Laserfiche WebLink
Burnett Counter 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATIO14 FOR LAND USE PERMITS 3. <br /> r <br /> rn o <br /> N <br /> CD <br /> C <br /> OWNER I C TELEPHONE G7? S n <br /> S v <br /> MAILINGADDRESS Q�J y� (t UCQ J r <br /> PROPERTYADDRESS o <br /> LEGAL DESCRIPTION(see tax receipt) L 0 �cr ci L_ � � �J Cl) <br /> 54, <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ O <br /> TYPE OF PERMIT(S): a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> N <br /> STRUCTURE/ADDITION USE: $ <br /> ( ome/Cabin;Commerci I Business; Bedroom; Deck;etc.) Cl) <br /> m <br /> BUILDING CONTRACTOR: m <br /> � W <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/a X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 G <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> al N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> In <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). y o <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. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o F <br /> v �J <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATTI< ��f �Oh E WHEN S <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONE LISTED BELOW. Z Q/ <br /> CONDITIONS OF PERMIT- <br /> FP <br /> / J P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTHREQUIREMENTS WITHIN 60 DAYS OF PC-RANT �20 �� <br /> ISSUANCE. _�TN� �� ) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELIN�3O�CO� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ,t' ^' <br /> PERMITTED. NQ ? <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER N CS <br /> ,SETBACK AREA. �` <br /> 5. C� <br /> l�� Z /iJaCIC f /lcsl c <br /> X <br /> M ma, 8 vnv <br /> 6. m 3m'o MO C& 7a <br /> a mcN ^ o � 3 <br /> 7. Z H o : <br /> o n A <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my — y A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m c`� iv, c <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m C o 0 <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CD� <br /> sue a permit. 1 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 d <br /> authorized person to ha a access to tjle above descrikolp-remises at any reasonable time for the purpose of inspection. m o <br /> f 7-� m <br /> SIGN HERE <br /> 11 a : <br /> (si atu of ownerrny or building c n cto ) I (date) -CJ: <br /> ZONING ADMINISTRATOR <br /> O w e» <br /> fA fA EA fA � N <br /> N (T N N O O <br /> U1 O (T (T O O <br /> TOWNSH P PERMITS MAY BE REQUIRED <br />