Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator - o z <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> N 0 <br /> N <br /> CD <br /> CC L ^�/- U� C <br /> OWNER �f'6 �id C 1 V - �t! I n L- TELEPHONE �y 7j 5�� / SL�� p <br /> O <br /> MAILING ADDRESS �s- <br /> 1-2 <br /> m <br /> 0 <br /> PROPERTY ADDRESS 1, r <br /> V 1 <br /> p <br /> Sp rfr�� I <br /> LEGAL DESCRIPTION(see tax receipt) Sw 1-¢ J0d 1- SPC//Oh T go/V. /\, /7 6 y <br /> I [""""�111�111,�� <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ® ADDITION ❑ cS I ° <br /> TYPE OF PERMIT(S): n <br /> FILLING/GRADING ❑ CAMPING UNIT 1:1 SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: F le Sit P d Ye q 1? y9u l la)l K (l,. <br /> A y (Home//Cabin; Co)mmekial Business;Bedroom; U <br /> eck;etc.) <br /> BUILDING CONTRACTOR: NOY A lOn A/ <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/a X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> A y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a (j <br /> n <br /> O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> CNORTH 0 <br /> 3. SHOW D M)ENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> -0 <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 ° <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. O <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. p <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. o <br /> O � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. (C� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o "I 1 <br /> CONDITIONS OF PERMIT: � <br /> In <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. I[D� <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. i l/ _S-y,-) This structure to be used as private residential r D o D O 9 <br /> CD <br /> s. <br /> (T/� ' / garage/storage only. Not to be used for human 3 a mO F n m � <br /> habitation. m 0 00° o 3 <br /> m <br /> Z N ' ' ° � <br /> 7. 0 T� : ;U <br /> C/) m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c ID <br /> C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a a : 'i. 55 <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize : m m O mo <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <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. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time,40the purpose of inspection. M <br /> o <br /> m <br /> CD <br /> SIGN HER a <br /> (signature owner or byficling contractor) (date) <br /> ZONING ADMINISTRATOR u>v1 <br /> (A fA fA fA — N <br /> y' N (T N N O O <br /> Ut O N) (n OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />