Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator o <br /> APPLICATION FOR LAND USE PERMITS s. <br /> r <br /> a o <br /> N <br /> OWNERJ&r,-r1 � TELEPHONE <br /> HOME ADDRESS �O 9 1 s7 Gr�1;r ,�}(, ,5���,. }�% IV A <br /> r m <br /> 0 <br /> EMERGENCY/FIRE NUMBER a q767 ROAD NAME 1/),, 4 APV ~ <br /> I <br /> 6 3,2 AaraJ <br /> V.174 P y76 <br /> LEGAL DESCRIPTIO (see tax receipt) �. G� 3 ��J/Y1 I// Gy., l y q'4.2w v 2 Pf P'4-140ca <br /> -� <br /> o <br /> C <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION Cr <br /> � a <br /> 5. <br /> w <br /> SANITARY PRIVY FILLIN DING CAMPING UNIT SUBDIVISION 0 <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Comr44rcial Business;Bedroom; Deck;etc.) v <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR T <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> 711 in <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. �A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE M n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m I 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, v Z <br /> STREAM OR RIVER. ° <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- C> <br /> INGS,ROADS, LAKE, LOT LINES. <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 ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q S Q <br /> ISSUED. a <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 0 0 <br /> CONDITIONS OF PERMI70 <br /> T: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ( / <br /> ISSUANCE. Cj <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 75 FEET OF THE OHWM OF LAKES, <br /> PONDS,RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> M � mr O <br /> 4 <br /> 3 a 4a m <br /> 70 <br /> 6. � 9C�n !^ o0_ z <br /> $ WO : Baa <br /> Ni i A <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my E Gf Cr E E ID <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of n` S <br /> all information contained In this application(including any accompanying schedule)and I further declare that I recognize o W m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Is- y C <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 d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other ; m <br /> authorized person to have acq^s jo4hq,49v9 described premises at any reasonable time for the purpose of inspection. <br /> C <br /> SIGN HERE <br /> �-o2 44 : <br /> natu a of, nor or building co a r) (date) <br /> ZONING ADMINISTRATOR <br /> MHfANiR(A� <br /> fn V1 O(!.(l1 O O <br /> TC( SHIP PERMITS MAY BE RE UIRED 0 0 0 0 0 0 o <br />