Laserfiche WebLink
�nCOhr�' <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N O <br /> / p N <br /> OWNER PvL � ,DIANE (/� R QNNO TELEPHONE '-7/5 SiG(v 7,P'71 O <br /> HOME ADDRESS / / iU , VLC 6Z WasrM 01 ST�g r 1 <br /> EMERGENCY/FIRE NUMBER y%S3 ROAD NAME <br /> nor ( to Towv6l; 140 Nnt J <br /> LEGAL DESCRIPTION(see tax receipt) ' m <br /> 0 <br /> r. <br /> DWELLING/BUILDING 2r GARAGE/ACCESSORY STRUCTURE El ADDITION 0 PRIVY 0 v) O <br /> TYPE OF PERMIT(S): C <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n <br /> STRUCTURE/ADDITION USE: d2M E Xq X S$ W"th /D FaOT yec -�. hen PSS FRoyT 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) C/3BUILDING CONTRACTOR: �g�E &( 406 S . -Xmc G (� <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/x X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> a cG <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 n <br /> n Z <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 C 9 n <br /> NORTH(N). y 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 Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <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. Iv <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS ) QJ <br /> MUST BE SIGNED AND DATED BY THE OWNER. m c <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 41 <br /> Cr ° p , <br /> NEEDED. �- l <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c ` <br /> CONDITIONS OF PERMIT: <br /> Q <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. 1 <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. q <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER d <br /> SETBACK AREA. 1 /�,' `Q <br /> 5. Al/ C .�J �lJl A LV`'r40-- ;ov0r. � v�vv <br /> 6. � m cm 09� M <br /> Z m COD q <br /> 7. 0 : : =?I : .'a <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G� c <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 m <br /> L7: <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 m ? E <br /> authorized perso a access to toolbove described premises at any reasonable time for the purpose of inspection. m <br /> m : <br /> / m <br /> SIGN HERE 1- 6— <br /> — d o <br /> (sig ature o er or bdin tr ,srr)) �. (date) ` R <br /> ZONING ADMINISTRATOR <br /> fn fn cn <br /> N N N <br /> Vt Vt 01C34 O p <br /> TO NSHIP PERMITS MAY BE REQUIRED 0 o 0 bob <br /> o <br /> 0 <br /> boov- <br /> b <br />