Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,W154872 Office of Zoning Administrator v G) Z <br /> APPLICATION FOR LAND USE PERMITS 3< - <br /> r <br /> N � <br /> CD <br /> OWNER � {—eGr-Gf'� TELEPHONE K051- yG�IJ_ t 5 _ <br /> rr d <br /> MAILING ADDRESSS,�ti / k 12�,Q ` 3n 1�- O <br /> m <br /> PROPERTYADDRESS <br /> I W <br /> LEGAL DESCRIPTION(see tax receipt) <br /> ` L Q Cn CD 0 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ U) 0 <br /> TYPE OF PERMIT(S): I1 <br /> ('// <br /> FILLING/GRADING ❑ y� GU <br /> CAMPING UNIT ❑ SUBDIVISIONS Cs, j V � �t��{ `�— n T- <br /> STRUCTURE/ADDITIONOSE: �1 ' 1 r ' L 0 1 f 0 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) rn <br /> BUILDING CONTRACTOR: <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. n <br /> M N O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> T 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). <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 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 <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 <br /> uz 0 <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN st <br /> NEEDED. M. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z <br /> CONDITIONS OF PERMIT: P �C, <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <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 /> 6. m m r 0 M M * m <br /> v3nm ,c mM <br /> ' COD c00a— <br /> 7. Z N m ° <br /> o m•2 : � <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my — r^ O <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of oO v, C <br /> L <br /> Cv, : ;a <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize (D O : 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 in this application. I agree to permit county officials charged with administering county ordinances or other cl�Q; <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. fD cn <br /> o : <br /> m m <br /> SIGN HERE <br /> n : <br /> afar f caner or building contractor) (date) <br /> ZONING ADMINISTRATOR <br /> OEA fA fA fA40 N <br /> N N N N O O <br /> QNOIT CF 00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />