Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d m o 0 <br /> APPLICATION FOR — LAND USE - PERMITS 3. 0 <br /> d a <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and I? I n <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m c �', <br /> Burnett County Land Use Ordin�nce, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of Wisconsin. y <br /> w � <br /> c <br /> OWNER 'QC„Iii/!{J� yz l`�ty7�OC TELEPHONE O <br /> `GG..11 r/�111 t11't f� iLL�((SL1�l O <br /> m � <br /> ADDRESS 3023-0 3 A fJBU(?j j W 1 <br /> EMERGENCY/FIRE NUMBER ', ROAD NAME Vn' /b <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p , <br /> SANITARY ” PRIVY i FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> m r -- <br /> STRUCTURE/ADDITION USE: _ 'F o' 2 <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z <br /> a v0 O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) � � <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). J <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). (.M <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building 11 O <br /> measurement to the ordinary high water mark of lake,stream, or river. G <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and M <br /> dated by the owner. C o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I a m <br /> PLOT PLAN o a <br /> m (� 0 <br /> 0 <br /> aLA ? <br /> m LO _ <br /> d <br /> N <br /> O <br /> J <br /> J <br /> 0 J <br /> N <br /> 2 <br /> I <br /> C <br /> r�1 rp��/1r> Do <br /> cJ.J � � a� m <br /> CONDITIONS OF PERMIT: m ; ,z T m i <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. e F ; 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N i i >7 <br /> 3. NO GRADING OR SHOREND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Sen E5 2 i ` m <br /> of E affE <br /> I declare that this application(i cluding any accompanying schedule)has been examined by me and to the best of my know!- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- ` i a ro.n At <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this nfor- p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I big o <br /> further accept all liability which!may be a result of the County of Burnett relying on this information lam providing in this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have m m <br /> access to the above described premises at any reasonable time for the purpose of inspection. ' <br /> m <br /> n 0 30 <br /> SIGN HERE I v3 3..► N N <br /> (aillature of owner or building contractor) hl� (date) <br /> ZONING ADMINISTRATOR 71m Aalvna-n <br /> MAR 3 i 1994 <br /> ) 8i <br /> - N WHNa <br /> m <br /> TOWNSHIP PERMITS MAY BE REQUIRE ---- --- u, <br /> ' o 'o 0 8 8 0 oo m <br />