Laserfiche WebLink
Uj') <br /> wmett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS3 <br /> m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the M c <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> E <br /> regulations of the State of Wisconsin. �_ o <br /> N N o <br /> C ? d <br /> OWNER Gerald Hayes TELEPHONE 715-689-2841 n <br /> d < T <br /> ADDRESS11513 No Shore Dr Grantsburg WI 54840 = 5 <br /> G7 <br /> EMERGENCY/FIRE NUMBER11513 ROAD NAME No Shore Dr <br /> LEGAL DESCRIPTION (see tax receipt) -)GL5 S27 T38N R18W C <br /> w <br /> CONTRACTOR Donald Daniels m <br /> N <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION - p <br /> n 0 <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> ° < <br /> STRUCTURE/ADDITION USE: o 0 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z v <br /> P v to <br /> 3 <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).3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building *IS f <br /> measurement to the ordinary high water mark of lake,stream,or river. 0 °i <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. O o r+ <br /> NOTE. BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I a O m <br /> c <br /> PLOT PLAN non C-) a <br /> 1 y. <br /> M � � <br /> See attached/ replace septic and pump tanks N <br /> m O <br /> u� 1+ <br /> I <br /> eo Pero �{' � <br /> I � <br /> � N <br /> t' Drlor� o N <br /> V <br /> o <br /> n W <br /> OJ <br /> i�e acp�►�� Tp s 6A) Z <br /> o c m a a Da : m <br /> _ EL <br /> r' >O & � <br /> �: _ n <br /> CONDITIONS OF PERMIT: <br /> o0< < ssHo0. ,o � <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z 1p o <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. : o <br /> gC <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o m S m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 8 <br /> mation 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 $ m 8 <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 person to have u, p <br /> access to the above described premises at any reasonable time for the purpose of inspection. 8 8 <br /> T i p A m <br /> A <br /> ,�(��J <br /> SIGN HERE 7/9/92 va - " " - � <br /> (signature of ownyr,or b ildinnglcontrac`tor) (date) Y <br /> ZONING ADMINISTRATOR JI� 7 *I <br /> A�16�N <br /> TOWNSHIP PERMITS MAY BE REQUIRED8 8«N N N 8 m <br /> ut ut cnni <br /> 8 $ $ $ $ $ 8r(n <br />