Laserfiche WebLink
Burnett Cbunty 7410 Co. Rd.K, No. 102, Siren,WI 64872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r o 1 <br /> ip1Z Stow —(n87 t CE�� J��3 <br /> OWNER C hV -TET TELEPHONE n <br /> 2-7 <br /> MAILINGADDRESS I q 40( po-k �O w- L-ty, ^��QK t� h Nt o� ( � <br /> PROPERTYADDRESS 'TRRkI SCAnT ToWfL) 5h% t v I- <br /> S12 38o l8 `r*o R ijfw - 2-41-U -t`F 18-0 012.46 <br /> LEGAL DESCRIPTION(see tax receipt) <br /> t-0-r1ir C5 VV\, V, l[k <br /> CD <br /> DWELLING/BUILDING W GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ <br /> 0 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIIVIISI N ❑ / . / a <br /> S. <br /> STRUCTURE/ADDITION USE: A Pel ry lP V' W ( r/ N <br /> O' <br /> (Hom Cabi ; Commercial Business;Bedroom; Deck;etc.) ( rn <br /> BUILDING CONTRACTOR: _ d UJ to Elz <br /> " ^ 1 <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN BY:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n - <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) pCD <br /> a <br /> O ^\ Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. � <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 <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 t <br /> BUILDINGS,ROADS, LAKE,LOT LINES. `. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADE7MAY <br /> [ <br /> N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, COfes, LANS IQ 0 � <br /> MUST BE SIGNED AND DATED BY THE OWNER. (�" o <br /> 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICADONENEEDED. QTHIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. BV 7 � / o Q <br /> CONDITIONS OF PERMIT: RNE ` <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Z N NG UNTy �.1 <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. (vim <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER ` <br /> $ETBACK ABEA. <br /> C ,l _ 1 <br /> 6. IIITTTT���` O CD W 8 B a m n ;a <br /> a mcy " o 3 <br /> wo <br /> 7. o H -n ?J <br /> I declare that this application(including any accompanying schedule) has been examined by me and to the best of my —�2 A <br /> G1 - C: <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d v, <br /> all information contained in this application(including any accompanying schedule)and I further declare that I 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- D <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 d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized perso/!n�to have access to the <br /> /above <br /> ydescribed <br /> �premises at any reasonable time for the purpose of 1nspection.11 �" �T <br /> N p <br /> }, N <br /> SIGN HERE <br /> n • <br /> Is a of owner or buildiee yOntractor (date) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />