Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o <br /> APPLICATION FOR — LAND USE — PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and 3 ?L <br /> regulations of the State of Wisconsin. w m <br /> OWNER Joe Joko.e12a TELEPHONE (715( 349-7247 n v f <br /> a ' <br /> ADDRESS 23950 TokkandeA Road P.U. Box 465 S4hen, WI 54872 = _ <br /> EMERGENCY/FIRE NUMBER 23950 ROAD NAME Tot.2andeh Road <br /> LEGAL DESCRIPTION (see tax receipt)pc,-*. NW 1/4, NE 1/4, Sec. 15, T38N, R17W, Town of Dane <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p 0 <br /> 0oOl �, <br /> SANITARY�_ PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ` <br /> STRUCTURE/ADDITION USE: San4togy Un$.y o ° <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc,) Z <br /> 0 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) C) ? <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 (D17. 0 <br /> 3. Show dimensions in feet of the following:(a)buiidingto all lot lines,(b)buildingto 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 /> dated by the owner. O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. on rn <br /> c <br /> PLOT PLAN -1 o n <br /> C <br /> m o H c <br /> N ki <br /> fns � : <br /> Ul <br /> � 1 <br /> M <br /> M <br /> SEE ATTACHED <br /> 0 <br /> N <br /> O <br /> O <br /> O y <br /> N <br /> Z <br /> Z <br /> F <br /> NN V rnr DDp 1] <br /> o c m m o a m <br /> A a a M <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F r� ? <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ = m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. ID <br /> g f [ a 5 <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o m '� m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- R u <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $ m <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 i i O 0 O <br /> access to the above described premises at any reasonable time for the purpose of inspection. m $ `R <br /> M ? o A a i <br /> SIGN HERE Wade Ru �ShoZrrl 10/15/92 <br /> N : : <br /> (signature of owner or di ont (d te) <br /> s : <br /> ZONING ADMINISTRATOR <br /> TOWN SHI PERMITS MAY BE REQUIRED 0 T C 1992 m <br /> N U O O <br /> 8 u 88 8888rmn <br />