Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,W154872 Office of Zoning Administrator o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> w O <br /> VI <br /> C <br /> OWNER �/l <br /> `(n n n <br /> �//��.��.��{�[I � TELEF'HONE�I a /�(.l8—9 p a <br /> CD <br /> OilMAILINGADDRESS �/ -) !V (J qk- Are r/ e "`'� <br /> c <br /> r <br /> 0 <br /> PROPERTY ADDRESS <br /> � 'd <br /> / P <br /> LEGAL DESCRIPTION(see tax receipt) `�/ /� _ rCD <br /> n <br /> Q a <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ (� C <br /> TYPE OF PERMIT(S): r a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION <br /> STRUCTURE/ADDITIONOSE: G s /� . A99-i9 <br /> (Home/Cabin; Commercial uslness;Bedroom; Deck;etc) <br /> BUILDING CONTRACTOR: 0 <br /> m <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/,X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) T n cL <br /> -A o z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m X \ <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C o <br /> NORTH(N). m <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO mCENTERLINE 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. Q <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 0, <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> NOTE: BUILDINGISTRUCTURE 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 t <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT 1 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I <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. X n r D O D 0 a <br /> CD m 0 (DCL m <br /> 3 ary Ox 14 .;0 <br /> 6. a mcy " o` � 3 <br /> z y W o ' o <br /> 7. ° �' ` m <br /> - � : <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my C) C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of nA <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m 0 0 <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 o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> m <br /> Lt : to <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. T m o <br /> CD <br /> d, io <br /> C : <br /> SIGN HERE a <br /> (signature of owner or building contra or (date) <br /> ZONING ADMINISTRATOR A 06) <br /> TOWNSHIP PERMITS MAY BE REQUIRED `^``1 <br />