Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator _0 ci Z <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> ` N O <br /> 03 - <br /> //q �j i N <br /> OWNER t P_S I L LEPHONE 76f/ � 5,.3f�(Oa <br /> � vJ1 <br /> MAILING ADDRESSerlis J <br /> r � <br /> a �h� 6 .T <br /> PROPERTYADDRESS .� <br /> LEGAL DESCRIPTION(see tax receipt) PL/ coil /o J� -rgox R14 <br /> DWELLING/BUILDING 1:1GARAGEIACCESSORY STRUCTURE 11 ADDITION U) n <br /> TYPE OF PERMIT(S): c 4 <br /> FILLINGIGRADING ❑ CAMPING UNIT ❑ SUB IVISION ❑ n <br /> S. <br /> STRUCTURE/ADDITION OSE: CA /)( / G�G/t/ /-}f�`� �(J/� 0. <br /> (Home/Cabin; Com7lercial Business; Bedroom; Deck etc.) ,.,-- <br /> C d <br /> BUILDING CONTRACTOR: 5F04 <br /> m <br /> � � 3 <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m0 <br /> c O <br /> DIRECTIONS FOR PLOT PLAN DRAWING, (AERIAL OR TOP VIEW) O m <br /> T a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n0 A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m :° <br /> NORTH(N). <br /> A <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO M _I� 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. I o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO f� <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 <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. <br /> o � � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a Q <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z ZZ <br /> CONDITIONS OF PERMIT: P n <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT RO, <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 t <br /> S TBACK AREA. <br /> 6. Uoncre-he f a.+ -� la.�e. IYIu,S4- be r._MoVe <br /> ,ZI M DODO M <br /> C W <br /> m c m n m m � f m <br /> 6. F3 ' Fns -JA <br /> -� p N C h N F = 3 <br /> 7. Z C N N O 2 <br /> m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m — °i �»: D <br /> PP , 9 y ) Y Y ; Vic : v : C <br /> knowledge and belief it is true, correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m E [ m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- `� I W O <br /> sue a permit. I further accept all liability which may be a result of the County of Burns on this Information I am ' m ` o <br /> io <br /> providing in this application. I agree to permit county officials charged with admini n r other °i <br /> o m <br /> authorized person to have access to the above described premises at any reasonable r e f e <br /> n : <br /> n . <br /> SIGN HERE QGL n <br /> (Signatu of o(w�ne'r]o�r builda9 con rector) X11, NOV (data) 0 : <br /> ZONING ADMINISTRATOR f 1 L(t,I l( I y <br /> NET COUNTY <br /> N <br /> COUNTY Go� oU` � No <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING C> <br /> JULSPER IT SHALL PIRE ONE-YEAR FROM DATE F ISSUANCE <br /> �la�t �i�n 11Pl b -6,6 <br />