Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administra or - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> m o <br /> OWNERTELEPHONECL <br /> CI <br /> HOME ADDRESS ' s C Uj 0 <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) _l/Kco <br /> 7 7 m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ PRIVY ❑ y o <br /> TYPE OF PERMIT(S): I r <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n <br /> _ N <br /> STRUCTURE/ADDITION USE: o' <br /> (Home/Cabin; Commerclal Business; Bedroom; Deck;etc.) y <br /> m <br /> BUILDING CONTRACTOR: <br /> — i <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X SHEET OF PAPER. ANY INCOMPLETE OR � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T-n .. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p <br /> n o. <br /> Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m EF <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 Cn m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <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 r. <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. i <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. (_. 0 c <br /> IN o �y <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN a O <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT i <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> ` r <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY n) <br /> PERMITTED. 7 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> IQ 1 <br /> SETBACK AREA. <br /> 5. This structure to be used as private residential ;a T 0 r gy o o m <br /> garage/storage only. l.(Jf`l��- ° <br /> y. Not to be used for human <br /> s. habitation. _� ���._..,,[[__��� �C�U rLc�— m � 3 n m ��� � <br /> 7. �S c&'& x-6. o m C <br /> Z : y m o o i <br /> � a7 <br /> Vim. m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of o E — <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize eo O <br /> M <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 iis application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized Aeon to have acce o t above described premises at any reasonable time for the purpose of inspection. m <br /> m <br /> CD <br /> SIGN HER 15-C;2/-01 <br /> (si re of owner or buLW45 contractor) (date) <br /> ZONING ADMINISTRATOR <br /> k <br /> n <br /> 000 � <br /> N O N(nO <br /> TOWNSHIP PERMITS MAY BE REQUIRED x 0 0 0 0 <br /> 00000 <br />