Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 � U rp.) <br /> Office of Zoning Administrator v 0 Z <br /> APPLICATION FOR LAND USE PERMITS 3 � ° <br /> r <br /> N � <br /> OWNER C r S a N TELEPHONE <br /> m <br /> HOME ADDRESS C a O <br /> 0 n <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION c =1 <br /> o. <br /> 5. <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o' <br /> y ^ r <br /> STRUCTURE/ADDITION USE:_ /'�o a71 t-_� <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE O (_// tel{ A <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. v (pzok, 5",�C"" 0 <br /> DIRECTIONS FQR PLOT PLAN nae"SIN 7 (AERIAL OR TOP VIEW) 0 QUA <br /> CLi1 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T IN Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m S <br /> NORTH(N). C • O <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, p <br /> STREAM OR RIVER. c <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- l <br /> INGS,ROADS, LAKE,LOT LINES. <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 6 ) <br /> MUST BE SIGNED AND DATED BY THE OWNER. g c <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 3 S a <br /> ISSUED. .7' <br /> St <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z Q <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. l <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 OH <br /> WM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> s. Mm <br /> 4 3 a 1 <br /> n <br /> t C w O <br /> 7. o ? <br /> it <br /> Zi <br /> -y: <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my g p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofm C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize C ; m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- E E E p <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 applfcaUon. 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 reasonab <br /> _ _ -n <br /> SIGN HEREJL <br /> _i_� L 7 7 w E <br /> lure of own or building contractor) ! i <br /> ZONING ADMINISTRATOR <br /> . . . . . <br /> N fo 4AH in fo+ <br /> `V/ ," {.Nh ON rii OO <br /> TOWNSHIP PERMITS MAY BE REQUIRE <br />