Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator W � z <br /> APPLICATION FOR LAND USE PERMITS a C � <br /> OWNER �_ TELEPHON G 'f, <br /> j2 a' c <br /> MAILING ADD��ttES��S -S C <br /> f�OT TrA( S £ <br /> i � rt <br /> PROPERTY ADDRE 5 _ <br /> /-t fJ <br /> c <br /> LEGAL DESCRIPTION543 0 <br /> v <br /> .a�. i.✓G/t. LoT/"/ .2-6?* z ooz?ooE. <br /> SINGLE FAMILY DWELLING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ STAIR ❑ ^' o_ a <br /> TYPE OF PERMIT(S): <br /> FILLING/GRAQIjJCy❑ CAMPING UNIT ❑ UNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK 13 <br /> STRUCTURE/ADDITION USE: f1,6oFA-J(:X )< Z <br /> (Home/Cabin; Commercial u ness; Bedroom; Deck; etc.) o_ ° <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Vx X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT P NS <br /> WILL BE RETURNED. a <br /> o_ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) c <br /> r c cJ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BES 1OWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BL ILDINGS/STRUCTURES (EB)AND ALL NEW y <br /> BUILDINGS/STRUCTURES (NB),INCLUDING DECKS, FORCHES AND OTHER STRUCTURES, m '9 <, <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: ( ) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) ^ <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREM NT(S)TO THE ORDINARY HIGH WATER MARK 2 <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF), AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. o'o <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITE , ENGINEER, BUILDER, CONTRACTOR, ETC.,THE E <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER a c, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 7 r� <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELO : <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. p <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Er <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ET .,ALLOWED WITHIN THE REQUIRED WATER yp� Ci <br /> SETBACK AREA. Yj <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE Of LY. <br /> NOT TO BE USED FOR HUMAN HABITATION. £ <br /> 6. <br /> Dr)LLQ DGS <br /> 7. <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowled Is o2 <br /> contained <br /> and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information o > <br /> contained In this application(including any accompanying schedule)and I further declare that I recognize that this Information "� N C H N > <br /> am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accept all <br /> liability that may be a result of the County of Burnett relying on this information I am providing In this application. I agree to — n _ <br /> permit county officials charged with administratlnq county ordl o other authorized person to have access to the above- o n <br /> described premises at any reasonable time for <br /> [he purpose nsp o <br /> OWNER'S SIGNATURE <br /> _ (date) <br /> N F <br /> ZONING ADMINISTRATOR <br /> c <br /> 8 C: <br /> TOWNSHIP PERMITS MA BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YFJkR FROM DATE OF ISSUANCE o <br /> "? <br />