Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o <br /> APPLICATION FOR LAND USE PERMITS <br /> kZ 3. <br /> N .. <br /> OWNER ' Cj /�s �- l�� SeCO 'eOTELEPHONE �� V -Z / 2e & <br /> /� ) <br /> L <br /> HOME ADDRESS -362-9 A)o m <br /> 6/P k)e N r ��//),,� �S��Z� <br /> r-+ o <br /> EMERGENCY/FIRE NUMBER lr1 7S Z ROAD NAME 5 L4 <br /> LEGAL DESCRIPTION(see tax receipt) <br /> 0 <br /> Co � <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE DDITION Cr <br /> S. <br /> a ' �l <br /> Vv <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION O <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;dWnmercial Business; Bedroom;Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> X N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m e jo <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C n <br /> NORTH(N). o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m `tea <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. ls�P <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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <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. m o <br /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE Cr <br /> ISSUED. s <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c L V <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <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, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> den p = d d v v <br /> c > 3 <br /> 7. J�// <br /> = m <br /> I declare that this application (Including any accompanying schedulej has been examined by me and to the best of my Ca' c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> 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- d 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 ; d <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 deggribed premises at any reasonable time for the purpose of Inspection. ,, <br /> CD <br /> L7 gge <br /> CSG <br /> SIGN HERE J �- D— ! 6 ' <br /> sign uure of owner or <br /> builds(contractor) (date) <br /> ZONING ADMINISTRATOR )42() m W <br /> fA fANN"00 <br /> N N N Oi 01 <br /> 01 P OI P O VI 01 O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />