Laserfiche WebLink
�D <br /> Burnett CoOnty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> N 0 —V <br /> �1 C <br /> OWNER 6V 4rlr�' CT� Q£ N�O TELEPHONE 570- - Z?; - 57A I p `b\ <br /> HOME ADDRESS I Cf O 0,0 fti 4-e /U� / OC��S r T ��!/lJ �6_/ O( v CD <br /> CD <br /> EMERGENCY/FIRE NUMBER Sb 7-.�S3-- 5999 ROAD NAME ?4LeY fS <br /> ��X f`eQ ,e <br /> LEGAL DESCRIPTION (see tax receipt) P� .¢17�, lvS , m <br /> 0 <br /> r. <br /> ur o <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION c ' <br /> a <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 C1 . <br /> Cn <br /> (Home/Cabin; Commercial Business; Bed om; Deck;etc.) <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T n <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) g 11A x /i P' e. O o O <br /> T Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS (EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). y o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m z 3 <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> 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 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 <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. cc o <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q 0 Qb <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: A nl I ^ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT v1 I <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I <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. a /� , v <br /> 5. / :;;A.L GG. Tb bG Ax4Aj# ' c''2 O� C�rlSr1�� A oti�-h $1�� z v 0 r. o Da o -0 <br /> 6. �� r/S fi o� like - /Uv //4c., �aJ rn 3 0 m CL <br /> IMg l,,Jtfi(t,n. ` a m c W . 0 3 <br /> 7. ,L_ 'wo Osd A-2g-9- >a 6cf see4kd ,jr-/h wl�ll�,>{- ) o <br /> y : m <br /> I declare that this a plication (including any accompanying schedule) has been examined by me and to the best of my � L7 p <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of �' a C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <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 <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above Pescribed premises at any reasonable time for the purpose of inspection. m <br /> m : <br /> CD : <br /> SIGN HERE <br /> wnerorbuild1ncoactor) ate) <br /> ZONING ADMINISTRATOR F» <br /> f» v+cn cn f»f»tn <br /> N N (71NN (J�U1 <br /> V7 NO (n fT00 <br /> 0 0 0 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 <br /> 0 0 o O o 0 0 <br />