Laserfiche WebLink
6-n tmy <br /> Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator -0 a Z <br /> APPLICATION FOR LAND USE PERMITS 3 4 <br /> w <br /> Sett /"h.�s <br /> OWNER TELEPHONE <br /> ii <br /> HOME ADDRESS f _ 0 <br /> EMERGENCY/FIRE NUMBER /A< ROAD NAME <br /> �.. <br /> LEGAL DESCRIPTION(see tax receipt) � r `S'� ' T3 8'Al ?)Y� / m <br /> W m <br /> n <br /> N <br /> 0 <br /> TYPE OF PERMIT(S):DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION- <br /> Cr <br /> CL <br /> N <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> f y ct <br /> STRUCTURE/ADDITION USE: r 36 XQ ID 1 rl ot—) <br /> —' <br /> (Home/Cabin; Commercial Business; Bedroom;Deck; ) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR 3 V ' <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m M <br /> ja N 0V <br /> DIRECTIONS FOR PLOT PLAN DRAWING' (AERIAL OR TOP VIEW) 0 <br /> Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m jp <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO mC 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N I <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. m c <br /> o � Q <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE Cr <br /> ISSUED. I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z Q <br /> CONDITIONS OF PERMIT: 13 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT r Q <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. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> m <br /> 6. 3 a ;M0 <br /> > <br /> M w w > <br /> w C w . <br /> 3 <br /> 7. Z i " m °� i <br /> o <br /> a.m: <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d C <br /> all information contained in this application(including an accompanyingschedule and I further declare that I recognize 0'm <br /> PP ( 9 Y 1 9 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- y : : p <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. T <br /> CD <br /> m : <br /> SIGN HERE 3/J <br /> (signet a owner build g ractor) (date) <br /> *P31ZONING ADMINISTRATORx <br /> N 46NfNJNC' [T <br /> N f 71 O N O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 000 <br />