Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,W154872 Office of Zoning Administrator ✓- o �Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> u W <br /> 11 // JI�IL.// 1 N 0 <br /> OWNER (C bC;e o vp' <br /> TELEPHONE 3 a�7 -�{f 5 ig <br /> HOME ADDRESS c. S �� 0 <br /> Ca <br /> 1110 <br /> EMERGENCY/FIRE NUMBER I ' ROAD NAME 0 0, (�d Z_ m <br /> a q Zi7 fj <br /> LEGAL DESCRIPTION(see tax receipt) S , /i 37/'qau) AlC re S <br /> 3 y <br /> L o r f 5br-f Z 7' C V g <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION v og <br /> CL o`{ <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> ll ra `/ 7 e <br /> STRUCTURE/ADDITION USE: Otehie1P nae — obOTp V <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) 3 <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR T L <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. M <br /> 0 H `0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> m a <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 Ir <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m IN OO <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. o <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. v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE '" o <br /> Cr <br /> ISSUED. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z70 <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT i <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. i�y b(2- p!iX*/�SL S�/G P A b LCYo/ w"�r_( Wor <br /> 6. 01 <br /> CW o <br /> Q <br /> 7. Z ,oE <br /> o <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of myZ5 r-C p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m i C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize 'm <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- ` E p <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 othe m <br /> authorized person to have access to the above described premises at any reasonable t1 o"Pope", <br /> sped T <br /> _. : <br /> SIGN HERE � — ti I D <br /> (signs re of owner u ing contractor) SEP (dat <br /> ` � <br /> ZONING ADMINISTRATOR <br /> N NNPj CnnLn 31 pppp �npp <br /> TOWNSHIP PERMITS MAY BE REQUIRED _... .__- <br /> ------ . . 0 0 0 0 0 <br />