Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -U 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> N a <br /> ,/ `1 7 !\ V <br /> OWNER (L `�G TELEPHONE O �J <br /> MAILINGADDRESS <br /> U)o <br /> PROPERTYADDRESS 1 '~ <br /> ALL <br /> v— 1 , ^ I c <br /> LEGAL DESCRIPTION(see tax receipt) S V/ /�/�5w ` S l/a V L()sC C� ^ {/U 6 <br /> 7 <br /> DWELLING/BUILDING I? GARAGE/ACC SSORY STRUCTURE ❑ ADDITION ❑ I (n <br /> TYPE OF PERMIT(S): C ' <br /> FILLING/GRADING <br /> }} ❑ CAMPING UNIT ❑ SUBDIVISION ❑ � <br /> a <br /> V V <br /> STRUCTURE/ADDITIONQSE: / "L 7 ,K 0 <br /> (Home/Cabin; Commercial Business;Bedroom;Deck;etc.) <br /> BUILDING CONTRACTOR: <br /> 1 <br /> v <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. In <br /> M °o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <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. S <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 0C!> <br /> MUST BE SIGNED AND DATED BY THE OWNER. o a <br /> Q o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. n <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Q/ <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 W <br /> PERMITTED. �y <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER U`! <br /> SETBACK AREA. <br /> 5. <br /> 3 am x- <br /> 6. a mCy � o � 3 <br /> NO <br /> 7. o CD z <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) C <br /> knowledge and belief it is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of m n e, <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize pv m 0 : <br /> 0 <br /> that this information 1 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 1 am m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m <br /> - o : <br /> m W : <br /> SIGN HERE V Z/ �/ J Q :)— Q <br /> s��LiG/� u <br /> (signature of owner or I ng contraf (date) <br /> ZONING ADMINISTRATOR to')a o )i <br /> C9 69 1A fA- N <br /> tj NNOO <br /> (TO (T Ut OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />