Laserfiche WebLink
i <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Adm nistrator <br /> APPLICATION FOR LAND USE PERMITS g 3 �� <br /> N <br /> O NER <br /> TELEPHONE o <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION <br /> SINGLE FAMILY DWELLING O GA"5E/ACIPESSORY STRUCTURE i? ADDITION ❑ STAIRS-0 o TYPE OF PERMrT(S): <br /> FILLING/GRADING O CAMPING UNIT D BUNKHOUSE O 59.692(IV)GAZEBO O GECK O <br /> STRUCTURE/ADDITION USE: r + ' 3 <br /> (Home/Cabin; Comm rcial Business; Bedroom; Deck; Mc.) z <br /> r ^ o c <br /> BUILDING CONTRACTOR:��T 1 1 <br /> A PLOT PLAN MUST BE PROTCFEEOVANTW X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PL T PLANS n \ <br /> WILL BE RETURNED. ; <br /> x � <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP'VIEW) C S. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES T&BE SHOWN OR DRAWN TO SCALE. CY <br /> .. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, +. <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWIN : (A) BUILDINGS)TO ALL LOT LINES, (B)BUIL DING(S) <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEAS EMENT(S)TO THE ORDINARY HIGH WATER MA K <br /> R RIVER AND WETLAND AREAS,AND(D)LONS, <br /> 4. SHOW THEFLOCATIONROF TEAMof WELL(W), SEPTIC TANK(ST)AND DRAINOFIEDLD IMENS(DF)=AND ALL DISTANCES ^ • <br /> n <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. (n°� <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED, e l� <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ET .,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STA KEO SO AN ONSrTE VERIFICATION MY BE DONE WHEN (,� D <br /> NEEDED. <br /> THIS PERMIT 15 SUBJECT TO ALL CONDMONS LISTED BELOW. 9-) <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n x p <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE JALLOWED UNLESS SPECIFICALLY PERMITTED. B <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS; ETC.,ALLOWED WITHIN THE REQUIRED WATERU r <br /> SETBACK AREA. \ <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLONIV FOR PRIVATE RESIDENTIAL GARAGE/570RAG ONLY. C <br /> NOT TO BE USED FOR HUMAN HABITATION. E <br /> 6. <br /> 7. <br /> I declare that this application(Including any accompanying schedul9)has been examined by me and to the best of my kno edge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all informatior <br /> contained in this application(including any accompanying schedule)land I further declare that I recognize that this informat n I rT c <br /> am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I further acc pt all <br /> liability that may be a result of the County of Burnett refylnq on thisltnformatlon I am providing In this application. I agree I� .i n•.�b v,� t— <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the abov <br /> described premises at any reasonable time for the purpose of Inspetton, s n y <br /> OWNER'S SIGNATURE <br /> n 'i 53 7 <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSU N g c <br /> c� <br /> EXHIBIT <br /> W <br /> W <br /> Q <br /> F- <br /> J <br /> Q <br />