Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,W154872 Office of Zoning Admini:;tra or 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> C <br /> OWNER �.� ��aYt TELEPHONE��� o <br /> m W <br /> HOME ADDRESS Q <br /> o <br /> EMERGENCY/FIRE NUMBERD 9/ ROAD NAME I T <br /> LEGAL DESCRIPTION(see tax receipt) / p�� '�/Lp� �aj <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ <br /> TYPE OF PERMIT(S): rL"It- <br /> FILLING/GRADING El CAMPING UNIT ❑ SUBDIVISIONLA{�'/-�'"�5 n •. 'n <br /> STRUCTURE/ADDITION USE: <br /> 0 <br /> _ <br /> Home/Cabin; Commercial Business; Bedroo ; Deck;etc.) ti <br /> /��j� <br /> m <br /> BUILDING CONTRACTOR: I-�y�y'� k.! ,L 5i <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> .�I N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> m c <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m y� <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE �J <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 <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 1 p <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 /> S. 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 /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z " ) <br /> CONDITIONS OF PERMIT: c <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT w <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 <br /> PERMITTED. Q <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER �J <br /> SETBACK AREA. <br /> 5. <br /> = dam m <br /> 6. a 0,L1 :0 <br /> N C N y O 7 3 <br /> 7. Z . y �lISO� � ."O <br /> o _Cn <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my Z)c ; i ID <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m <br /> PP (including Yaccompanying ) 9 O. <br /> all information contained in this application Includin an schedule and I further declare that I recognize lA : ': m E m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- `. d ; : 0 <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 C, m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other p, m <br /> r <br /> authorized pe have access to the abovdescribed premises at any reasonable time for the purpose of inspection. m <br /> m : <br /> SIGN HERE <br /> (signature ofor building contrac or) (date) <br /> ow r <br /> ZONING ADMINISTRATOR 'eU2 <Z� <br /> 4A4444464a4� <br /> N NMNNMui <br /> M P O P P O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 000 0 0 0 0 <br />