Laserfiche WebLink
Burnett Cdjnty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator _0 o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> _ r ��• <br /> N O V <br /> N <br /> C <br /> MINER D(AV 1 M —1 Vkh TELEPHONE W5 3 y9 aft _o <br /> MAILINGADDRESS �� Itye.-I <br /> rnrn rc <br /> PROPE17f WRE S 4 3 5) Rj N• Sire- 44-R-5 �o <br /> LEGAL DESCRIPTION(see tax receipt) <br /> 1 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ® ADDITION <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑� GLSUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: ,J a n7 (2, DIIO , o � <br /> (H me/Cabin; Commercial Business;Bedroom; Deck;etc.) rn <br /> BUILDING CONTRACTOR: -3�fF [/ Cd,6 <br /> M <br /> M <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. p <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> TZ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF o <br /> ? <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <br /> 0 <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 V} <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 /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE V IFftiA D &,BE DONE WHEN o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. ✓G ;> . o <br /> CONDITIONS OF PERMIT: a N� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS <br /> O;'I�RMIIT <br /> ISSUANCE. cc(���r // <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG <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 /> SETBACK AREA. <br /> 5. <br /> m <br /> Wr 00 n 0 � <br /> m <br /> 6. PD 3nmOn ;a <br /> 'o M C N N o j 3 <br /> 7. Z H o 1 <br /> ° m ` m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o o ? N <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize (D o mo <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 m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> � : <br /> authorized person <br /> �toJhave <br /> access to the above described premises at any reasonable time for the purpose of inspection. fD o <br /> CD <br /> (Dl/d'i./ �D i <br /> SIGN HERE 1' Ua- <br /> CIE, <br /> (signa re f owner or ii ng contractor) (date) C"� <br /> ZONING ADMINISTRATOR ` ' . <br /> fA fA'A K/-N <br /> N N N N O O <br /> NO [T (TOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />