Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator v n- o <br /> APPLICATION FOR LAND USE PERMITS 3 4 <br /> r <br /> w <br /> OWNER9(i�Aa&d L. _8/ane-11 —T ''TR DCIn{�TELEPHONE <br /> /1// � ' ) r41 <br /> HOME ADDRESS ;� V(O �IQh�I� (U/7t? �et7/n / (J�/S- Jrr�7J�`1 r m <br /> 0 <br /> EMERGENCY/FIRE NUMBER ROAD NAME 0 ~ <br /> /1E 34-ay 5­-5&/a7io 53j111�*1Q1&U) des 7,0W <br /> LEGAL DESCRIPTION(see tax receipt) 2-3q -&-34-0 051.1 51& /V /Z SE SW N of '70' <br /> e: <br /> C4 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION 4 <br /> 5. <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION— <br /> STRUCTURE/ADDITION <br /> UBDIVISION STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR m w \= <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> .'0 a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. S 'o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE M n <br /> NORTH(N). H <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 LAKE, Z <br /> STREAM OR RIVER. P <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS,ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 64 <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. G <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE S <br /> ISSUED. 2 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 0 <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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 <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. qq0 DID <br /> 3 n 3F 2 � <br /> 7. e N <br /> c : 31Q ` <br /> _m '• <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my ': C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of i a <br /> all information contained In this application(including any accompanying schedule)and I further declare that I recognize m m . . m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Is- m t7 <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 �m ; <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. <br /> e : <br /> e : <br /> SIGN HERE ry�f� <br /> t> rn <br /> (signathreeoof owner dr <br /> building contractor) . nl (�� )`S'f <br /> ZONING ADMINISTRATOR <br /> � drMMNHH� <br /> NNNNNNf7 <br /> JUN 31997 60ou,(Doo <br /> TOWNSHIP PERMITS MAY BE REQUIRED o o S o 0 0 0 <br />