Laserfiche WebLink
ON COMPUTE <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator SClM 0 o <br /> APPLICATION FOR LAND USE PERMITS . <br /> r <br /> OWNER ` JCS GK M Qt' 4A Crow- W1 (- TELEPHONE <br /> n <br /> r �/i m <br /> MAILING ADDRESS OBI ?! e' �nIC�� r N 5574 r <br /> PROPERTY ADDRESS 7, �' G 1 Q (fi U M) Cn <br /> 4C C <br /> LEGAL DESCRIPTION(see tax receipt) L�o1-- I V-V-t C�h 6 <br /> 1 r' <br /> zz <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE El ADDITION cn o <br /> TYPE OF PERMIT(S): 0- <br /> FILLING/GRADING 1❑ CAMPING UNIT ❑ SU,DIBDIVISION ❑ n <br /> STRUCTURE/ADDITION USE: L _ +k V�Sti Z� l /f CYO :/ U i <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; <br /> -etc.) C <br /> BUILDING CONTRACTOR: _f t'��Q Iti �_t? IVY C <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) Om CD <br /> -n CZ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n <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 ITt 3 <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 p <br /> BUILDINGS, ROADS, LAKE, LOT LINES. O <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 ha <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, ETC., THE PLANS d 2� <br /> MUST BE SIGNED AND DATED BY THE OWNER. �� J(J� 11 � �`�F <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERI9 TION MAY �jElyVj1 �' <br /> NEEDED. <br /> 001 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. b o <br /> CONDITIONS OF PERMIT: &�I/��r "'W rt <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMITZO UIV XJ ul <br /> ISSUANCE. /A/G -� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. pp <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. �9 <br /> 5. &77l /O-g'03 CD 0) r DoQvv <br /> a N C N y O_ q_ <br /> 7. o ;U <br /> _. m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of ! a <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize m O mt7 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> G : <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 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to hav ccess to the above described premises at any reasonable time for the purpose of inspection. Cn <br /> CD <br /> CD m <br /> SIGN HERE �> '� n <br /> (signatu owner or building co tractor) (date) <br /> ZONING ADMINISTRATOR <br /> Hf fA J N)(T N N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> _l !, i. - /, /1. , , atis► 4e _ .PA,4nJ . <br />