Laserfiche WebLink
Burnett County Office of Zoning Administrator d - 0 0 <br /> APPLICATION FOR — LAND USE — PERMITSi3 a <br /> d <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and 'Z io <br /> located as shown herein.The undersigned agrees that all work shall be done in accordance with the requirements of the Bur- CD m £ 1 <br /> nett County Land Use Ordinance,S ' ation Code,and with all other applicable County Ordinances and the laws and regula- 3 a 0 O <br /> tions of the State of Wiscon ' = v a <br /> m m <br /> N <br /> F 'rst Wi David Huff ,°, O <br /> OWN (Please Print) Contractor or Surveyor or Agent M <br /> o. Box 69 "- <br /> Address Address a <br /> Grantsburg Wi. 54840 <br /> City,State,Zip Code City,State,Zip Code <br /> (715) 463-5301 <br /> r <br /> Telephone Telephone l <br /> Permit(s)Applied for: ° <br /> New Building Filling/Grading <br /> 3 <br /> Addition Moving o <br /> .v <br /> Sanitary X Camping Unit G) m <br /> o <br /> Privy Subdivision .`.- <br /> m r <br /> 2 single family homes ° w <br /> Structure Use: �-- v <br /> (family home/cabin,garage, addition,etc.) o v p y <br /> m J <br /> Directions for plot plan drawing: i .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 (DF). <br /> 3. Show the location of any lake or flowage-if within 1000 ft.and the location of any river or stream-if within 300 ft. 0-- <br /> 4. <br /> 4. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building to lake, <br /> river or stream, if applicable. <br /> 5. If,separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and dated by f <br /> the owner. <br /> 6. Provicle legal description an the side of thisform) as on aemen o .v <br /> PLOT PLAN 3 <br /> a N <br /> c <br /> 4-o a <br /> .JCI <br /> See Pd � A'��aveo(_ <br /> P/ar)s n <br /> ti lfx <br /> I <br /> � a <br /> P N <br /> A,6 <br /> g N <br /> s <br /> 0 <br /> N � <br /> O �J <br /> T <br /> / � O <br /> Z <br /> O <br /> Z <br /> I v � <br /> f <br /> G <br /> X! c <br /> w n a9°m <br /> a a a o.-.m <br /> mate - m =as <br /> v <br /> H 0 0 3 <br /> Z o <br /> « B : m <br /> o c C <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all i= m <br /> o <br /> 9 P 9 P y n m <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that <br /> this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a o <br /> permit.I further accept all liability which may be a result of the County of Burnett relying on this information I am providingJ1 m <br /> in this application. I agree to permit county officials charged with administering county ordinances or other authorized <br /> person to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> SIGN HERE ""�"�""� /"�'� ' Z"`'' 2 <br /> (si lure of owner ruilding contractor) f (date) o o <br /> ZONING ADMINISTRATOR <br /> o IJNOlJ��Nm <br /> TOWNSHIP PERMITS MAY BE REQUIRED u,v,p'u,o. Pm <br /> 0000000fA <br />