Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator a o ' �Z <br /> APPLICATION FOR LAND USE PERMITS a <br /> • � r <br /> ° <br /> OWNER C/4i"&j J�) S�77a� � T TELEPHONE s"y0._T6 yr_//7 t/� v <br /> HOME ADDRESS /yZy ,r'AGI.tJrT"� a � 0 <br /> r o <br /> EMERGENCY/FIRE NUMBER ND C.(A)Pkr ra 7 � ROAD NAME aG,� 5� 00 .. <br /> LEGAL DESCRIPTION(see tax receipt)ler .2, cs-m il l y �q /(�Ov zer-1/ y <br /> 7 // 8 <br /> 0 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION o! ' <br /> c <br /> a (v n <br /> N N <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> C <br /> I ) <br /> L� (� <br /> CIQ <br /> STRUCTURE/ADDITION USE: /f/�/Z. 1}f!�Q I� <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) 1 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR R <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T 3 CJ <br /> DIRECTIONS FOR PLOT pI AN DRAWING. (AERIAL OR TOP VIEW) <br /> 0 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m I <br /> NORTH(N). a n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m .Q 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, v <br /> STREAM OR RIVER. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- o <br /> INGS, ROADS, LAKE, LOT LINES. <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 i <br /> MUST BE SIGNED AND DATED BY THE OWNER. c <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q o, <br /> ISSUED. <br /> n <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. .. 1 <br /> _CONDITIONS OF PERMIT: c ��S <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. / <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. l� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> ;0 .00rDQ O�O � <br /> 6. � o.i6a MM <br /> aCw �" o <br /> 7. c : !A �m 1 <br /> _rA <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m _C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m ' ;U <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m O <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 <br /> providing in this application. I a9 ree to county officials charged with administering county <br /> ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> m <br /> o : <br /> SIGN HERE <br /> Islipinatpre of owner or bIdi g contrac r) (dam,) <br /> ZONING ADMINISTRATOR E i <br /> h H/H. <br /> N Nb1N VIN <br /> �Npp, PPPTOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 <br />