Laserfiche WebLink
ON COMPUTER/SCANNE51,Q _ amp <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator d - 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 = <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work o <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor. <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other 3 $ <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y m° <br /> 2 m <br /> OWNER ,/;(- L�^ TELEPHONE <br /> �b We bst� g V <br /> HOME ADDRESS e O 1 <br /> 1 <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR 1 _ <br /> o Q— <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> 0 <br /> L) S' <br /> 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> STRUCTURE/ADDITION USE: V a l� r U5 -9 (- — <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) (- <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE O <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. S <br /> In <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) A o <br /> O 'R <br /> Co <br /> 1. All required dimensions or distances to be shown or drawn to scale. o _ <br /> 2 Show the location and size of all existing buildings (EB)and all new buildings (NB)and indicate m 5L <br /> North may: <br /> O C �' <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s) to centerlineIn of In L <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or rir. w r <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to build s, o R) R <br /> roads, lake, lot lines. Uj <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. O _ <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must e U 0 a <br /> signed and dated by the owner. <br /> C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION <br /> BE- <br /> FORE A PERMIT CAN BE ISSUED. o <br /> N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. r <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT n <br /> ISSUANCE. G <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 OFT E <br /> 5. OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> f <br /> 6. <br /> Ny V (nrDD � <br /> 7. a <br /> °• 1 . z of o 3U 3 <br /> moi I,a.2 1 <br /> 8. <br /> In <br /> is that this application me and to the best mye and belief it is truethe detail and accura y of N y �; pation contained In ther declare that I reco nize [ om o <br /> oInformation I am provdetermining whether o is-mit. I further accept g on this information I am in this application. unty ordinances or ther d person to have access to the above described premises at any reasonable time for the purpose of inspec Ion. 3 <br /> a w <br /> SIGN HERE y <br /> N ; <br /> (signature of owner or building convector( date) <br /> ZONING ADMINISTRATOR ,gao <br /> o ' <br /> rn is en�vi -n <br /> TOWNSHIP PERMITS MAY BE REQUIRED N N U N N N m <br /> O N U t O N (l i UP O <br /> O O O O O O O O N <br />