Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> H O <br /> N <br /> C <br /> n <br /> OWNER 17f CU C'(Lq/V DALL TELEPHONE 9y?� <br /> LS ° O <br /> MAILINGADDRESS G .3Ai AdIj7T-OwA Rp f1fQEXf t S3o"871 � <br /> W r � <br /> 0 <br /> PROPERTY ADDRESS 3 S/ M f 07'oG✓N QD <br /> V \ <br /> LEGAL DESCRIPTION(see tax receipt) -5EC -.4_7z%tvN 39 AAI&F/(o W CLAIM AA: ill n 3 1e71� O ' <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION © 1 <br /> TYPE OF PERMIT(S): as l•� <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ _<` �^ <br /> J/ 3 y. <br /> STRUCTURE/ADDITION USE: /VoMG AM'7717h o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) ( <br /> BUILDING CONTRACTOR: SEL jr <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN SY X 11 SHEET OF PAPER. ANY INCOMPLETE OR In3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 = <br /> -iO N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> T C 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 /> CvNORTH(N). Cn o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 9 <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. 1 ° <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. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. O o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS E. W <br /> MUST BE SIGNED AND DATED BY THE OWNER. �n' F <br /> o c <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° O <br /> NEEDED. " O� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o F' <br /> CONDITIONS OF PERMIT: 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT -41- <br /> ISSUANCE. w <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY �O Q <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER a <br /> SETBACK AREA. <br /> 5. <br /> m mmd > 0a0m <br /> 6. m x3 nm xar= .� <br /> 9 OS y <br /> Z C m ry O <br /> 7. O N i TIS E i m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m <br /> PP ( 9 Y ) Y Y E Oc ' � ; C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of f m c r" : A <br /> a ^ <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- [ ` N <br /> G 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 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m n <br /> D <br /> SIGN HERE n <br /> (signature of owner uildi�contractor) (date) <br /> ZONING ADMINISTRATOR JirnrQn(olan <br /> 3n: 3»w <br /> �63HER fA� N <br /> p O N N W W N 0 <br /> ONO (TN (lO <br /> TOWNSHIP PERMITS MAY BE REQUIRED Q <br /> THA PERMITS ALL EXPIRE ONE YEARFROM DAT OF ISSUANC Qr' 3-1r7-6k, <br /> + Imi l- le �{e��Ic �eauP bI� RiCh�d G�i-a <br />