Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. 4 <br /> r <br /> N 0 <br /> OWNER t}>zR y SC}io 4Fn1 TNA_e � TELEPHONE 1/J1 L13 b>b ,Pa o <br /> HOME ADDRESS Ale. Jj-Il Z tV A-T C xZV.. S3-0 <br /> 44 0 <br /> EMERGENCY/FIRE NUMBER 0 d QaS ROAD NAME S'O-`IG AV-Ci,,) l+xc <br /> LEGAL DESCRIPTION(see tax receipt) asp✓, Aur- -. 4-4r-Tj,N 93 TNsIM/ /�� Np.,efv f <br /> WrS7- <br /> TYPE OF PERMIT(S):DWELLING/BUILDING c <br /> GARAG CCESSORY STRUCTURE ADDITION <br /> rr U\l <br /> n <br /> 5. <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o' <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 1 <br /> V c <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR 3 .- <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> DIRECTIONS FQR PLOT PLAN DRAWING. (AERIAL OR TOP VIEW) O <br /> nr <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m Ir <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m a <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, <br /> STREAM OR RIVER. Z <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. Q� <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N (ly <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 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE <br /> ISSUED. 3 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z o (' <br /> CONDITIONS OF PERMIT: M <br /> I � <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 <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. <br /> ;o ' n r- <br /> 6.6. ; <br /> c ? CQ 1 <br /> -C6 ;a <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my m <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d r C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize mm ; m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- p <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 Q <br /> authorized person to a access to the phiove described premises at any reasonable time for the purpose of inspection. <br /> -n <br /> m <br /> SIGN HE <br /> (signature owne r building contractor) (date) <br /> ZONING ADMINISTRATOR _ ? i <br /> u w w w w w <br /> N N N N f n f l, <br /> p, NON V7OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />