Laserfiche WebLink
ON CVj PI FR� ANNECI 9 L�� <br /> Burnett County 7410 Co. Rd.K, No. % , tren, 15ri872" Office of Zonin Administrator it 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> • w T <br /> OWNER TELEPHONE <br /> HOME ADDRESS 4. - R"I tonn Ho 55 I I 1 c � <br /> EMERGENCY/FIRE NUMBER $� ROAD NAME ('mQ1n ►\00� <br /> i8-�ao sss ��9 <br /> a-40 -ho-119-0 oasoo <br /> LEGAL DESCRIPTION(see tax receipt) CJ O 5 I cc _ <br /> Ctn a 5w F-9k coo <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION a <br /> LA. <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> uJ <br /> /n� __`` Aryl P�-4( 041IN-ON �x�s� p <br /> STRUCTURE/ADDITION USE: l"(lY]\Y\ Awn til �� �,�.Se/� fir <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE�jR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. � E'f(� �Y/I O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) T�:cr- ,SAAf 'tkV L- — T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. (J m e Zo <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE if <br /> rn .. n <br /> NORTH(N). to O <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO M v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. P <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- 1 <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' <br /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o ' <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. DO <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 /> z � 91� gso m <br /> 3 CL n <br /> 6. a w co <br /> w m <br /> 7. 0 � <br /> mi <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my ; 12-211 ? 10 <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of CL E <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize a .. . m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to is m 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 m i <br /> authorized person to have access to the above described p mixes at any reasonable time for the purpose of inspection. n : <br /> W : <br /> CD : <br /> 40 <br /> SIGN HERE <br /> ign ture of ow r7 bui ding contractor (date) <br /> ZONING ADMINISTRATOR ' <br /> fA N H N H N� <br /> NNtl1NN VIN <br /> V1 Vt O ut N O O <br /> 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 <br /> 0 <br />