Laserfiche WebLink
&I c <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m v -1 Z <br /> a f <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes 2 ° <br /> g by application for a Permit for the work described and � c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the a <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and 3. o <br /> regulations of the State of Wisconsin. <br /> // <br /> OWNERO <br /> PL, TELEPHONE 7/s'/di` -_ 73S—S— a E <br /> C2� <br /> O m <br /> / � w <br /> ADDRESS 76 y0 L �+ c: T �Z of Alf bSte <br /> EMERGENCY/FIRE NUMBER .,i.].ryl ROAD NAME T <br /> �7� � � V <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> �c � 2e w ✓ <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_ ADDITION p <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> �1 <br /> /_ <br /> STRUCTURE/ADDITION USE: 13 a n 1- lc/.,a c4 5 (-}�o fL,4 6 C /to <br /> (Home/Cabin;Commercial Business;Bedroom; Deck; etc.) Z <br /> O O <br /> D <br /> N <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). o <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. 0 <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. 0 o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 713 N L <br /> PLOT PLAN n o c <br /> a <br /> = I__ <br /> O <br /> 35� o <br /> Al 15 Of 0 <br /> T y►tel LU <br /> �J <br /> S1-4 <br /> EL8 i I <br /> I <br /> CONDITIONS OF PERMIT: o m g iu c w o''�' <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMT ISSUANCE. '. o f 0 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N ]7 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N62 <br /> O <br /> c : LT <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 0 C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- " :` H m a m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- B g p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o Or <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.1 agree to permit county officials charged with administering county ordinances or other authorized person to have ; O o <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> T [ 3 A <br /> A N <br /> SIGN HERE , ,�yA'r,/93 . <br /> Hi <br /> (signature of owner or building contractor) (date) �E f rx ; i <br /> ZONING ADMINISTRATOR Rai) AaLn H " <br /> IL <br /> $ : <br /> «: <br /> TOWNSHIP PERMITS MAY BE REQUIRED W�6)�O N N N N 0 M <br /> m <br /> 000000000 <br />