Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No. 102,siren,WI 54872 Office of Zoning Administr for *0 0 z <br /> APPLICATION FOR LAND USE PERMITS P <br /> r <br /> y o <br /> f' c <br /> OWNER /�/r /ChQ,�/ TELEPHONE n �J <br /> m .Y" <br /> MAILINGADDRESS �y8 <br /> �7 � o <br /> PROPERTYADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) L,OT `q r SoC5'74��es 5-/3 <br /> m <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ CO a <br /> TYPE OF PERMIT(S): Cr <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: o <br /> (Home/Cabin, Commercial Business, Bedroom; Deck; etc.) m V <br /> BUILDING CONTRACTOR: Se <br /> v C1 <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> � y S C <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p m <br /> n n <br /> -n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n [� <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m 9 <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. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO O <br /> BUILDINGS, ROADS, LAKE, LOT LINES. 1 <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 7 N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE P ANS0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN <br /> NEEDED. 0 (� <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z (� <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT V �1 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. -� o <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 /> X coo r 0QnDO 'D <br /> 6. f m <br /> COD 0� <br /> 'o p m C y y o = 3 <br /> 7. Z w' m o co <br /> 9 m Tom : : m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best o m - A <br /> PP (� 9 Y ) Y Y � �� C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accura y of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recoC nize U m m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether is- (D n : C <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 d o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or c ther o (D <br /> authorized person to have access to the above described premises at any reasons T pd peC ion. <br /> nn <br /> m D : <br /> SIGN HERE _n <br /> fA n <br /> ( ' ature f ner or building contractor) DEC '(date) o <br /> ZONING ADMINISTRATOR I LEC 2 ? 2UU4 �- 0 ' <br /> fA fA EA N <br /> URNETTCOUNTY �o " oww � o <br /> TOWNSHIP PERMITS MAY BE REQUIRE ��ll d <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS 'IvAP <br /> 1et4erq- perMt-+ maI, V4 -[vM'aae'l <br />