Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No.102,Siren,WI 54872 Office of Zoning Administrator - 0 o <br /> APPLICATION FOR LAND USE PERMITS <br /> r <br /> (�p-7 C <br /> OWNERCII� tS 0.k W�Ie-Y-F2_ ��v�elr TELEPHONE /--/0 l- 1-7-77 o <br /> e^ 1 O <br /> MAILING ADDRESS S-r�.� MO <br /> E+� <br /> PROPERTY ADDRESSa6a7o Wf'St L, seE-r LQITe <br /> 1P <br /> LEGAL DESCRIPTION(see tax receipt) '�4 Qo�y 3 1`3 O3 �00 CD <br /> DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ c o <br /> TYPE OF PERMIT(S): a <br /> FILLING,,/G\\ ElElRADING CAMPING UNIT SUBDIVISION El <br /> STRUCTURE/ADDITION USE: Oyyte- <br /> (Hom /Cabin; Commercial Business; Bedroom; Deck; etc.) m <br /> II ,,1t - M -71 S7 o <br /> BUILDING CONTRACTOR: �Cc t c 1'� t~� r5 t'D`amu ) n <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81h X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O UI <br /> 77 N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> ?l O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m 11 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m -,- <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. <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. 9-1 N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS 2. � <br /> MUST BE SIGNED AND DATED BY THE OWNER. / �/ U Il, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFIC N M �( ° <br /> NEEDED. � J� <br /> w <br /> ian. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 4 / w ry o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT CO <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. �ON//VG �NT� I 11 �1 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. ((( p l�J( <br /> 4. NO STRUCTURES, INCLUDINGRETAININGWALLS, ETC, ALLOWED WITHIN H iEQUIREQ WATEFj <br /> rSEITBACK ARE �tY� �-'r <br /> 5._ V�Y IItiQ } X 0r- DODO V <br /> �/yy �/ 3-Q\`.3�/�y/__ (,.ri le +7d �' "IU�� 0 3 a Om °" aM <br /> Z COD <br /> $7' Ate�� ;A � IICG/lt ,�.f�`�'�I✓�y I ( eSS ' !/`Q '� (� ° E -n m <br /> Ppb P-affY n9�c ) Y Y G)- ` : D <br /> I declare t at this a I�catlon I c u n ac a i hedule has been examined b me and to the best of m <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of d m r- v, C <br /> CL u, • <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize m o 0 <br /> CD <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- ; I <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 w <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other ; Cn <br /> authorized perso to hav a to the above described premises at any reasonable time for the purpose of inspection. T m o <br /> SIGN HERE 3-«°°5 <br /> (sign tura of owns r b ilding contractor) (date) CL <br /> ZONING ADMINISTRATOR — <br /> ... lis 'AfA� n�i <br /> rpA t Sn�I�Q�' TOWNSHIP PERMITS MAY BE REQUIRED 1' <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />