Laserfiche WebLink
Burnet(County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator C 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. o <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work y <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- m C 9J <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other 3' o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. c V <br /> 1J O <br /> OWNER !10.�m wry TELEPHONE 3q? <br /> _5a q d _, <br /> rt Cr �iS�CJ / <br /> HOME ADDRESS � �CI _`'lo C-� S f a-,e` (.� V, PtT _rD I I r o v <br /> EMERGENCY/FIRE NUMBER 3 3 2_6 ROAD NAME YYl O ctrl <br /> n LttFCotlle/tkc <br /> LEGAL DESCRIPTION (see tax receipt) /J(rGVp rn P^�. L n t 5 71 a n 7 ;c e <br /> 15 weS✓✓ (3urAe-et Co (:Kk A <br /> CONTRACTOR SE1 <br /> g v ) <br /> o _ <br /> TYPE OF PERMIT(S): DWELLING/BUILDING J`1 GARAGE/ACCESSORY STRUCTURE ADDITION 0 -`-- / <br /> m rc <br /> o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> 0 v° <br /> m <br /> STRUCTURE/ADDITION USE: NAWa Qy lf0.i0.je >b- <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. It <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> T P rn <br /> T Z o <br /> 1. All required dimensions or distances to be shown or drawn to scale. m o n <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings (NB)and indicate y <br /> North (N). m <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <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. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. (� <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be 5U <br /> signed and dated by the owner. ¢ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. e <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. l <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY z <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. U� <br /> 5. <br /> f <br /> 6. <br /> V1N oD DDpim <br /> '9 <br /> (/ 1 r d /OG(1��� y/r [ al p..G m <br /> 7. U I PP J C, / <br /> C o . m 3 <br /> O <br /> m <br /> declare that this application (including any accompanying schedule) has been examined by me and to the best of my i <br /> d 5; m <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of r„ m Ci <br /> PP (including Yaccompanying 1 9 . om o : <br /> all information contained in this application meludln an schedule and I further declare that I reco nize E <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Information I am O p <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other ? 3 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. <br /> B <br /> ;IGN HERE ° N <br /> gna re of owner r bullding contractor) o i <br /> j' In (w �� - [ E <br /> O : [ [ i <br /> ZONING ADMINISTRATOR / <br /> . ti15 RMF»sn e3 j'F»wei�' �I <br /> N N n N N N n <br /> OrnNONNNO m <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />