Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator m o° o <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> C W <br /> ��yq�\ \ — L Z�J f1� <br /> OWNER J\O t�14'\' \ OW"U Com. \� �/� TELEPHONE�s —�J �'��/ O / O �! <br /> O <br /> MAILING ADDRESS O© (=>O.,�. <br /> o <br /> PROPERTYADDRESS a I9b S I l enh-g- 9s)e ebsktT' c) <br /> LEGAL DESCRIPTION(see tax receipt) w M <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ 3 <br /> TYPE OF PERMIT(S): c <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ �, o ' <br /> STRUCTUREIADDITION USE: <br /> " N <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Cl) (� <br /> G <br /> BUILDING CONTRACTOR: p1 3 <br /> 12 J � <br /> m � <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 33 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. C7 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) OT <br /> T O V7 Z <br /> t. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE, m LZ X <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE M M o <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 3 <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. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS, ROADS,LAKE, LOT LINES. O <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N QJ <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS c d <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. U.) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o b <br /> I � � <br /> CONDITIONS OF PERMIT: ' <br /> RN <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ,� W <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. o <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 /> 5. Acce sSary S ftkgc ure%6a,r )°� a Il�v(� �r eYl va+e re�slcEenfia l6�u o a £ m <br /> g. Sf u ro p�( 0 n ly I a a�tFse� fu r h urntir�ha bl+ad�a n- �. a y <br /> 0 g <br /> 3 <br /> 1 v R C o w <br /> 7. M1 bt,�Dh C�mP��Fi6h--Fvr Ing Y.G-170n - o "z U�� <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 2 <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of o. C <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize _�- m <br /> that this information I am providing will be relied upon by the County of Bumett 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 : d : <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other f< <br /> authorized person to have a essthe ab soles ibed premises at any reasonable time for the purpose of inspection. T o <br /> ol <br /> � ' B <br /> SIGN HERE <br /> n : <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR `^ <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> o ��o <br />