Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMIT§�N 3 <br /> COUP, <br /> a <br /> OWNER TELEPHONE .m p' <br /> f Vli <br /> MAILING ADDRESS <br /> 5 <br /> PROPERTY ADDRESS ' fJ S7" <br /> LEGAL DESCRIPTION(see tax receipt) ct 4 , 6 5 5X !l �3b3P1 I C <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ cn ° <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ p(N� R, <br /> T. <br /> STRUCTURE/ADDITION USE: it— ' 0 <br /> (Home/Cabin;Commbrcial B ness;Bedroom; De k;etc.) cn <br /> ��� v <br /> BUILDING CONTRACTOR: <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> 3 ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> M <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> n z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 3 o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS (EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m <br /> NORTH (N). o <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 Z <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 9 <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. 9 <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <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. 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. <br /> �n <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z <br /> ° <br /> CONDITIONS OF PERMIT: 70 — <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT I rl <br /> ISSUANCE. / <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. �J <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY P <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> c�D n�i r 00 Q <br /> m <br /> 6. m 3 am 0, T x <br /> a m C y vi <br /> o <br /> 7. Z � m ° <br /> o r Tom : <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my D <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of ,: o- (P <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m O . ma <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 <br /> providing in this application. I agree to permit count officials char ed,with administering count ordinances or other <br /> P 9 PP 9 p Y 9 9 Y C <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> ° (D <br /> a) <br /> SIGN HERE /�. - _ (� C `�' 7 <br /> a <br /> (si na re of owner r building contractor) V`i (�} (date) <br /> ZONING ADMINISTRAT R � '��' � � <br /> BUR.NETT COUNTY Cn(A�, f N <br /> N (T N N O O <br /> (T C) (T Ut O O <br /> TOWNSHIP PERMITS MAY BE REQ¢ WqG <br />