Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator1 z <br /> APPLICATION FOR LAND USE PERMITS 3 ; p <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> in actor- B ` <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with <br /> described and located as shown herein. The undersigned agrees that all work shall be done <br /> a110 ther V <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y ° <br /> m <br /> OWNER <br /> TELEPHONE <br /> HOME ADDRESS m '— <br /> EMERGENCY/FIRE NUMBER c'p <br /> &V ROAD NAME U <br /> /SCC <br /> LEGAL DESCRIPTION(see tax receipt) <br /> CONTRACTOR /J^f N <br /> 9 (e e O <br /> TYPE OF PERMIT(S): DWELLING/BUILDINGnn <br /> GARAGE/ACCESSORY STRUCTURE ADDITION <br /> 0 <br /> N » <br /> SANITARY PRIVY FIL NG/GRADING CAMPING UNIT <br /> SUBDIVISION <br /> Z <br /> STRUCTURE/ADDITION USE: I .n �GJ ��/ l ` P m <br /> (Home/Cabin;Commercial Bu/si'n s; Bedroom;Deck;etc.) n <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INC MPLETE OR ° <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) A b' <br /> O <br /> 1. All required dimensions or distances to be shown or drawn to scale. z S <br /> r <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate O ° <br /> North (N). m <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of C ° <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. m <br /> 4. Show the location of the well (W), septic tank (ST) and drainfield (DF), and all distances to buildings, <br /> 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 must be <br /> signed and dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- C <br /> FORE A PERMIT CAN BE ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. ° <br /> CONDITIONS OF P RMIT: <br /> ° <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 7u <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWEDUNLESS SPECIFICALLY <br /> PERMITTED. 7CJ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> 5. OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 3. F <br /> f m N v m r D D p <br /> a ° C <'' � � A of m <br /> m F� a m R <br /> _ cn <br /> m <br /> o ac [ A <br /> declare that this application (Including any accompanying schedule) has been examined by me and to the best of m � C <br /> nowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of o <br /> f O: <br /> II information contained in this application(Including any accompanying schedule)and I further declare that I recognize ' d'C : m <br /> u m u O <br /> tat this information I am providing will be relied upon by the County of Burnett Wisconsin rt determining whether to recognize <br /> o m o <br /> us a permit. I further accept all liability which may be a result of the County tt Burnett relying to this information I am o �^ o <br /> roviding in this application. I agree to permit county officials charged with administering county ordinances or other i 0i <br /> 0 <br /> uthorized person to have access to the above described premises at any reasonable time for the purpose of inspection. : a : H <br /> 3 : <br /> IGN HERE <br /> (signature of owner or building c ntractor) ro ; <br /> �r yrdate) i o i ' : i <br /> ' <br /> JNING ADMINISTRATOR I i Dyl 1 31995 i� S <br /> TOWNSHIP PERMITS MAY BE REQUIRED _ 8 0 <br /> 66 9"(n N .UN, Om <br /> m <br /> 000o0o0m <br /> 00000000fn <br /> Gly. �nT /0- iy-�S <br />