Laserfiche WebLink
Burnett Coui)ty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Admi*trat or-0V o)? <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> y O <br /> Q <br /> OWNER ;� L9�� rd�X /J SSG, .L/Y C TELEPHONE <br /> lir <br /> 1RHOME ADDRESS <br /> �(s G�ed- . r .2d - ib W <br /> 0 <br /> 0 <br /> EMERGENCY/FIRE NUMBER i Sys ROAD NAME6Q1j Sr r �~ <br /> UDIZZ <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ PRIVY ❑ �f <br /> TYPE OF PERMIT(S): a <br /> FILLING/G DI ❑ CAMPING UNIT ❑ SUBDIVISION ❑ S. <br /> STRUCTURE/ADDITION USE: 66N.4 S L S IZ e Q c S-0 M. <br /> (Home/Cab ; Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: N Ljj-#V4 Cgee 5t <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 61A X 11 SHEET OF PAPER. ANY IN OMPLETE OR m a <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 H <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0C <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. . "m W � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE im n <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 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. P <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. n <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N XJ <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. v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q S <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o I <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT L <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. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. oddpQo�v <br /> 10 <br /> R I gill 6. a mCrNi, Noo <br /> N O 0 f0 <br /> 7. o ; <br /> —� E m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G�off <br /> C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of n <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- ; m <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying ori-this information I am m <br /> providing in this application. I agree to permit county officials charged with administe�d u ori ces or other E m <br /> authorized person to have access to the above described premises at any reasonable time s i spection. <br /> 40 <br /> rte, m <br /> SIGN HERE &2044 &0*06 aw,-1,�— a4&4 <br /> (signatur of ownqW building contra or) ' <br /> ZONING ADMINISTRATOR �J ' m C I 3U�NE " 6" <br /> v�wv+tnwtn� <br /> ZON/NNNu, NNOM <br /> G � � o ��oo <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0 0 0 0 0 <br />