Laserfiche WebLink
MW/ <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator 0 0 a o <br /> APPLICATION FOR — LAND USE — PERMITS 3. 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 2 w <br /> located as shown herein. The un Jersigned agrees that all work shall be done in accordance with the requirements of the m A <br /> Burnett County Land Use Ordinal ice,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 a <br /> regulations of the State of Wiscor sin. m <br /> 6�a G�1866- 7P�SG H <br /> OWNER TELEPHONE n O <br /> m <br /> m <br /> ADDRESS / If P 1051,111,11 <br /> EMERGENCY/FIRE NUMBER /1 ^ ROAD NAME <br /> LEGAL DESCRIPTION (see tax rece t) <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/ ILDING GARAGE/ACCESSORY STRUCTURE L ADDITION o <br /> n L) <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISIONo 0 <br /> nn r� 0 <br /> STRUCTURE/ADDITION USE: OL YX / .Y JV ' <br /> ° <br /> Home/Ca in;Commercial Business; Bedroom; Deck;etc.) z o <br /> 0 0 / <br /> m 9� <br /> 3 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> 1. Show the location and size f all existing buildings (EB) and all new buildings (NB) and Indicate North (N). <br /> 2. Show the location of the we 11 (W),septic tank (ST), and drainfield (DF). S <br /> 3. Show dimensions in feet of Ill efollowing:(a) building to all lot lines,(b)buildingto center line of road,(c)building <br /> measurement to the ordinary high water mark of lake,stream,or river. 0 <br /> 4. If separate plans are submitl ed by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. <br /> Go <br /> NOTE: BUILDING/STRUCTURE LO TIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a to <br /> 71 Z `v <br /> PLOT PLAN n o n <br /> M o <br /> C ) ° <br /> M <br /> J ° <br /> w <br /> o <br /> N <br /> Z <br /> mb <br /> 0 X �MWw,r- ¢ m m <br /> m D � 2. = y <br /> v m 5. g' <br /> CONDITIONS OF PERMIT: < a Z C R ro9 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F �� rA: <br /> 2. REMOVAL OR CUTTING O TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N Zn M <br /> 3. NO GRADING OR SHORE ND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. P' : ,O 0 <br /> I declare that this application(i cluding any accompanying schedule)has been examined by me and to the best of my knowl- o <br /> edge and belief it is true,correc and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion n contained in this applicatio (including any accompanying schedule)and I further declare that 1 recognize that this infor. `,a O <br /> mation I am providing will be ri lied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 $ <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. N <br /> plication.I agree to permit cour y officials charged with administering county ordinances or other authorized person to have O N p <br /> access to the above described iremises at any reasonable time for the purpose of inspection. <br /> rl 3 $ i <br /> SIGN HERE <br /> (Signature of or building contractor) (date) 8 i x�v. <br /> o . 8 <br /> ZONING ADMINISTRATOR `J102 r-1410 1 t'"2) 8 ' x <br /> X <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0 o fn <br /> 000 0ill <br /> m <br /> Fs <br /> 0 <br />