( �/G� {,, <br /> O �Q011 N <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION `C <br /> CrCL <br /> N � a <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION � <br /> y <br /> STRUCTURE/ADDITION USE: 012�.�d G� /�>< Gars L d e G k I? Azesg Iv <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.)��c tl4.c /Do�Nf RN+nir 'I <br /> v In <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR T 3 V <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> �l N <br /> DIRECTIONS FOR PLOT PLAN DRAWING (AERIAL OR TOP VIEW) 0 <br /> z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m ! ;b2 .SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C O <br /> NORTH(N). y ° <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m o <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, z <br /> STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 9 <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- t <br /> INGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N _(z <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. o <br /> o N <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE <br /> ISSUED. � ° <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z <br /> CONDITIONS OF PERMIT: P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. V <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 75 F HE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. C q Jhl jl f' CL fi� j04 4vf �& ) <br /> r, M M a M <br /> 6. <br /> z : COO '0 <br /> z <br /> _ rn : m <br /> I declare that this application (including any accompanying schedule) has been exa a an a be of my �j p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsib r h tail and ac r cy of m C <br /> all information contained in this application(including any accompanying schedule)and at I ecognize °O m m M <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in miniOhether to is- (I`l y 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 application. I agree to permit county officials charged with administering county ordinances or other "o' m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. -n <br /> p <br /> SIGN HERE <br /> (s' nat a of owne r Iding contractor) (date) ft <br /> ZONING ADMINISTRATOR �l • 3 40 <br /> to to w v+v+v+ <br /> N N °1 N N°t (n <br /> (T V7O Vh NOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />