Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> 5 o <br /> /10 <br /> C _ CD <br /> OWNER TELEPHONE �� ^ILj�J ; V f o <br /> MAILINGADDRESS <br /> r <br /> I o <br /> PROPERTYADDRESS /'j'I <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ U <br /> TYPE OF PERMIT(S): C 4 <br /> FILLING/ RADING ❑ CAMPING / IT ElSUBDIVISION ❑^ � n <br /> STRUCTURE/ADDITION USE: H o <br /> t/ <br /> (Home/Cabin; Co/mm'/ / <br /> Commercial Business; Bedroom; <br /> lDeck; <br /> ^etch. <br /> BUILDING CONTRACTOR: . PIYA r�U�� 1 ('0/ , Q <br /> iv <br /> v ` <br /> CD ) <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O - vv <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) n a <br /> 0 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m X <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). C ° <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m a <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 O <br /> BUILDINGS, ROADS, LAKE,LOT LINES. <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> m <br /> w <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. (� <br /> t <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o C <br /> CONDITIONS OF PERMIT: � <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. Vv <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. /r <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER W <br /> SETBACK AREA. <br /> 5. <br /> 0onom <br /> m x 3 =a m F a m A <br /> 6. c� comjEF <br /> � � <br /> Z <br /> 7. m <br /> — v' in[ A <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my a <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 n m <br /> XJ <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- U) t7 <br /> O s : <br /> sue a perm further acce t all liability which Pay be suit of the County of Burnett relying on this information I am o <br /> providin m th application. ree to permit c n o ials charged with administering county ordinances or other ��— <br /> authori d per n to ve ac to the above d cr' ed emises at any rea on I -n a <br /> SIGN R a <br /> ig ature of o r buil g contractor) (date) <br /> ZONING INISTRATOR JUN 2 2 20@5 <br /> va <br /> IQ f W W rfl N <br /> O (T O CWT (T N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUING <br />