Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -U0 Z <br /> APPLICATION FOR LAND USE PERMITS <br /> ^ r <br /> 57 o <br /> OWNER p j� k0�✓1��ISMA.r'f1 TELEPHONE �C I6,5-1— Y e2t,3A Q <br /> ll �-11 J(1 <br /> MAILING ADDRESS g <br /> r <br /> o_ <br /> PROPERTY ADDRESS 3ovl 6 4/les p,, Add bury WI: <br /> LEGAL DESCRIPTION(see tax receipt) -r 0 44& N REQ t ev )rw �14 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION CVv7pp4/ rn o <br /> TYPE OF PERMIT(S): ' <br /> LING/GRADING ❑ � <br /> ❑ CAMPING UNIT ❑ SUBDIVISION n <br /> FIL <br /> STRUCTURE/ADDITION USE: SEEt S_ O/v A24C# AWW PAA 0 b <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) Cn <br /> 2 p <br /> BUILDING CONTRACTOR: NfI�E v' F <br /> � � am <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. n <br /> O — <br /> 5 O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a 90 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. a A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m o <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m <I <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. j o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO I <br /> BUILDINGS, ROADS, LAKE, LOT LINES. 0 <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N W <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o I <br /> o Z <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. G <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z c� (- <br /> CONDITIONS OF PERMIT: o O <br /> I <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. O <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 /> 5. �1 11S �62MIT �EMSES j14E /AND USE P&w of 5 Tp /� f / <br /> /,3D/�3 IBX aov <br /> 6. SJJC�bS6O �o/%►I f Wf i H hN Q D6u Ddd� 6v 13(C 6r reset, 1CVf 6 m_ s 3a y m a m M <br /> p N C N F �+ <br /> 7. c2I- ;*x/ -I UN06N r t(E het- AND VLea--� 15 Waosw r&L- 6To- 7e- o " T ° <br /> — � : m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 0 <br /> knowledge and belief it is true, correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of m' c o C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize ^� m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m : rn <br /> G) : <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 d o <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances o other iv <br /> authorized person to have access to the above described premises at any reason I r tl n. m <br /> a [ <br /> mD . <br /> ((�� m <br /> SIGN HERE t L J Vn a <br /> (sign owner orbuil n ntractor) Q date) � <br /> ZONING ADMINISTRATOR Sr �f R 1 8 M <br /> i <br /> ^ O N (P (J (J N O <br /> TO SHIP PERMIT MAY BE REQUIREDBURNETT COUNTY CJ <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM )DATE OF ISSLQ '/�e/7!' S/Y1ltl <br /> 7 7 K 9 / <br />