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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v0 Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> N <br /> C <br /> OWNER Charles E & Sarah D Ward TELEPHONE 219-253-6364 v <br /> CD0 <br /> MAILINGADDRESS 1246-W State Road 16 Monon, IN. 47959 F <br /> r 'm <br /> 0 <br /> PROPERTYADDRESS 2006' N. Rice Lake Road Spooner, WI 54801 <br /> LEGAL DESCRIPTION(see tax receipt) On Plot Plan Drawing CDCcn <br /> DWELLING/BUILDING ® GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ rn o <br /> TYPE OF PERMIT(S): C v <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ `Itl' a <br /> fll <br /> STRUCTURE/ADDITION USE. 6. <br /> Home/Cabin <br /> (Home/Cabin,Commercial Business;Bedroom; Deck;etc.) rn <br /> m <br /> 0 <br /> BUILDING CONTRACTOR: 4e1 f u <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> M N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m T <br /> NORTH(N). ( ` <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO M3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO 1 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. q <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 /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICAT ON*AY_BE DONE WHEN B <br /> NEEDED. V �� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. v I) 0 <br /> CONDITIONS OF PERMIT: APR i <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT/' 8 20p <br /> i <br /> ISSUANCE. /�/�II ) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORB�iERENPrT co(j <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ZOIUIQ NryPERG `� <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. — / eiM ^/I m 0r, > a0m <br /> 6. (�.L l2y.I'v/ m 3 & m O a <br /> Z w 2 <br /> 7. O o T�2 ;D <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my � Oe <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m c, v, <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize m 0 0 <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 m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m CD o <br /> `� <br /> m <br /> m <br /> SIGN HEREIV r(I ��I/t� 'S`�/–2 <br /> CL <br /> (signatureof r or building contract (date) <br /> ZONING ADMINISTRATOR <br /> O O <br /> �(TO UU00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />