Laserfiche WebLink
BurnettdeKinty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - 0 o <br /> APPLICATION FOR LAND USE PERMITS 3 �- <br /> r <br /> OWNER (7(Y�IVIIC rn�Ter � "TELEPHONE <br /> R <br /> HOME ADDRESS II2C�S �rM I k R � o <br /> `��u�i ✓`T 7 <br /> (DT� r <br /> EMERGENCY/FIRE NUMBER ('Z�J ROAD NAME0 <br /> e Lk RJ <br /> S 3 5ftrD/Rbi W 5/tir,�s a s 4 1 s 3 s o3 40o Z-3� Cn <br /> LEGAL DESCRIPTION(see tax receipt) S' ' r w � S 3J�17 4W/l05 <br /> s4q CD <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ PRIVY ❑ + a <br /> TYPE OF PERMIT(S): C'c 0 <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ �a <br /> STRUCTURE/ADDITION USE: v�1t7rL S �p 87rViCe. 6 x V6 <br /> 0 <br /> HomerCab' ommerclal Business; Bedroom; Deck;etc.) <br /> Tab de, <br /> BUILDING CONTRACTOR: Q. Qrry� L,� '—� An , <br /> m <br /> 'o <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/�X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n 3. <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) A <br /> O m <br /> 'T o- <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. Tz <br /> 0 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 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. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO 1 P <br /> BUILDINGS, 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 N <br /> 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o 0 <br /> NEEDED. ` <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PE <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHO <br /> INE��� /�� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICl ") <br /> PERMITTED. <br /> &P <br /> F/j/ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE RE UI REDG1ktiYER <br /> TBACKAREA. (— <br /> 5. eUAN " Upj <br /> ll� F <br /> 6. 2TrC ;CD oDoM <br /> 0 . d O F m <br /> (/ m 3 o'a o-m � <br /> 7. CNiNC NTy M y <br /> Z rnm0 = i0 � <br /> o �t m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my r 0 � A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of 0 <br /> all information contained in this application(including any accompanying schedule)and I further declare that ICLrecognize ` 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 I am <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other ° <br /> authorized person to have ess to the above described premises at any reasonable time for the purpose of inspection. <br /> M <br /> m <br /> SIGN HE E <br /> (signature of oOIQ <br /> er or uilding contractor) 1p' (date) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />