Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v 0 Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> u <br /> H <br /> CL <br /> � t C <br /> OWNER KE V I A 3 CJ' I-a /`V,t/,D TELEPHONE <br /> HOME ADDRESS 7 !6- / H(te � 35 K/ 6 S72-�k, v �j <br /> r � <br /> 0 <br /> EMERGENCY/FIRE NUMBER 755 7 ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ PRM' ❑ cn ° <br /> TYPE OF PERMIT(S): 8^�+�(( /� Cr <br /> a <br /> FILLING/GRADING ❑ CAMPING UNIT 1:1SUBDIVISION ❑ O�y-X J"f V (�-YGLC _ 5 <br /> STRUCTURE/ADDITION USE: 1?eoA.4 C 6 PR&7y l d V SU f�<i GC ll�V/�AlT /�� �t/. <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) rn rp <br /> BUILDING CONTRACTOR: IJA 2tl �A A L3E iv 1 1 <br /> v <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR T <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> I Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C n <br /> NORTH(N). y 3 <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. C 7Z <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. <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. , <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q ° �}? <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c (} <br /> CONDITIONS OF PERMIT: (� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 6. This structure to be used as private ; - d g0 g o <br /> 6. residential garage/storage only. Not to be M C NCL rn <br /> y o 3 <br /> y N O <br /> 7. used for human habitation. o <br /> _ Cn : m <br /> im <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 l� o Er <br /> -I <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize s m m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- O <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 m <br /> authorized person to have access to the above describe ises at any reasonable time for the purpose of inspection. CD <br /> m <br /> m : <br /> SIGN HERE 1 <br /> (signature o wner or building contractor) (date) <br /> ZONING ADMINISTRATORyJIJTA <br /> to to to tnww� <br /> N 0 NN N0 <br /> Ot VI 0 ut ut .0 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED a (�� 0 0 0 0 0 0 0 <br />