Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator v G) Z <br /> APPLICATION FOR LAND USE PERMITS 3< ° <br /> otnrt R �RRRy D-eb Ut, TELEPHONE p�s-`(1` 3 69- 746 F a ob <br /> MAILINGADDRESS ;,gz 4.2• FtZ&-NL + RoPrD / DA-abtity k)lsc stqr.3p o <br /> PROPERTY ADDRESS .�eL tri <br /> LEGAL DESCRIPTION(see tax receipt) , o13 . Xo_4,p . j` Cs,*1 Mk 16 �,tytf 2SS v C/ <br /> TYPE OF PERMIT(S): DWELLING/BUILDING ElGARAGE/ACCESSORY STRUCTURE 54 ADDITION ❑ Zs` 1 <br /> FILLING/GRADING CAnaPINOUNIT ❑ SUBDIVISION ❑ <br /> a <br /> STRUCTURE/ADDITIONUSE: GHRrile, C? /X 3to ^ _ <br /> o' <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) rn ' p <br /> BUILDING CONTRACTOR: SP-1p <br /> m <br /> � � 1 <br /> m <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. O N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T Z <br /> n � � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO CO) 3 <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. N o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO -IO <br /> BUILDINGS,ROADS, LAKE,LOT LINES. v <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED-Q8 FILLED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONT fit, TC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. J �/ o <br /> U 'o <br /> g <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICN MAYo W <br /> NEEDED. V � � <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW- 8 p 70 <br /> CONDITIONS OF PERMIT: e ` A O <br /> UR <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PER <br /> ISSUANCE. IO�COU �I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. NO • 7 d <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 6. This structure to be used as private residential )� <br /> �� m ddo 0'avm <br /> s. garage/storage only. Not to be used for human �. � a m x a � � <br /> habitation. m c7. y ^ o 3 <br /> P -n� : >a <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best my — A <br /> of <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o�`o to C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- im <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. <br /> mo : <br /> m .3 <br /> SIGN HERE dAAAj <br /> (signature of own r ilding contracto `n (y� (date) <br /> ZONING ADMINISTRATOR <br /> n <br /> lt�t <br /> /v <br /> OO <br /> NN <br /> TOWNSHIP PERMITS MAY BE REQUIRED / � Nle , O <br /> V <br /> ' GUu K�t/ 16-lo-63 <br />