Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator w o 0 <br /> APPLICATION FOR LAND USE PERMITS d 3 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for th work y _ <br /> described and located as shown herein. The undersigned agrees that all work shall be done in ccor- 3 n <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with al other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNERI O 5 TELEPHONE I c, <br /> I c Zi o <br /> m _ <br /> HOME ADDRESS �-- , .�- �p -J-p� (�f'j L-�O <br /> ^L> <br /> EMERGENCY/FIRE NUMBER �1 5- D ROAD NAME .Y TT 1 �' <br /> LEGAL DESCRIPTION(see tax receipt) LAT V JJJ ' oV j S <br /> 111 <br /> CONTRACTOR 1') / <br /> 0 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE- ADDITION <br /> O <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION Z o Q <br /> —� o 0 �^ <br /> STRUCTURE/ADDITION USE: /O A rck � <br /> (Home/Cabin; Co rcial Business; Bedroom; Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE C R ^ <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. r �� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> -n 'P ti <br /> T o a <br /> 1. All required dimensions or distances to be shown or drawn to scale. <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings (NB)and indicate m N: <br /> North (N). y <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. <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. Uj <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. I <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans mus be j <br /> signed and dated by the owner. v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- c ° <br /> FORE A PERMIT CAN BE ISSUED. N 9jr <br /> "J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 7J <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ? <br /> PERMITTED. p <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF HE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> F <br /> 6. <br /> (nmv(nrDD7. <br /> O � <br /> y oc �. w do �fm <br /> a <br /> a m = <br /> Z F �t y ; M <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the bes of my <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and aCCL racy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I relognize <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining wheth r to is- <br /> o : o : <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this informati n I am ! 0 [ o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances c r other 3 <br /> authorized pe reo to have acces to the above described premises at any reasonable time for the purpose of Insp action. r H <br /> SIGN HERE <br /> N ; <br /> (signature owner or building contractor) (date) `: o <br /> o <br /> ZONING ADMINISTRATOR I i i i i i <br /> N N U�N N N t n m <br /> TOWNSHIP PERMITS MAY BE REQUIRED `n m o u, u, v, o m <br /> 00000000 <br /> 0000 000o r/1 <br />