Laserfiche WebLink
Burnet4County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> fn O <br /> dingy-ya 7 <br /> OWNER TELEPHONE 0 <br /> m <br /> HOME ADDRESS aq i)3 <br /> Aharfk U0 M ' O <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION see tax receipt) rn <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE Pq ADDITION 1:1 PRIVY ❑ Cn <br /> 0 <br /> TYPE OF PERMIT(S): c <br /> FILLING/GRADING 1:1CAMPING UNIT 1:1SUBDIVISION ❑ CL` <br /> STRUCTURE/ADDITION USE: %AII.AkX— <br /> ome/Cabin; Commercial Business; Bedroom; Deck;etc.) y <br /> � � <br /> BUILDING CONTRACTOR:��125 ' <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR In 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> ;a N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 0 <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m p <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C n <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 /> IS <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. ( 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 /> 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. U3o <br /> O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q <br /> NEEDED. 2 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <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 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> ;av0'r- CL <br /> vCvv <br /> 6. 3 ny y <br /> c <br /> m C N _ <br /> 7. o : H o <br /> W ! m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 3 a p <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of o c <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m <br /> M <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- d a <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. 1 agree to permit county officials charged with administering county ordinances or other <br /> authorized pe!un to have access to the above d scribed premises at any reasonable time for the purpose of inspection. r <br /> m [ <br /> SIGN HERE � <br /> (signature of neror it ing ontractor) (date) <br /> ZONING ADMINISTRATOR 1 fn <br /> fn 4etoo <br /> Fn 4 <br /> N NNCA0 <br /> V NN O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 00 00 0 0 <br />