Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator CD- o 0 <br /> APPLICATION FOR LAND USE PERMITS a <br /> N O^ <br /> UI <br /> C <br /> OWNERt.C�K7Jd1NE !7/ /1 oN <br /> i `? p <br /> HOME ADDRESSLh(� 5+ 3O ScC p��-/6 P LCJ ��1��Ll <br /> EMERGENCY/FIRE NUMBER ROAD NAME ellgm <br /> LEGAL DESCRIPTION(see tax receipt) :25 eg—/ S"r 3 9 /Y R I Ll/ "I L i <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑❑ AT❑ PRIVY ❑ 1 N <br /> TYPE OF PERMIT(S): n 1 <br /> FILLING/GRADING ❑ CAMPING UNIT K SUB IVI ION ❑ S. <br /> STRUCTURE/ADDITION USE: 0 <br /> ( ome/Cabin; Commercial Busi ss; Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: <br /> v <br /> M <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. <br /> W <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O <br /> c <br /> ii <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <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. o <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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N Q <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. C <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN <br /> NEEDED. f ,W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o W <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Q <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. (ll <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER ^, <br /> SETBACK AREA. 1.1 `J <br /> CD m <br /> N < <br /> 6. a x c— <br /> �I VN N W 0 3 Cln . <br /> y N O O O <br /> MAY - 1 2000 I ; o <br /> 7. _y m <br /> I declare that this application (including any accompanying schedule) has be nod by me and tot est of my �� ? ` C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am rth�Sd1�1 Ei 100@i11d accuracy of n <br /> all information contained in this application(including any accompanying schedule)arp Ireclare hat I recognize �^ m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin rmining whether to is- 00 O <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 d E <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized pe have access to the above d scribed premises at any reasonable time for the pjarpose of'nspection. Tm <br /> m , <br /> SIGN HE !/"Ce/ gj <br /> —v — <br /> (signatu f aWner or building co rac ) (date) <br /> ZONING ADMINISTRATOR <br /> w�nf»tncnfn� <br /> N N u1 N N V7 01 <br /> OI (T O ut V7 O O <br /> O 0 0 0 0 0 0 <br /> OWNSHIP PERMITS MAY BE REQUIRED O 0 0 c 0 O <br />