Laserfiche WebLink
LE4 cD-r"-p <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator U m -- 0 <br /> APPLICATION FOR - LAND USE - PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and H <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 n - <br /> 0 <br /> regulations of the State of Wisconsin. w ?' <br /> OWNER TELEPHONE o 1 F0 <br /> ADDRESS �j <br /> 3-->EMERGENCY/FIRE NUMBER ROAD NAME 1 \ <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR C <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> O <br /> n <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> 0 <br /> o — <br /> 0 <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) o a <br /> 0 <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). 1 ° <br /> 3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> n <br /> dated by the owner. Q � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. on a rn <br /> onc <br /> Z v <br /> PLOT PLAN Q o a <br /> 0 <br /> C`s fn m 0 <br /> V, <br /> U <br /> N <br /> O I - <br /> v � <br /> 7 <br /> z <br /> 1 � <br /> f <br /> M iS'c�j 00 of T <br /> -&4 o-m cmy <br /> CONDITIONS OF PERMIT: v m 2; Q C S T� <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F : <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =r^ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. oO <br /> o : ig <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> l and accuracy of all informs- o : « '0 : m <br /> edge and belief it is true,correct and complete.1 acknowledge that I am responsible for the detaiB o <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 0 <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $� $ <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- d, <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have <br /> access to the above described premises at any reasonable time for the purpose of inspection. E 3 $ R <br /> T 9 <br /> N e P a <br /> M W $ <br /> SIGN HERE (date) ' <br /> (signature of owner or building contractor) <br /> ZONING ADMINISTRATOR g ' <br /> �NN4�NNN N m <br /> TOWNSHIP PER ITS MAY BE REOUIRED O U N N N U Orn <br />