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 /> VT <br /> ' a <br /> OWNER JAE /11 LLi eA4 D ELEPHONE <br /> HOME ADDRESS �,e-i u <br /> / r/ �p /J <br /> l9�a7 �C��C,Q�irl,�-�,L (i/l1Ct,�! t �{usr M)3 s'5-0 3r <br /> � r � <br /> EMERGENCY/FIRE NUMBER ?j/,/ ROAD NAME <br /> Cl'N GoU 1 lIDT S <br /> LEGAL DESCRIPTION(see tax receipt) 'w p 4c Q, l y boT5 m V I P7-60 t� m <br /> 7 1 <br /> DWELLING/BUILDING O GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ o <br /> TYPE OF PERMIT(S): v <br /> c <br /> FILLING/GRADING ❑ CAMPING JUNIT ❑ SUBDIVISION ❑ n <br /> STRUCTURE/ADDITION USE: <br /> CN <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) M <br /> BUILDING CONTRACTOR: <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 <br /> O <br /> A m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a \Z <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m S <br /> NORTH(N). y o <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 Z <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 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I o <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. 5, <br /> Q o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. //��/ Z I <br /> CONDITIONS OF PERMIT: <br /> RMI V� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHI AYS O PERMIT ; <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED LONG SHOR6LIIdE op {11 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS LONG <br /> �W� / L <br /> PERMITTED. ��VVrr CC,, <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THZ �gER Nj <br /> SETBACK AREA. ����]] ���1^�J�� n � l <br /> 5. �4ilce 6-arkva 4nd 'l"d �� (S/ 40n o-/{Lu.m. Dr- like <br /> M m d 0 CD m <br /> COD 3 c o o a <br /> 6. Exi cab;,,i � to renwv4 (Ui Elir/1 I Y� c 4� (D c N y a T.= 3 <br /> 7. r ez-) �m�t i�u eq ® "` in o _ 1 <br /> o n 'cn : m <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my G <br /> knowledge and belief it is true,correct and complete. I acknowledge that I 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 recognize CD <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 <br /> providing in this applipffM I agree to permit county officials charged with administering county ordinances or other <br /> CD <br /> authorized person t e access)o to above described premises at any reasonable time for the purpose of inspection. -n <br /> CD <br /> CD <br /> SIGN HE L D 2 <br /> (signature of owner or building contract (bate) 3l 1 <br /> ZONING ADMINISTRATOR - <br /> V <br /> TO NSHIP PERMITS MAY BE REQUIRED ann C (�{ <br />