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 /> UT O <br /> N <br /> C <br /> n <br /> OWNER 5�-P.I' TELEPHONE 0 � o0 <br /> MAILING ADDRESSL CD <br /> W 1 �` t/C Ej�OP�t/yt I Wl ►+-� r rY11�J 7 J `+ <br /> yr CD <br /> 0 <br /> PROPERTYADDRESS Q ri 61f 0 <br /> Je bl ri ' jr (/L)� <br /> !9,-oc4kon -rwA. SFO Q 17 Prl►�(rSS Plnt SflnreS <br /> LEGAL DESCRIPTION(see tax receipt) "4- ��Z' C S; , V I Z P 0 3 CSrK V f I /�� <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE 1:1 ADDITION �- P �,(/ 1 / 0. <br /> c 0 <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ ,/ �N ,n <br /> STRUCTURE/ADDITION USE: b P C K ,;!Cfee,n!° ®e rU / X 0 <br /> `_ <br /> (Home/Cabin; Commercial Business; Bedroom:Deck;etc.) <br /> BUILDING CONTRACTOR: �Ol�C CUvn -e-q ld►10r✓tiloY- /( h�e� (�r�(l/- d <br /> Z <br /> m <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. T 'A <br /> y v 1 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) OT o Q <br /> ?+ v z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m ` 30 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C <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 y� <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 <br /> BUILDINGS,ROADS, LAKE, LOT LINES. <br /> S. 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. f <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 <br /> NEEDED. ^ / <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. fy�J�(' 1 /0 1 0 ~ <br /> CONDITIONS OF PERMIT: Ct <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT In <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. Vnj) <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> X d <br /> rw > O Dn O V <br /> 6. 3 am � ?J <br /> O N C y N O j 3 <br /> Z N N O O <br /> 7. o i T� m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) c C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m a o m <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize �o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <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 /> P P tY Y tY Y� 9 O <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized perso Ve access to the above described premises at any reasonable time for the purpose of inspection. m <br /> o : <br /> CD <br /> m m : <br /> G-27�m 3 <br /> SIGN HERE Ll n <br /> (s a re of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR /! Fn w <br /> p .nwenfn � N <br /> NCTNN OO <br /> O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> 01cu t C �'`-0 3 e A/-or <br />