Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v a Z <br /> APPLICATION FOR LAND USE PERMITS <br /> N <br /> r j C <br /> WNER eo1 /` t 0 <br /> O <br /> `�1 TELEPHONE `0� <br /> MAILINGADDRESS HaydenN <br /> PROPERTY ADDRESS (5".t 615 C (#v- a <br /> LEGAL DESCRIPTION(see tax receipt) G � ` Of PC 17 'r ' � k C C� <br /> G . 1 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE S< ADDITIONE1 <br /> TYPE OF PERMIT(S): ��X I� <br /> FILLING/GRADING ElCAMPING UNIT ❑ SUBDIVISION ❑ S. <br /> STRUCTURE/ADDITIONQSE: Yak-'✓ S t CJac.4'"1 nt q <br /> flHome/Cabin,wCommercill Business; Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: <br /> S m <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n <br /> X n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a Q �` <br /> m .I7� <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <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. 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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. 'I <br /> f <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN O <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: 9 I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. ( 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VE GETATION 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 /> SETBACK AREA. <br /> 5. �'hvfz 7'r) <br /> � � aoavv <br /> m m 0 m a f m <br /> 6. m 3 n2 oam A <br /> 'O N C N N S. 3 <br /> 7. Z m m O 7 ( 1 <br /> O n z <br /> I declare that this application (including any a companying schedule) has been examined by me and to the best of my c <br /> knowledge and belief it is true,correct and cor iplete. I acknowledge that I am responsible for the detail and accuracy of m o 69 <br /> all information contained in this application(in Auding any accompanying schedule)and I further declare that 1 recognize m o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m a <br /> sue a permit. I further accept all liability whict 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 other <br /> authorized person to hav access to the above described premises at any reasonable time for the purpose of inspection. m m <br /> m <br /> o <br /> CD <br /> CD <br /> SIGN HERE IfflAl &tirk ir C <br /> ... y•v2 <» a ; <br /> (si nature of ow wilding contractor) N (date) <br /> ZONING ADMINISTRATOR <br /> Cn EA <br /> tj <n0N <br /> N N N O O <br /> 0 <br /> (TUt N 00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />