Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> N 0 <br /> OWNER6&4fjf EPHONE 0 <br /> CD <br /> HOME ADDRESS <br /> O <br /> r � <br /> aa n 0 <br /> EMERGENCY/FIRE NUMBER oJ� ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) /-7- m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ .� y <br /> 0 <br /> TYPE OF PERMIT(S): Cr <br /> FILLING/GRADING <br /> ''❑ CAMPING.UNIT /❑ SUBDIVISIONS L3' <br /> STRUCTURE/ADDITION USE: �C V 40 / � 0 \ <br /> ���1t(H,,o--,,me/Cabin�C gm/m�ercciiaal Bu Bedroom;Beedroom; Deck;etc.) m 1 <br /> BUILDING CONTRACTOR:�ZI�u1�l to�,Xd4�fnIZ(J7AI�IL �l <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR "" 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 <br /> XI N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0o <br /> Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C n <br /> NORTH(N). y 3 <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 Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <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. d <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. to 0 I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q ° (.11 <br /> NEEDED. a "q�\ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. a <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ppQ' <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 /> m r- <br /> , Molt!m <br /> 6. �'.� 3 am 'XQ 76 <br /> m <br /> CIO y ( <br /> 7. O : N -1j � =O <br /> 0) : M <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my \ t3 c 0 <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- O <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 <br /> providing in this application. i agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. T <br /> m : <br /> CD : <br /> 4a : <br /> SIGN HERE <br /> (signatur of owner or building (date)tractor) <br /> ZONING ADMINISTRATOR e+ <br /> wfMK) MM N <br /> Ut ut <br /> N N P N N Ill O V1 V1 O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED c <br /> 0000000 <br />