Laserfiche WebLink
Burnett County 7410 Co. Rd. K,No.102,Siren,WI 54872 Office of Zoning Administrator - c a <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER <br /> "TELEPHONE �S' 6-7- 3—(�S��p ^p <br /> O <br /> MAILING ADDRESS r ( C� 6 ;�C ��V -,Z1' D <br /> CD <br /> PROPERTY ADDRESS <br /> r <br /> LEGAL DESCRIPTION(see t is receipt) S� \j_�� �7 Gi R 1 LA.) <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE VL ADDITION ❑ O.� 0 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADI/NG ❑ CAMPING UNIT ElSUBDIVISION ❑ S. <br /> STRUCTURE/ADDITION USE: _ _ C21 ° <br /> (Home1/Cabin; mmercial Business; Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: S-e-�T LtJ <br /> 1 <br /> v <br /> ID <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> 31 vi <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m 3 C <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE rn 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 v <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. ° <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE V { ATN cWkJF�AL S <br /> , r, 5. f <br /> NEEDED. <br /> � i Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 1' o <br /> CONDITIONS OF PERMIT: �1jt ✓ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS O <br /> ISSUANCE. CGU ` C1( ) .1/ <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOREL INY <br /> G,t , <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY &I <br /> PERMITTED. auC 8 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WAf `� Coq, <br /> � <br /> SETBAC1K,AREA. 20A',qC'0 <br /> 'o � �0- . /9•�(' "� /.SS j 'Y�'V0 v�i";. � M m a �a f 1M11 <br /> 6. �{l(W I This structure to be used as private residential S. 3 a y ;1a 21 <br /> 7 garage/storage only. Not to be used for human o T <br /> habitation_ m� <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m 6 <br /> PP (� 9 Y ) Y Y <br /> knowledge and belief it is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of a ; <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m e C <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 furl er 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 t13 have access to he abovpf de Ibed premises at any reasonable time for the purpose of Inspection. T m o <br /> SIGN HERE ° <br /> C1. <br /> (signat f owner or build g contractor) (date) <br /> ZONING ADMINISTRATOR 171 '. <br /> Qin ro <br /> cNi�o� o <br /> (GLS TOWNSHIP PERMITS MAY BE REQUIRED PW <br /> (�" �f l� THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> �" <br />