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 3. <br /> N O^ <br /> CD <br /> OVVNER�f�77 ��S'T/�"` v ��,//`/ /N / - TEI.EPHONE716— 6 �(�"� 7 / O <br /> MAILING ADDRESS D u <br /> r m <br /> PROPERTY ADDRESSIWO <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION IQ� I (n 0 <br /> TYPE OF PERMIT(S): Sv.FILLING/GRADING 11 CAMPING UNIT 1-1 <br /> SUBDIVISIONN <br /> STRUCTURE/ADDITIONQSE: f ?U/� lA36"X3V <br /> 4gHome/Cabin;Commercial Business;Bedroom;Deck;etc.) c <br /> BUILDINGCONTRACTOR/(! / / ' / �:: A149) <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p N (w� <br /> 0 N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O CD (� <br /> m o Z c5 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m ;b� <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). y " 3 <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. <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 Q, <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. o j <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIF ONE WHEN <br /> NEEDED.THIS PERMIT IS V'Z74,CONDITIONS OFS ERMTT TO ALL CONDITIONS LISTED BELOW. -1 ©nr o <br /> 4I1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OBJ ) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHO__RE�,L�'VE�CQ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY VINO, VNTy b <br /> PERMITTED. (J <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> s. This structure to be used as private residential m d°>o a o v <br /> garage/storage only, g 3 OR ; ;n CD z <br /> y Not to be used for human m c y N o <br /> habitation. CD o <br /> 7. m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of myVLj C A <br /> knowledge and belief it is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of in <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize (D my <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to is- @sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am d <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other n <br /> authorized person to have access tot a above described premises at any reasonable time for the purpose of inspection. D o <br /> CD <br /> CD <br /> SIGN HERE r IiJ/�ti�/� a` 'a <br /> ig� of nr building contractor) (date) yn <br /> ZONING ADMINISTRATOR V/ - . <br /> .n 1» <br /> N NOO <br /> � � Ut OUt UtOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />