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 /> r <br /> N <br /> C <br /> C W <br /> OWNER W TELEPHONE <br /> MAILINGADDRESS ' S Wv � 'wgq� <br /> r m <br /> PROPERTY ADDRESS Lee— k <br /> LEGAL DESCRIPTION(see tax receipt) Gt-a W q led tt C;i 4 — —/7 <br /> CD <br /> -1 C <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE El ADDITION Elto ° <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURFADDITIONOSE: j- D M tS a X 7 a `LIA X 4/8 W <br /> N 9,� <br /> ° s <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) d <br /> BUILDING CONTRACTOR: 42 <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 /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 O Q <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). CO)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 V Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <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 _l <br /> MUST BE SIGNED AND DATED BY THE OWNER. Cil t <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN CU °, <br /> NEEDED. 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> ` pOp <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT V <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 Q. <br /> PERMITTED. O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> �r � vnvv <br /> 6. �O 3 nm yam ;a <br /> o ( C 0 iC <br /> 7. Z y (Do Ifo <br /> o T`� M <br /> M Ln M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my cj C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of `{ m ° v, <br /> au <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize El <br /> , m m : O mm <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 w <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. CD <br /> n - _ m m <br /> SIGN HERE K��C CE \• 4. ��+� 4 -S 'D 3 "' C <br /> (signature of owner 'ding contractor) (date) n <br /> �� <br /> ZONING ADMINISTRATOR4Q1 : <br /> / „ • fA 6A fA fA � N <br /> �1�V��r NCTNNOO <br /> O UtO(T (POO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />