Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator _U G) Z <br /> APPLICATION FOR LAND USE PERMITS . <br /> r <br /> OWNER r I ltlA„ TELEPHONE ( n <br /> wLllw�.t, �_ � l gra- � Its_ � `(�l l o J <br /> r 'I <br /> MAILING ADDRESS +8 00 <br /> 6 1 l� ill Ut[f �V� S. ST,L44�S 66tr K, f y�k. .e� .Z(10v O <br /> r � <br /> 0 <br /> PROPERTY ADDRESS 4 �I L t 1i4 t` LA <br /> LEGAL DESCRIPTION(see tax receipt) Q rn <br /> ffpplI ^ m �. <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION IBJ Cl <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> .o A T. U, <br /> STRUCTURE/ADDITION USE:12�($ gA et llte.i..,-. 1� e�/� „, tAL�Ao Bsj ,i.:t-L Ce4Ait ° (�.. <br /> JF(Home/ abin; Commercial Business; Bedroom; Deck; etc.) ro )C) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN S'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 A <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n <br /> O — <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n <br /> n <br /> 'n <br /> 2 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m O X �. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <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 3 <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 o <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 /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 N <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. O <br /> W v <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. 2 h <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z t' Y <br /> CONDITIONS OF PERMIT: P Q <br /> I <br /> 1 DRIVEWAY <br /> MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. n <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 THE REQUIRED WATER I <br /> SETBACK AREA. <br /> 5. <br /> X W 0 r D 0 n O M <br /> d <br /> 6. F3 nmxa1 � <br /> 0 (D <br /> Z C U! O (O <br /> 7. o m rl < m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m — ^ O <br /> pP ( 9 Y ) Y Y G�� -4 . C <br /> knowledge and belief it is true, correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of m �_ <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognizem m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- ° to <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 v o <br /> providing in this applic ion. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to h e acc a above described premises at any reasortab ctl m <br /> -n a <br /> m a <br /> SIGN HERE m <br /> '(signatu)6 of owner or building contractor) (date) 0 <br /> ZONING ADMINISTRATOR AUG 9 MUM <br /> 1173W ND6y1C0rl✓ 10y1113 <br /> BURNETT COUNTY O0 con N 0 W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED nT <br /> G a N u <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSLIQ <br /> Rani_ X4164+ if rh ( V d - ❑w ps -Bi,+i (S &A -�S <br />