Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No.102, Siren,WI 54872 Office of Zoning Administrator _U o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r � / y O <br /> OWNER J C��- P4'6v'L' r TELEPHONE ?C ! V%�O <br /> MAILINGADDRESS �J 0 n. 6 <br /> PROPERTY ADDRESS f �eL J.% L''Q <br /> 1 <br /> LEGAL DESCRIPTION(see tax receipt) t U 'l ,.._L.kQ �, 'V (y V <br /> DWELLING/BUILDING GARAGEIACCESSORY STRUCTURE 4 ADDITION ❑ qz"l m O <br /> TYPE OF PERMIT(S): iz <br /> FILLING/GR DING ❑ CAMPING UNIT SUBDIVISION ❑ ��` �,J <br /> m <br /> STRUCTURE/ADDITION USE: <br /> (H me/CaP Commercial Business; Bedroom; Deck; etc.) Q) <br /> _ m <br /> BUILDING CONTRACTOR: <br /> a <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 " <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> � � Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m S <br /> NORTH(N). y 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m a <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. 1 9 <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 SU <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS 0 I <br /> MUST BE SIGNED AND DATED BY THE OWNER. 0 <br /> 0 <br /> 0 <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 <br /> NEEDED. <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> 0 <br /> CONDITIONS OF PERMIT: w <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT , (� <br /> ISSUANCE. _ Q <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 /> X Cd ° 0 Mnf m <br /> 6. 0 'c� 3 a m F a m x <br /> 0 CD Cy .`" o � 3 <br /> 7. o <br /> m <br /> Z c y O �'< <br /> _ U, : m <br /> 1 declare that this application (including an accompanyingschedule has been examined b me and to the best of m LJ <br /> PP (� 9 Y ) Y Y <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of n ^ A <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m O 0 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> ; <br /> sue a permit. I further accept all liab ' 0' hich may be a result of the C I�-lnformation I am m O <br /> providing in this application. I ag a to pe it county officials charg7�Ed r g t o nces or other <br /> authorized perso o have access the abov d cribed premises a o e o f inspection. n O <br /> y m E n : <br /> SIGN HERE 1 <br /> (si ature of owner or building contractor) 1 e) 0 <br /> ZONING ADMINISTRA R V C o <br /> F» E»w <br /> ZA'�I14v`'� <br /> O N Ut W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIR <br /> t�OI�IM O Vl O (T CT U1 O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />