Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator vO 'V <br /> APPLICATION FOR LAND USE PERMITS _3, <br /> OWNER 77�h n/�. �u I/ HONE I +4-3 <br /> � 29D C� <br /> ry r T TELEP <br /> e� 7 IS- (035-769 I a_ <br /> MAILINGADDRESS P. ©. gDY �3Z STI LI �. /,g—r M tJ SSO 2 <br /> r m <br /> PROPERTY ADDRESS 114-4- <br /> LEGAL DESCRIPTION(see tax receipt) 1-01- 2 <br /> 1- � 6-Z4-W1� Dpi'-w . I cn <br /> ra t <br /> T sF�W +, m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE NADDITION ❑ Seo-rr y a. <br /> TYPE OFPERMIT(S): CTowal Si�tP <br /> c <br /> FILLING/GRADING 1-1CAMPING UNIT ❑ SUBDIVISION ❑ o: <br /> STRUCTURE/ADDITION USE: C-4ARA CU e a& tl N <br /> o' <br /> (Home <br /> a/Cabin;Commercial siness;Bedroom;Deck,etc.) (n <br /> / <br /> BUILDING CONTRACTOR: �O A&L l-C)G k CPO IS FEM D 1►1/� I R� <br /> v <br /> M <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'G X 11 SHEET OF PAPER. ANY P � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. t I^' -n <br /> N O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) i p a <br /> APR 1 S 2pp3 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TOS LE. n 0o X <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEI�BUH,D{�,(y@6yNIDI TE m <br /> NORTH(N). C 1 1 (;UPJ C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(20ftj"q (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. t <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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. = --i t <br /> F <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHENo <br /> NEEDED. � X J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: C <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. N <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 THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> This structure to be used as private residential t-S r. <br /> 6. garage/storage only. Not to be used for human $ W 5 0,v n o v <br /> 3 n m x n A <br /> habitation. o C y S 3 <br /> 7. z n m o : ' o <br /> o T� M <br /> 1 declare that this application(including any accompanying schedule) has been examined by me and to the best of my - p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofd v. C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- C O <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 oG) <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. m <br /> m o : <br /> SIGN HERE <br /> n : <br /> (si nature o ner or building contractor) ate) <br /> ZONING ADMINISTRATOR1!1) 1� <br /> rR fAC O <br /> N <br /> QN(T N O <br /> (T <br /> TOWNSHIP PERMITS MAY BE REQUIRED ON 0 O O <br />