Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No.102,Siren,WI 54872 Office of Zoning Administrator m o° o <br /> APPLICATION FOR LAND USE PERMITS . <br /> N <br /> � �� /� C <br /> G Lf� Z9� n <br /> OWNER /C10C� ^'1 � C�E" TELEPHONE ��/� 7�3— <br /> _ O <br /> MAILING ADDRESS /�s�3a �y �r G%"/ZG'LF /itl['rTDN /L1`�✓ 3Sl7L� <br /> PROPERTY ADDRESS L[yf-d 12 <br /> LEGAL DESCRIPTION(see tax receipt) ,S� l A)j j yiL I�Q1� <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ m <br /> TYPE OF PERMIT(S): <br /> a <br /> FILLING/GRADING X CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: / tZ✓ !�f//`/E 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) ib <br /> BUILDING CONTRACTOR: N t ti K <br /> Z <br /> iV1'6- V441/r <br /> � w <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR T <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0a <br /> m <br /> 71 v z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m �o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C o <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. ° <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO CQ O <br /> BUILDINGS,ROADS, LAKE,LOT LINES. <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. f <br /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN m <br /> NEEDED. <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 <br /> ISSUANCE. �I <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 /> SETBPCK4A�F/��EA. [ �r O�O 7 �f/ �Il(�J J Int pit <br /> 5. fl�I H�1�� _ell <br /> o s / COSH a ro <br /> 6. IG� l� "^^ / ^i a� lM t�1 / T s V /TV� /J• `� v N C y O a 7 M <br /> Z N COD <br /> 7. O T T <br /> 1 declare that this application (including an accompanyingschedule has been examined b me and to the best of m D <br /> PP ( 9 Y ) Y Y G)c : i : C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a o : u, <br /> CL v <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize m `� c 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. I further accept all liability which may be a result of the Coun , rmation I am m <br /> providing in this application. I agree to permit county officials chargedyu�t i u 08 or other <br /> S m : rn E <br /> authorized person to have ac ss to the above described premises at any i} e r inspection. <br /> o , <br /> SIGN HERE <br /> n ; <br /> nater of owner PR (date <br /> ZONING ADMINISTRATOR R1 IRNIETT COUNTYE E <br /> ryaila �,� ZONING Lq oQ <br /> TOWNSHIP PERMITS MAYBE REQUIRED <br /> �� THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />