Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator m - -. O <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> 0 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> described and located as shown herein. The undersigned agrees that all work shall be done in 1 ccor- c <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other _ <br /> 0 <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNERL :ELEPHONE yy o <br /> TJ kf v <br /> HOME ADDRESS Q Aie `q K 6 /f O ' <br /> EMERGENCY/FIRE NUMBER (JO ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) o ter. L T3n.,CAl— „if/ <br /> CONTRACTOR C �j o <br /> � o <br /> TYPE OF PERMIT(S):DWELLING/BUILDING GARAGEIACCESSORY STRUCTURE ADDITION 0 "> <br /> 0 <br /> O <br /> SANITARY PRIVY FILLINGIGRADING CAMPING UNIT SUBDIVISION p <br /> STRUCTURE/ADDITION USE: k N7 C <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) — <br /> o <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. I G <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 03 N <br /> T Z c <br /> 1. All required dimensions or distances to be shown or drawn to scale. m ° <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 centerli a of <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or ri/er. <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to build ngs, <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 r <br /> signed and dated by the owner. <br /> Lam, iQ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATIONBE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: _ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERM T Ui <br /> ISSUANCE. Ill <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOREL NE. Z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY D <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET 0 THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> f <br /> 6. <br /> T TT�vhP d ®LO �L�"�f in iu m a M <br /> 7. mgc ccm on <br /> O o f0 3 <br /> 9 N O N Q <br /> 6. p �n E G D <br /> M <br /> o i <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the b st of my m <br /> knowledge and belief it Is true, correct and complete. I acknowledge that I am responsible for the detail and ac uracy of B V[ G <br /> om o : <br /> all information contained in this application(including any accompanying schedule)and I further declare that I cognize m b , <br /> that this Information I am providing will be rolled upon by the County of Burnett Wisconsin In determining wh her to Is- $ 0 <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this Inform tion I am o <br /> providing in this application. I agree to permit county officials charged with administering county ordinance or other 3 ; ig <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of In _e�tlpu-.T ' 9 ` �' '• <br /> mm m : <br /> SIGN HERE <br /> ( aforeof ar or builmng contractor) (date) I o <br /> Milt 2 <br /> ZONING ADMINISTRATOR °(p' tn' `((qq E_n <br /> �i i'" '. N NNNNN (n m <br /> TOWNSHIP PERMITS MAY BE REQUIRED U 4 00 0 D o m <br /> $ 000$ '00 fA <br /> IT <br />