Laserfiche WebLink
en I <br /> Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator U 0 a <br /> APPLICATION FOR LAND USE PERMITS . E <br /> h � Iol'z SISI- 53�� <br /> OWNER /r� A(�( � TELEPHONE /-716 34 Z— <br /> g <br /> 'a c <br /> .f N it t"1{T r Lel PL $ Q <br /> HOME ADDRESS -)411 our 1 'U JL D P, �Q y) Ft w r 9 <br /> I Q o <br /> EMERGENCY/FIRE NUMBER 7l lq ROAD NAME G,LLV r 1 it <br /> wesd awn �e 3, � i Hi (� w t <br /> LEGAL DESCRIPTION(see tax receipt) 17 U RW T-r CQ UNTY r W 5 L0nj Sj Al 7,$y 3 2 <br /> N 0 <br /> TYPE OF DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION— <br /> SANITARY- <br /> DDITION SANITARY PRIVY ^ FILLLII,N�G,/fGRADDII1N'G CAMPING UNIT SUBDIVISION 0 <br /> STRUCTURE/ADDITION USE: GaRp `�0EVh Er <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) -� <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR m <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p ^' <br /> y w <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 0 <br /> ;b <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m IF O <br /> NORTH(N). 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. P <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 <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. m o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q $,M <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. (� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY 1�J1 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> p � mr s2pq3yE�o9 <br /> 6. .'� vawiao . � <br /> vlitCw <br /> 7. o a lb . ?IP A <br /> N: m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my E LZ g ; C <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of n`� E <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I recognize m ij E E m <br /> that this information I am providing will be relied upon by the County of Bumett Wisconsin in determining whether to Is- ? m 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 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m E f <br /> authorized pereon to have access to t e above described premises at any reasonable time for the urpose of inspection. T i <br /> o <br /> m <br /> SIGN HERE <br /> 1� �,t•,� <br /> (signature o�f owner orulldi contractor) (date) <br /> ZONING ADMINISTRATOR <br /> � MMHN HlAH <br /> N N N N N N N <br /> VI Vt O fr tr O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />