Laserfiche WebLink
Rurnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v ci Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> 0 <br /> N 0 <br /> OWNER l7IrRt70,'U C2,qDAC TELEPHONE <br /> HOME ADDRESS IDS) <br /> 9 <br /> EMERGENCY/FIRE NUMBER ¢ ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) <br /> L b y <br /> TYPE OF PERMIT(S): <br /> DWELLING/BUILDING ElGARAGE/ACCESSORY STRUCTURE I� ADDI ON ❑ PRIVY ❑ y o <br /> � <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SU DIVISION ❑ n <br /> <. <br /> STRUCTURE/ADDITION USE: vf <br /> s <br /> Home/Cabin, Commercial Business; Bedroom; Deck;etc.) <br /> y <br /> BUILDING CONTRACTOR: I✓ <br /> Er <br /> T <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. -n 3• J <br /> O { <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 w <br /> -n o <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n � �L ? <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m o p A <br /> NORTH(N). C Co n <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 <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO O <br /> BUILDINGS,ROADS,LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. Q <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR,ETC.,THE PLANS 0 C, <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 <br /> NEEDED. a Q t <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT C? <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 �4 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> 6. m. y m O O V <br /> ,o CamCR CL M <br /> 7. N H N fn 0 <br /> O m W i <br /> C0 <br /> : M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my O <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of ' C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize `n° m m <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is. <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 <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other <br /> D <br /> authorized person to have access to the abc a described premises at any reasonable time for the purpose of inspection. m <br /> b m <br /> \SIGN HERE <br /> sign ure of o r o �nt�radtor) (date) <br /> ZONING ADMINISTRATOR <br /> wwVwtoto— <br /> N N Ut N N fn N <br /> Ut N O Vt,01 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0l�0 0 0 0 <br /> 0000,000 <br /> \i <br />