Laserfiche WebLink
.,,,.deft County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N 0 <br /> N <br /> C <br /> OWNER nU ��1 1�.` TELEPHONE 3Z/4?-60,/'3 4-1 <br /> HOME ADDRESS U JOIC Jt,741 &'.0,EW d <br /> r � <br /> 0 <br /> EMERGENCY/FIRE N';MBER ROAD NAME G Qrn shell L.Cqnf T <br /> LEGAL DESCRIP'-ION(see tax receipt) - 3335 '" O Z ' 2 OU p-r CSrn �� 15 c <br /> DWELLING/BUILDING �I GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ o) 0o <br /> TYPE OF Pk ,MIT(S): n <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ 5 <br /> !-1 <br /> STRUCTURE/ADDITION USE: YT-NQ. 0 <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: 5t Cr"e i K F°4'KS klyyy-CSS fii V <br /> 3 � <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> � m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) n o. v 1 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m , v <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO tyil 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 ( C <br /> BUILDINGS,ROADS,LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. o <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. o �tI�,JMM <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a S <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: C�. <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. �1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. {� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY 00 lY JW <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. I I r <br /> 5. <br /> CvaM v�ov <br /> m <br /> 6 3n <br /> . ��Q - A <br /> N C N !� O j 3 <br /> Z : No oro -i <br /> O '< <br /> 7. . : '1_.rn: : m <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my 6 a C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m mm <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- : 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 application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m <br /> M :: <br /> ,64 <br /> SIGN HERE <br /> �l <br /> (signature of owner or building contractor) (crate) <br /> ZONING ADMINISTRATOR \ 1GY1 <br /> N N VINN VIN <br /> Vt fT O ut V7 O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />