Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator V 0 o <br /> 3 <br /> APPLICATION FOR LAND USE PERMITS 4 <br /> PW <br /> r <br /> U) <br /> c <br /> OWNER TELEPHONE <br /> m v.' <br /> i9 O <br /> HOME ADDRESS i(AIAIV \ I <br /> ` t' r <br /> v- <br /> EMERGENCY/FIRE NUMBEROAD NAME t!►1 <br /> LEGAL DESCRIPTION(see tax receipt) (4 I'A _ 10300 0 <br /> { 1 0 <br /> e7 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION a <br /> 5. <br /> m <br /> SANITARY PRIVY FIL ING/GRADING CAMPING UNIT SUBDIVISION <br /> N <br /> m <br /> x <br /> 7 <br /> STRUCTURE/ADDITION <br /> (Home/Cabin;Commercial Business; B om; Deck;etc.) <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. gg <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 n <br /> T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. �A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m n <br /> NORTH(N). 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, O Z <br /> STREAM OR RIVER. ° <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. <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q ° <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <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 <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. ✓1 -/ Il <br /> 5. ONe tlm,P- u�w/ c��p / /�y�Q�� uS�r/ Ivy l h IY�s /me e;a - mor, 0 o v <br /> 6. �l tJ fa�G[r�Iu .( f 1LCGu hJti �(J 5-t de PG� tb .1 3 n��-a-._ � <br /> 9 m N <br /> : �Q <br /> O ' <br /> 7. —y '• m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my ': Gf E E C) <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of p: a <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- <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 lti 03 E E <br /> providing in this application. I ag a to county officials charged with administering county ordinances or other k) 0 E <br /> authorized person to have access,to he ab ve escri ed premi s at any reasonable time for the purpose of inspection. T <br /> m : <br /> (5 : <br /> _aa <br /> SIGN HE C?J <br /> sl o w er or bui tractor) (date) <br /> ZONING ADMINISTRATOR 3 h««fn w h <br /> NNNfI, <br /> TOWNSHIP PERMITS MAY BE REQUIRED 1 1L 0o oo mo co 0 c oo <br />