Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator o 0 <br /> APPLICATION FOR LAND USE PERMITS 35T 0 m <br /> OWNER /rOL <br /> TELEPHONE 7 f <br /> d <br /> � I A <br /> MAILINGADDRESS lam/�I'1? �,.t-T I vy\ <br /> PROPERTYADDRESS -� t" k <br /> LEGAL DESCRIPTION(see tax receipt) ' cn <br /> T $ a <br /> DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE ❑ ADDITION rn <br /> TYPE OF PERMIT(S): `v <br /> FILLING/GRADIN ❑ CAMPING UNIT ❑ S BDIVISION ❑ °' <br /> STRUCTURE/ADDITION USE: <br /> n (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) y Olt <br /> BUILDING CONTRACTOR: I m <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 m o4 <br /> A y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) Oo <br /> Tz <br /> LL <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C7 m ;o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). c <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <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 U� O <br /> BUILDINGS, ROADS, LAKE, LOT LINES. i O <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRAD I Iv <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, NTRAC ( F� <br /> MUST BE SIGNED AND DATED BY THE OWNER. C o <br /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFI TION 90"4w-WHEN '» o 0 1 <br /> NEEDED. r' <br /> BURNS <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. co Z 1 <br /> CONDITIONS OF PERMIT: 2ON�NG LINTY c <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT `7 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Q <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 /> $ETBACKAREA. r� ^•^ J <br /> 5. ,ta'-Un •,}-V�. Jt �,LC+/�Q L�� ��ji�1 � � <br /> G{CLtQ> 'r '0 v n v m <br /> 6. �' 3 a <br /> a m cN o 3 <br /> Z 0m o -� <br /> 7. o M <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j c <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d <n <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize 0i m F i o i m <br /> CD <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- ff� <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 W m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> (D m <br /> SIGN HERE <br /> ( i ature of wn u din nuactor) (date) a <br /> ZONING ADMINISTRATOR ICY) l O <br /> r EA EA fA fA�N <br /> N O(T N O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED v <br />