Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v �p z <br /> APPLICATION FOR LAND USE PERMITS 3 ° <br /> OWNERj 1 0 <br /> RR Kkr + �o�bt� SN�AIc�rS TELEPHONE G2\`d- �r"l5- x`19`1 0 �.. <br /> q r / a n P1 `1 � <br /> HOMEADDRESS 1 13� �G K R 1\�I L DC`�f; 1AI�r�-1- ri M ' N N <br /> �I r e <br /> EMERGENCY/FIRE NUMBER 1\1n� ROAD NAME (Ott 5 <br /> LEGAL DESCRIPTION (see tax receipt) .W 1 \ G m <br /> DWELLING/BUILDING ❑ GARAG, CCESSORY STRUCTURE ADDITION El PRIVY ❑ rn o <br /> TYPE OF PERMIT(S): � c <br /> FILLING/GRADING 11 CAMPING UNIT 1:1 SUBDIVISION El S. <br /> p 1 5. <br /> STRUCTURE/ADDITION USE: GOL A StO r RES`; <br /> ` p (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) m <br /> BUILDING CONTRACTOR: �f:t� r\ SOA/ GO NSA. G n <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3. d <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O _ fW <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 O m <br /> In <br /> "n C <br /> Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> n <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 a <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <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. o C <br /> o 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN q 0 -- <br /> , <br /> NEEDED. ® �, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z <br /> CONDITIONS OF PERMIT: p 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> Cj- <br /> ISSUANCE. 1 <br /> y 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> --43. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> v 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> TRACK AREA. <br /> D <br /> �iJ / Cv CD W Fi Cvm <br /> 6. m 3 a � Q .G <br /> M <br /> 7 z : y � <br /> . <br /> o : <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my L7 c p <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m C <br /> all information contained in this application(Including any accompanying schedule)and I further her declare that I recognize <br /> (nt`` CDm <br /> that this Information I am providing will be relied upon by the Co kfBurnetft Wisconsin in determining whether to is- W O <br /> sue a permit. I further accept all liability which may be a resultf fBurnett relying on this information I amproviding in this application. I agree to permit county officia ao <br /> tering county ordinances or other m <br /> authorized person to have a ass to the above described pre ises at n " e for the purpose of inspection. T <br /> (� cs <br /> SIGN HERE `O VE r lj <br /> (signatu e o owner or build! r) (date) <br /> ZONING ADMINISTRATOR CAL--=L� <br /> '• <br /> N N(T NNUI CT <br /> � T' (�fl fl O fT PPP <br /> VOWNSHIP PERMITS MAY BE RL�UIE[T 0 0 0 0 0 0 0 <br /> ^'7000 000 <br />