Laserfiche WebLink
Burnett County 7410 Co.Rd. K, No.102,Siren,WI 54872 Office of Zoning Administrator -U G) Z <br /> APPLICATION FOR LAND USE PERMITS M. <br /> ^' r <br /> y O <br /> 41 <br /> C <br /> m <br /> OWNER b TELEPHONE ] ��I v 0 <br /> ev <br /> q�7 Q ��`�, / j� r m p <br /> MAILING ADDRESS � l l�(J I r lC_F t/� 7Vf �cLAO w� ? <br /> c-1" <br /> PROPERTY ADDRESS c � J �A <br /> LEGAL DESCRIPTION(see tax receipt)S- J / • // /P Ila h Lo c� CS-M 1116 {0/39 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ NW S'kv` c0 <br /> TYPE OF PERMIT(S): CD <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: re�4-Gf P_ nb= I t7� /X 1�l 0 Ivt�V <br /> O r ( e/Cabin;Commercial Business; Bedroom; Deck; etc.) (n v ` <br /> BUILDING CONTRACTOR: <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81h X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m <br /> M N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> T <br /> TZ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. tj m jp <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m <br /> NORTH(N). <br /> C) <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <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. O' <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N Ml <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. o o <br /> O E <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: 0 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ' C <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Q� <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 /> CD 3 CL :E m <br /> 8. m a m �c � <br /> (D C y N 0 0 <br /> 7. o wmz : 7`o <br /> . m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m <br /> PP ( 9 Y ) Y Y Oc <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of m ; v, C <br /> n^ : cn • >1 <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m $ : o E m <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 relyin o formation I am ro E <br /> providing in this application. I agree to permit county officials charge noes or other m <br /> authorized person to have access to the above described premises ata n f e f inspection. m CD o <br /> r <br /> SIGN HERE <br /> (sign re of olvner or buildin ontractor) r] r1MI CL <br /> JUL G LUVY ' E <br /> ZONING ADMINISTRATOR 0) hadlQEhn <br /> RURNETT CSU I-y4 � ro�ro r) N <br /> y_-Qj�J— N (n N N O O <br /> TOWNSHIP PERMITS MAY BE RE'OUIRE Ni'i �((�J k c' o rn <n o 0 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />