Laserfiche WebLink
u, <br /> Burnett _-nty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> o <br /> �' <br /> OWNER TELEPHON 6 ,p2 � o <br /> m <br /> O <br /> HOME ADDRESS <br /> CD <br /> EMERGENCY/FIRE NUMBER 6 ROAD NAME Viese (� <br /> /�,� �J <br /> LEGAL DESCRIPTION (see tax receipt) V, �. �G, rQ —Sg— J C <br /> tai <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ rn 0 <br /> TYPE OF PERMIT(S): a <br /> FILLING/GRADING ❑^^CAMPING UNIT ❑ \S/UBDIVI I?N ❑ <br /> STRUCTURE/ADDITION USE: �)�� * m <br /> I X 14 0 G <br /> /� (Home/Cabin; Comeircial Business; Bedroom; Deck; etc.) m <br /> BUILDING CONTRACTOR:/-�/30,5ec,mLs \ a 14 Lenlir <br /> Q <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR .n <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p = W <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 ii <br /> n o Z <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 c <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> P <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. r o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO O <br /> BUILDINGS,ROADS,LAKE,LOT LINES. <br /> S. 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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. v <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN q <br /> NEEDED. C> <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 I W <br /> ISSUANCE. () <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. YIJ <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 /> S ISO �w`e %le0,4.4-&.e $�Fydr �e /h a+ ti� */OL rG�e p 1./ �_ d a m <br /> 6. o m c W, W 3 <br /> Z <br /> N O O O <br /> — aE m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G)' c <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a IF <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize mCD m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m O <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 ap ication. I agree to permit county officials charged with administering county ordinances or other TN . <br /> authorized person ave access to the above descrilled premises at any reasonable time for the purpose of inspection. T <br /> CD : <br /> / m : <br /> SIGN HERE <br /> b 4 : <br /> (s na u e owner o it ng contractor) atell <br /> ZONING ADMINISTRATOR464 W 40 44 <br /> N NV, NN VIN <br /> U V, O Vn M O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 o o 00 0 0 0 0 <br /> 00 0 00 <br />