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 . <br /> N <br /> C <br /> CD �O <br /> OWNER T TELEPHONE <br /> C <br /> MAILING ADDRESS 21 ? ) f , <br /> 0 <br /> PROPERTY ADDRESS �'IFF LRAIE DAiIIB <br /> p> �D-f I3 er-;x � , -q)-l�o c CnCDLEGAL DESCRIPTION(see tax recei tC <br /> gyp( 0 <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ILy ADDITION ❑ v� 0 <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑11 CAMPING UNIT ❑ SUBDIVISION ❑ 2a' <br /> STRUCTURE/ADDITION USE: J&D/Y1E b Ds a K Z ;3p- 414 2 I& <br /> -// (Home/Cabin,Commercial Business; Bedroom; Deck;etc) v <br /> BUILDING CONTRACTOR: L/AAD 7J L 5,'Jz.4r <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. T <br /> .71 N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) CI <br /> n 0. <br /> -n O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS (EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH (N). rCh 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m — o <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF 0 Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 1 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 <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. <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> I <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. <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 vrrDiO > <br /> d <br /> 6. <br /> 3 nO Fam A <br /> 'O N C(00 y N O � 3 <br /> 7. o m En-'Z <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my : <br /> G) A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o mCDy <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 f relying on this information I am m <br /> providing in this application. I agree to permit county officials char i I unty ordinances or other o <br /> authorized person to have access to the above described premises at'J � e purpose of inspection. `D o : <br /> SIGN HERE � a, �GIiCt9l� 0 yprl�5t.�r. �� a <br /> (signTa� re of owner or building contractor) �c�^(date)T— <br /> ZONING ADMINISTRATOR v I m I IoY I <br /> ENA EA EA O0 � <br /> TOWNSHIP PERMITS MAY BE REQonYG TO <br />