Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator 10 ° o <br /> APPLICATION FOR LAND USE PERMITS <br /> N w <br /> N <br /> C <br /> OWNER �� a -2_y �� \ TELEPHONE <br /> HOME ADDRESS 1 (`��-4e ` r <br /> $ $ <br /> C)fi <br /> c� 1 <br /> EMERGENCY/FIRE NUMBER el.� y W ROAD NAME <br /> 1 <br /> LEGAL DESCRIPTION(see tax receipt) Q a� S MCI <br /> TYPE OF PERMIT(S):DWELLING/BUILDING _GARAGE/ACCESSORY STRUCTURE /rDDITION n �v <br /> 10. <br /> SANITARY PRIVY FILLING/GRADING-CAMPING UNIT-SUBDIVISION °y v' <br /> FILLING/GR� ca I y <br /> 1fir <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) v <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR O _ <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) <br /> T o ^I z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m 0 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE c <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m a <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, c <br /> STREAM OR RIVER. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- I <br /> INGS,ROADS,LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS S o <br /> MUST BE SIGNED AND DATED BY THE OWNER. to <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 2 <br /> ISSUED. <br /> Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. p <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. v <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVERUNLESSSPECIFICALLY PERMITTED. <br /> 5. (hq�uc� Tura sl <br /> 1-6nk mwsf- 6,e- 3o 3=t-4 � P6d Pft1l�1v3 a l's "DQ QOQ O v <br /> 7. =y: m <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my Gf C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of WzCLI <br /> all information contained in this application(including any accompanying schedule)and I further declare that I reco ize m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin '1 or <br /> Is- m i v <br /> sue a permit. I further accept all liability which may be a result of the County of a ly.%o tFiis t am E m <br /> providing in this application. I agree to permit county officials charged with ad R9,j o^uttY ordinances or or E m E <br /> authorized person to have access to the above described premises at any reasons a for the purpose of Inspect n. m ; <br /> + m i <br /> H <br /> SIGN HERE � <br /> (s natu of owner or bull tractor) , `, +1 (da <br /> l._ Rill <br /> t N <br /> ZONING ADMINISTRATOR 40 w w <br /> N NCn NN NN <br /> �P P O P P O O <br /> 0000000 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />