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 /> o <br /> OWNER lir h< Q�I // TELEPHONE I,��Cc 75��`YyS (Q <br /> MAILING ADDRESS I / m/✓1 vt O� Com,,kt. � lbw u/-�-� S^`-' <br /> M <br /> 0 fes. <br /> q o V ' <br /> PROPERTY ADDRESS <br /> /nYl�w <br /> LEGAL DESCRIPTION(see tax receipt) Luf Jn v t !7Q J f — I J 1 C <br /> TYPE OF PERMIT(S): <br /> DWELLINGIBUILDING ❑ GARAGEIACCESSORY STRUCTURE ❑ ADDITION - S UJ (� <br /> ii <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ ❑ <br /> SUBDIVISION �/ n <br /> STRUCTURE/ADDITION USE: Adyd1 e)'j Z/Vt'!S ►"C�I"'� a U /t y 0 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) rn <br /> 7 <br /> / l m <br /> BUILDING CONTRACTOR: 1A/a-V rLP- MCI TT �U i7 4VI4 Gf 16 <br /> jl! <br /> T� <br /> vo <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n <br /> 3. <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> M w <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m <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 d <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. <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 ?, o <br /> U)I <br /> MUST BE SIGNED AND DATED BY THE OWNER. % o ? <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VE = 0M. 9j <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Oct 1 0 � <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Cac, v 1 <br /> ISSUANCE. Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE "V IG <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY d <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> `�=, m mdrDi � a0m <br /> 6. 3 nm xn ;a <br /> O ry C N N O = 3 <br /> 7. Z N N O O 10 <br /> O -n� ZI <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m 0 v+ <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o : mt7 <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. I further accept all liability which may be a result of the County of Burnett relying on this information 1 am _ d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other v, <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. o : <br /> J � M <br /> 7 m : <br /> SIGN HERE W o�✓�'� ® � ' <br /> 9 a : <br /> (affgnature of owner or building contractor) (date) t, <br /> ZONING ADMINISTRATOR <br /> �1 iii F70n i <br />