Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator m c o <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> U' <br /> 30._x"93 0V9 <br /> OWNERDaniel & Diane La Sota TELEPHONE 715-866-7454 o a d <br /> 40/ M P SCN/AI 4 RO o <br /> HOMEADDRESS3408 Chenoweth Dr. Webster, Wi 54893IfoSPi/P. /L (,o/7Z $ <br /> EMERGENCY/FIRE NUMBER 3408 ROAD NAME Chenoweth Drive <br /> 012 4225 05 L700 <br /> LEGAL DESCRIPTION(see tax receipt) a <br /> 0 <br /> Xo <br /> Vl � <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION v <br /> o. <br /> 5. <br /> ut <br /> SANITARY PRIVY FILLING/GRADING gAMPING UNIT SUBDIVISION o <br /> STRUCTURE/ADDITION USE: Cabin 3 X 3 f/`t X a0 (_2'elewl <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR ,n B. <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> v z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). y o <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 LAKE, Z <br /> 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 BUILD- <br /> INGS, ROADS, LAKE, LOT LINES. ct <br /> 5. 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 om <br /> MUST BE SIGNED AND DATED BY THE OWNER. fc U <br /> o � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE Cr <br /> ISSUED. 2 Q. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c <br /> CONDITIONS OF PERMIT: 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT a <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 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, Q <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. zvC) � <br /> o�0m <br /> M M. m m c <br /> 6. a a w W <br /> wo <br /> 7 o yM <br /> . <br /> y; M <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c 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 m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- a <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 ' ation. I agree to permit coun o ials charged with administering county ordinances or other m <br /> authorized pe to ave access the abov remises at any reasonable time for the purposp of inspection. T <br /> m : <br /> p� m <br /> SIGN HERE <br /> �gnature of o er or building cont? c or) (date) <br /> ZONING ADMINISTRATOR ' ' . . ' ' d+ <br /> to 4040 fn w W <br /> N <br /> P.) U1 N N) CA fn <br /> n N O N P O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> 0000000 <br />