Laserfiche WebLink
-Wo-71 - i has <br /> Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office o Zoning Administrator M 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> y o <br /> N <br /> C <br /> npp 7 yy�� N <br /> OWNER bAV1b rlEj � y TELEPHONE Ltl - y39-iy32 o <br /> _ d � <br /> �} a / A /� /�' /� �j O <br /> MAILING ADDRESS �� 5 y I s/ • lV ) f L L �1f A-rEk- M V 5"4 F <br /> PROPERTYADDRESS y �/ WISALX //Vy / /AIC LA <br /> LEGAL DESCRIPTION(see tax receipt) 0q .4 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE 19 ADDITION ❑ t X wt ( ° <br /> c � <br /> TYPE OFPERMIT(S): /A/ (>O✓ 44DT <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> / n r (� / yt �rAr N y <br /> STRUCTURE/ADDITIONOSE: CT/"L �L / ` /"1� <br /> SEL <br /> Commercial Business;Bedroom;Deck;etc.) m <br /> S <br /> BUILDING CONTRACTOR: ` r <br /> Z � <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 T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> H <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 c O <br /> n <br /> m <br /> T o Z <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 C <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <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. ° <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. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS �1 <br /> MUST BE SIGNED AND DATED BY THE OWNER. ° YJ <br /> v, 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. /p�U 11ci— o <br /> CONDITIONS OF PERMIT: V <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT C \. <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. CA <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY C <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> This structure to be used as private residential d- '0 0 a o m <br /> s <br /> 6. garage/storage only. Not to be used for human 8 3 a m a "_ <br /> (-Op C <br /> habitation. 0 y T07. ' O <br /> =_ rn : [ O <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j ? ; <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of rr 11'' a 0 � <br /> W75 <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize m O m0 <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 1 am m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> Cn <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. T m o <br /> (D <br /> v+ iu <br /> SIGN HERE ° <br /> (si u e of owner b Iding contractor) (date) <br /> ZONING ADMINISTRATOR <br /> �N) <br /> EN CLn MN <br /> N (TfA 0 N N 00 <br /> (TO (T CTOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />