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 . <br /> r rn <br /> OWNER TELEPHONE y-3 .55 <br /> MAILING ADDRESS l o7 L Fi,- "Q <br /> o h (l c . jqSCeo 1( WJ- s7 �- O <br /> PROPERTY ADDRESS h e ` gOSa <br /> '1 <br /> LEGAL DESCRIPTION(see tax receipt) 5e-(--3q 1w 4ou ik&e 17w &2v wet <br /> DWELLING/BUILDING ❑ GARAGEIACCESSORY STRUCTURE ❑ ADDITION V� �a <br /> TYPE OF PERMIT(S): Cr <br /> FILLING/GRAD NG ❑ CAMPI UNIT [I SUBDIVISION a <br /> i (O < <br /> STRUCTURE/ADDITION USE: C—C, i N l (�IXC ( I /1 �1 LI V k Lf- <br /> � L AOD rh o v <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; e ) m <br /> BUILDING CONTRACTOR: 1 J P I S <br /> m <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. T0 63 <br /> _. <br /> C <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) OT a <br /> -n 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 <br /> NORTH(N). W \ 3 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m J <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. t N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS O <br /> MUST BE SIGNED AND DATED BY THE OWNER. V� 'o o <br /> 0 <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN Fh o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o 0 <br /> CONDITIONS OF PERMIT: Q „ 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. _ Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY O <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> m cawm0GCL m <br /> 6. m F3 yam xn ° x <br /> a o cc o 3 <br /> Z = m O <br /> 7. O M Tn C : m <br /> Cn : <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my <br /> - in A <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of n C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize (D m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- W <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. I agree to permit county officials charged with ad . i o er p D <br /> v <br /> authorized person to have access to the above described premises at any reasopV a or t Ulf o f t <br /> CID <br /> m a <br /> T <br /> D <br /> CID a <br /> SIGN HERE vi ` a <br /> (sig ur of owner riding contractor) MAY 1 i (Gaud <br /> ZONING ADMINISTRATOR <br /> BURNM COUNTY [ N(A W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING d� <br /> THIS PEPAAT SHALL EXPIRE qNE YEAR FROM DAT OF SSUANCE <br /> 40 T er-l-y <br />