Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS <br /> n O <br /> N <br /> C <br /> owNER (95JyoC_0 o <br /> o <br /> MAILING ADDRESS <br /> —T CD <br /> 0 <br /> c 0 <br /> PROPERTYADDRESS <br /> } Cn <br /> LEGAL DESCRIPTION(see tax receipt) ��f / 6 P!7 <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION ❑ rn <br /> TYPE OF PERMIT(S): O a —tom <br /> FILLING/GRADING ❑ CA PING UNI ❑ SU DIVISION ❑ //,-7� a 1 ' <br /> STRUCTURE/ADDITION USE: (�AI !� I77A� WI C�GIP / i <br /> (Home/Cabin; Commegbal Business; edroom; Deck;etc.) kjti <br /> 11 /� + m <br /> BUILDING CONTRACTOR: t{ �p hl �A7R DUCLQ— <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 3 C <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> A N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> 'n z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). y ` <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. I P <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO J{ <br /> BUILDINGS, ROADS, LAKE, LOT LINES. t4 <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 �' 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> o _ zz <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. 2 i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Qh <br /> ISSUANCE. L�JJ <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. JJ/ A <br /> 5. / / C^^�l�'��' L�fil <br /> C/t�'' m �OidrDi0af -0 <br /> 6. 83 am Ox <br /> z aC:00 3 <br /> 7. z m 0._ o <br /> T <br /> o ,2 ' m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) c C_ <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of iu n w <br /> CL v <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize : m o my <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. 1 further accept all liability which may be a result of Ing on this information I am m <br /> providing in this application. 1 agree to permit county officials ccounty ordinances or other o <br /> authorized person to have access to the above described premises /// r the purpose of inspection. m CO <br /> Am <br /> SIGN HERE rA . r <br /> n : <br /> (signature of owner 'iding fontractor) ` (date) <br /> ZONING ADMINISTRATOR /71 4 N <br /> ZONIN � � 0 <br /> TOWNS PERMITS MAY BE REQUIRE <br />