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 3 <br /> N <br /> N <br /> OWNER N <br /> 1�5 PQ TELEPHONE a <br /> MAILINGADDRESS 2-75-9-1 A dk, Pi . tv L , , _ <br /> vl � 3 03 rJ1�-- <br /> LEGAL DESCRIPTION <br /> -(see tax receipt) t1 CSIv► v P Zo (it, NE111E f fieypl Z+3 <br /> I00fD i LiWIWING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION �I c� C rj) o <br /> TYPE OF PERMIT(S): c� <br /> FILLING/GRADING ElCAMPING UNIT 1:1SUBDIVISION ❑ <br /> r <br /> STRUCTURE/ADDITIONUSE: `7 SeaS0►1 Sa¢Q r pe'Gt' 0 v <br /> (Home/Cabin;Commeraal Business;Bedroom; Deck;etc.) �+/ <br /> A ,(( P f"Y+ T��_` J �nJb-1369 <br /> BUILDING CONTRACTOR: l Ul�-U F-/hs (U-10dW- � .l1 71� m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m0 .33 /�+[ <br /> M N V <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 m <br /> -n a <br /> n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. i7 . 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). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO CO) 0 3 <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 <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 -4�) 0 1 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> o 7� <br /> v, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFI� ( DONE WHEN M. o <br /> NEEDED. J �V� M. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: / P C� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF ffRMITV <br /> ISSUANCE. Q(% IT <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORMIIteti/vjj�d (jlv <br /> (r Uv <br /> 3 NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY C( <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER NJ <br /> SETBACK AREA. <br /> 5. <br /> 6. m oaf m <br /> $ 3am snSM <br /> O ry C N N O = 3 <br /> 7. Z N ry O f0 1 <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 1 t ; — A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am � w <br /> v <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m <br /> / 1I m o : <br /> SIGN HERE { 6 QZ <br /> a : <br /> si atu of owner b ilding contractor) I (dal ) 1 <br /> ZONING ADMINISTRATOR <br /> N �n 0 <br /> 0 N IV p <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> o c t Jq <br />