Laserfiche WebLink
R <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -D OZ <br /> APPLICATION FOR LAND USE PER({M'II�TS� 3 o <br /> OWNER % TELEPHONE '� � Q> <br /> HOME ADDRESS <br /> r� Jit r' �-ti L <br /> � r e <br /> 0 <br /> EMERGENCY/FIRE NUMBER ) ROAD NAME G 1, <br /> LEGAL DESCRIPTION (see tax receipt) A/ /? c <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE* ADDITION ❑ PRIVY ❑ Cn o <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRAD NG ❑ SU DIVISION o; <br /> ( CAMPING UNIT <br /> In <br /> STRUCTURE/ADDITION USE: CJP� o' G <br /> '(Ho a m;Commerci Bus nes , edroom; Deck;etc.) 6L u1 <br /> BUILDING CONTRACTOR: <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 6Y:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m <br /> �I N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 n <br /> 'n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C1 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE im <br /> NORTH(N). <br /> n <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 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. <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. c <br /> O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHENq 0 <br /> NEEDED. <br /> ^. I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: o <br /> a <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT t <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 1 <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 /> /� / <br /> lie ' &j,?e oullf ef-� Yl TCoae� O�Ce l,4eq S ueAYel ;a M.-6. <br /> ;r, prn <br /> R g o <br /> NO. CL <br /> 7. (, o <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my \ c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m E 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- V' : 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 application. I agree to permit county officials charged with administering county ordinances or otherm <br /> authorized person to hays access to thea ve described premises at any reasonable time for the purpose of inspection. W <br /> m <br /> I i <br /> SIGN HEREC <br /> Ignatu Mwne u actor) date) <br /> ZONING ADMINISTRATOR <br /> N NfnNN(nN <br /> N UtO V1 V700 <br /> OWNSHIP PERMITS MAY BE REQUIRED o S o 0 0 <br />