Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS s . <br /> OWNER LEPHONE�IcltAcha'T a �' � wy-w <br /> I V l m <br /> MAILING ADDRESS Rf <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION tj o <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTUREX ADDITION ❑ STAIRS ❑ o <br /> TYPE OF PERMIT(S): b <br /> FILLING/GRADING <br /> -I❑ CAMPING UNIT ❑ BUNKHOUSE ❑ 59.6992(1V)GAZEBO ❑ DECK El ,h <br /> STRUCTURE/ADDITION USE: Iq/` �f� HrSP J —S AR -kr )b I 1.141h ) o <br /> (Home/Cabin; Commercial Business; Bed -- S <br /> BUILDING CONTRACTOR: 0f �4701'CA_ <br /> A PLOT PLAN MUST BE PROVIDED ON AN 81h X11 SHEET OF PAPER. ANY IP ' <br /> n ?U <br /> i _' <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DW " M d ' <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STR L I <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S) TO ALL LOT LINES, (B) BUILDING(S) c <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK .o <br /> (OHWM) OF 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 <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. v°o ?' <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. G o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE 5. <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> ll ; <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ' <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n z `C <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> n 'X79 > O ^0 <br /> 7. xA 02.5 din cn, <br /> ` - °o w <br /> I declare that this application (Including any accompanying schedule)has been examined by me and to the best of my knowledge ,z'a'5- <br /> fl5� <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information E p '� <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Information I w g <br /> am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accept all <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree to n <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- o a n <br /> described premises at any reasonable time for thepurpos f Inspection. ro <br /> , rt m�y' y rc <br /> �> <br /> SIGN HERE is -. X . L <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR ^ ,'wo` $ ts�9 <br /> TOWNSHIP PERMITS MAY BE REQUIRED i <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE w w <br /> U o � � o <br />