Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICAT N FOR LAND USE PERMITS 3 <br /> r <br /> N O _XJ <br /> a \ <br /> p `ryI <br /> N <br /> OWNER �� �' 1'�w` el�e.C s(? TELEPHONECD <br /> MAILING ADDRESS �o �ft 3� 1� . Ga a fit, <br /> 111 r � <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) � � J� � 15(n 3S R\6 to <br /> CD <br /> 2 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION N <br /> TYPE OF PERMIT(S): ' <br /> FILLING/GRADING ❑ CAMPING UNIT El SUBDIVISION ❑ <br /> STRUCTURE/ADDITIONUSE: � � !1 I a W �X�1�- ��L� 0 <br /> (H me/Cabin; Commercial Business;Bedro m; Deck;etc.) C <br /> m <br /> BUILDING CONTRACTOR: t AR X66 :5, <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. -n <br /> O _ <br /> y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n V <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n p V a4 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m i (/NF <br /> NORTH(N). C I <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 1 ti 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 1 �� <br /> BUILDINGS,ROADS, LAKE, LOT LINES. `e <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. rj <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 -- <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE A 71, <br /> WHEN n o <br /> NEEDED. j <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. l o <br /> CONDITIONS OF PERMIT: LI AM q n7 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAIM QR PIERMIT `out <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SH OUN7-Y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALG <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> m an d o'0 a F m <br /> 6. 3 a m F P m ;a <br /> N C w to O � 3 <br /> 7. z o <br /> T TI <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of pd r, v+ <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I recognize m I : 'o G <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- -r m <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 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to h access to the bove described premises at any reasonable time for the purpose of inspection. m o <br /> SIGN HERE n <br /> (signature of ow er or building contractor) (date) <br /> ZONING ADMINISTRATOR v I <br /> Hi EA fA M� N <br /> N N N N O O <br /> UONUOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED �� aU� <br /> l(PosiC�- l,U,She <br />