Laserfiche WebLink
(D'o � . <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator N m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS s. ' <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and '2 ' <br /> m c <br /> 1 <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 <br /> regulations of the State of Wisconsin. w m <br /> VV -7/ <br /> a � <br /> OWNER A V, lb,i cI '1 f'c, G I cam, k_ A� TELEPHONE 7/ .0 ' 41,�.r- 0 /5 0 O <br /> ADDRESS �� I U () J 7 —7 1 <br /> EMERGENCY/FIRE NUMBERC) G 7 ROAD NAME rel -), i V <br /> /� f) U, <br /> LEGAL DESCRIPTION (see tax receipt) 1310 k U I,U- n <br /> CONTRACTOR >�, I-� F1 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING Ae GARAGE/ CCESSORY STRUCTU j_ DDRION� o <br /> � L7 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> f �`r 9/V k S4.,2F0 Per H <br /> STRUCTURE/ADDITION USE A- V n 1 o r c C- 4- J <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) A hd Pa 11 1 it Q-T Qa4[I o a <br /> 0 <br /> a <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 /> r <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). <br /> 3. Show dimensions in feet ofthefollowing:(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. C <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and M <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1fI v rn <br /> PLOT PLAN C) ° L zi�� z `v <br /> S wi /P L y ( � lam. :z -7 . / 111 Cti) < <br /> T{I6 <br /> C <br /> ° V `-� "' r Z <br /> �-t <br /> ,L <br /> � Z <br /> a o c 0 0 a F <br /> Wm <br /> sDw : ° coos ; <br /> CONDITIONS OF PERMIT: g a: Q u o no <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z 'm'o °'Z -I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. p £ T M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Z2 i i m <br /> 'm pg : : O i o. � C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o' a Is ' <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- y! m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- ? u : m <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I 8 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 O <br /> access to the above described premises at any reasonable time for the purpose of inspection. a p <br /> m i v A s <br /> (rNm a : <br /> 8 <br /> SIGN HERE <br /> ( n urs of ow or building contractor) T_ _ (date) a . - <br /> i P [ <br /> 8 i i <br /> ZONING ADMINISTRATOR "� '• <br /> APR ` i f <br /> . N' . <br /> - I i -W m <br /> TOWNSHIP PERMITS MAY BE REQUIRE i v v p, u o o . m <br /> "88888888 rn <br />