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 3 <br /> o <br /> OWNER I�tAIe r) OPi TELEPHONE '0 n <br /> 9, <br /> MAILINGADDRESS 1 3/ � �7�I5w�G�2 P�, Ob bIlud i e r,/IV f <br /> �7 lake, <br /> PROPERTY ADDRESS D(/OA 4t Vn lake, e0a d, blM b�' ' lu/t <br /> 1 ) <br /> Pew �J <br /> LEGAL DESCRIPTION(see tax receipt) �(b�/�F Tvt7,4o m <br /> a. <br /> DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ (n <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRA/DINGyEl Z&—b 'PINGGUNNIIT ❑ SUBDIVISION ❑ a �e <br /> STRUCTURE/ADDITION USE: 0 <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) (n <br /> te,�s <br /> BUILDING CONTRACTOR: C � <br /> m � <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> M °o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o Q 1 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). y v 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 v I Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <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 /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N Shy <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS 2 t <br /> MUST BE SIGNED AND DATED BY THE OWNER. ` 'o <br /> 'ti o <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: r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT \ IN <br /> 1 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. f 1 (� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY w <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> X w d m a m <br /> 6. 3on.mxa ;a <br /> v m C y T o 3 <br /> 7. w N o 1 <br /> o -�'2cl) m <br /> 1 declare that this application(including any accompanying schedule) has been examined by me and to the best of my a c 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 1 further declare that I recognizem o mo <br /> : <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 1 am <br /> L m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> m : <br /> authorized p rson o h ve access to the above de cribed premises at any reasonable time for the purpose of inspection. . <br /> m o <br /> M a a m : <br /> SIGN HERE o, <br /> signatur f owner or buildin ntractor) (date) <br /> ZONING ADMINISTItTOR <br /> T� N <br /> EfA N/N N <br /> N <br /> N N 0 O O <br /> �N OCT N OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />