Laserfiche WebLink
G2 L c`Z__YV_) Al <br /> Butnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o o <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> Sheri �- SSC y&C o <br /> 4 O <br /> OWNERI TELEPHONE /a f%pL9g O <br /> m <br /> c. <br /> HOME ADDRESS I A'700 ' ' N vt'm e " y v w <br /> EMERGENCY/FIRE NUMBER a 173 ROAD NAME (�C) CD P-4- j <br /> 36- 0F <br /> 1/T39/ 812W t ('rrs 0 <br /> LEGAL DESCRIPTION(see tax receipt) X0y <br /> 0 <br /> n <br /> DWELLING/BUILDING {t7�J/GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ ) (n o <br /> TYPE OF PERMIT(S): 1-1�Cr ' <br /> FILLING/G D)IN(ff❑ CAMPING UNIT 1:1SUBDIVISION ❑ <br /> lam/ t r) N <br /> STRUCTURE/ADDITION USE: 0 <br /> (H <br /> o <br /> me <br /> //Cabi ; C mer ial�uysiness(^Bedroom;Deck;etc.) en <br /> BUILDING CONTRACTOR: ✓(ti�I , <br /> v <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. 0r, <br /> M y W <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m 'b <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m 19 <br /> NORTH(N). y c <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. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO t <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN q ° <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z i <br /> CONDITIONS OF PERMIT: a <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ➢.) Q <br /> ISSUANCE. 30 � <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. C ` (\ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. —O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> Xv0r�- oo •v <br /> ai <br /> 6. �• � CDCa 09mR <br /> 7. Z . y <br /> o : <br /> =CA m <br /> Cr <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my v3 c <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of [� o <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 m' <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. m <br /> m : <br /> CD : <br /> SIGN HERE <br /> (signature of ownerr Idin ntr r) (dote) \ <br /> ZONING ADMINISTRATOR <br /> Fn ei cn d+w v+ <br /> N N(TNNN [n <br /> fT N OtT U100 <br /> TOWN HIP PERMITS MAY BE REQUIRED <br /> 00000 0 <br />