Laserfiche WebLink
Burnett,County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m c c <br /> APPLICATION FOR — LAND USE — PERMITS ' <br /> m ° <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and a <br /> located"shown herein. The undersigned agrees that all work shall be done in accordance with the requirem ants of the $ <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and th 9 laws and _ <br /> regulations of the State of Wisconsin. H m 1 <br /> m R <br /> m O <br /> OWNER TELEPHONE r o. £ <br /> 4rr� Su9- a r.3�'3—V 259 —�SyS e <br /> ADDRESS F'lyth trf9� rY)N S54y� _ m <br /> b <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> o F6 <br /> LEGAL DESCRIPTION (see tau receipt) ' /v <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> n L7 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 ° `( <br /> / H 0 <br /> STRUCTURE/ADDITION USE: `D wJ ° <br /> IC°I�1 /'Q7/� o <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z <br /> o ° <br /> a <br /> m <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). <br /> 2. Show the location of the well (W),septic tank(ST),and drainfield (DF). o <br /> 3. Show dimensions in feet of thefollowing:(a)building to all lot lines,(b)building to center line of road, )building <br /> measurement to the ordinary high water mark of lake,stream,or river. 0 _ <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be Igned and <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE TAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 113 N <br /> PLOT PLAN e.�: — --- — o a <br /> M ° <br /> Lt <br /> `Ic ' <br /> I 1 ° <br /> I Lti l <br /> li <br /> Z <br /> ! l n <br /> t <br /> I <br /> bn N n7 D D y <br /> CONDITIONS OF PERMIT: m <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F i SQ - <br /> 2, REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ' =N': M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. wrr" G1 mm <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- oai <br /> edge and belief it is true,correct and complete.I acknowledge that 1 am responsible for the detail and accuracy ol all informa- a m m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- �$ B ' p <br /> matlon I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized pelson to have p <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> \` $ m - <br /> SIGN HERE ��� — - <br /> rA <br /> 9S— <br /> (signature or building contractor) � (date) <br /> ZONING ADMINISTRATOR - " o:: - <br /> 0 8 i <br /> Gh <br /> TOWNSHIP PERMITS MAY BE REOUIRED a o 5 g$tort tiN $' m <br /> 8888$888rn <br />