Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> 7i s <br /> OWNER DA W D /l U D l p TELEPHONE L 5.33 Jr�tS n <br /> HOME ADDRESS 43n 72 LQ W S/14„ /`✓-G1rJ� AdAl <br /> EMERGENCY/FIRE NUMBER'7'� "�2 G ROAD NAME <br /> 3,11 50n-/T371oe /Sw - 32- )8- oZ-G 0_?000 <br /> LEGAL DESCRIPTION(see tax receipt) f m <br /> P cC d)00 Lo7 ptCD <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE ❑ rc <br /> ADDITION a PRIVY ❑ R rn 0 (� , <br /> TYPE OF PERMIT(S): 1V1 <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION a <br /> STRUCTURE/ADDITION USE: 1 c L_ <br /> ✓ - o <br /> �^ (Home/Cabm;in; Commercial Business; ;;rooDeck;etc.) (n <br /> BUILDING CONTRACTOR: SL / T- Er <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR In <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> :0 y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0a <br /> m Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. t7 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). 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. 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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <br /> S. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. Coo <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN W 0 Q <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c I <br /> CONDITIONS OF PERMIT: C*31 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT IkZi <br /> M+ <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. (tj <br /> 4. NO STRUCTURES, INCLUDING REWALLS, E,T�C'.�A�L,L�O/WED W T IQUIRED WATER <br /> 5. SETBACK AREA. n e / r"' _" <br /> 0 ; c' 3 0CL <br /> CD 2i m <br /> 6`. m � 3 am x <br /> /7. � r�/,I,/� 'o mCinyic <br /> 0j <br /> COD <br /> y : m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my (j c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofCL <br /> C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize CDCD <br /> M <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- : d: 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 m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m E E <br /> authorized persog to have acce to the bove described remises at any reasonable time for the purpose of inspection. -n <br /> m : <br /> CD <br /> SIGN HERE Z <br /> (signatu owner r build ntractor) (date) <br /> vk <br /> ZONING ADMINISTRATOR /)o . fn <br /> ^ to <br /> N Nfn N N MM <br /> (n (n O fn Ut O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0 0 0 a 0 <br />