Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator W _0 Z <br /> m m o 0 <br /> APPLICATION FOR - LAND USE - PERMITS3 <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes 2 °- <br /> 9 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 <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 n <br /> regulations of the State of Wisconsin. — o <br /> N d <br /> -�i S X53 - 555 m <br /> OWNER �('� �� TELEPHONE a O <br /> r <br /> nz6 -36 7 — <br /> ADDRESS y P <br /> .�.ti712 �o�11J4r c� ty�dClV, wil �lO �Cf'M9^ST ��' O� Wr 1 M <br /> EMERGENCY/FIRE NUMBER ROAD NAME �1,U �.0�� M <br /> t <br /> LEGAL DESCRIPTION (see tax receipt) 5;.�-+ ♦= 1 S��s ©aJ 3S O-4 5 <br /> CONTRACTOR <br /> L/ <br /> TYPE OF PERMIT(S): DWELLING/BUILDINGARAG ACCESSORY STRUCTURE_ 4- ADDITION X p 1 <br /> o <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION o < <br /> � to R <br /> STRUCTURE/ADDITION USE: 1�Tr� 'h.-e.J (�"�1A (`00 rr CUT' ^Vt o ° <br /> (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) z 'a <br /> 0 0 <br /> a <br /> m <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 (DIF). o <br /> 3. Show dimensions in feet of the following:(a)buildingto all lot lines,(b)building to center line of road,(c)bullding -0 <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. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSRE VERIFICATION BEFORE A PERMIT CAN BE ISSUED.' 'fI 3 m <br /> PLOT PLAN <br /> sem err,, Z <br /> �� r S/kN r`tq, '1' rlG r�cJL r o <br /> ),7 w <br /> - ti <br /> - -- I <br /> Uj <br /> I <br /> m <br /> m <br /> n <br /> — <br /> �� <br /> rn <br /> � m <br /> 1 <br /> S z <br /> T) 1 <br /> g SCM 0a: m <br /> m, D$.* ' o-ai o= m <br /> CONDITIONS OF PERMIT: v N.: c O <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o f 0 _ �•2 1 : 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N' <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> g . <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 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- w a m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit; I gig <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 N <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> SIGN HERE 'l H <br /> (signu o er building ctor) I <br /> ZONING ADMINISTRATOR <br /> D <br /> SHIP PERMITS MAY BE REQUIRED ' 2 o N nN m <br />