Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator u -0 o 0 <br /> JE <br /> APPLICATION FOR — LAND USE — PERMITS 3_ <br /> d a <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <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. ,n m _ <br /> m <br /> h /� n O <br /> OWNER / TELEPHONE o <br /> ADDRESS 4— <br /> EMERGENCY/FIRE <br /> EMERGENCY/FIRE NUMBER ROAD NAME � l,e <br /> LEGAL DESCRIPTION (see tax receipt) L6--r ( .{ /U0 bj e PI NC,S <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE__ ADDITION o <br /> n 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> ( —A �Q �J t �/�/ <br /> STRUCTURE/ADDITION USE: X o_ � <br /> (Home/Cabin;Commercial siness;Bedroom; Deck;etc.) Z p <br /> 0 0 <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). <br /> 3. Show dimensions infest of thefollowing:(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 ONSrrE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I c m <br /> �I Z c <br /> PLOT PLAN —' -- o <br /> M V o <br /> C <br /> � fA <br /> C-1 <br /> 30' _ m <br /> "W- , <br /> O <br /> I,�P �Xnf <br /> s <br /> i3at <br /> S r D D 0 <br /> m <br /> m —$-� ama = M <br /> CONDITIONS OF PERMIT: v �L- C✓Z-5 j G�L� g m N. Z 9 a ; <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F o �� ' <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =y- M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. �" ' �c2i "'' m <br /> nib` O <br /> I declare that lois application(including any accompanying schedule)has been examined by me and to the best of my knowl o <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- i '^w rn <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- �? d p <br /> mation 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap- i i i <br /> plication.1 agree to permit county officials charged with administering county ordinances or other authorized person to havea O p <br /> access to the above described premises at any reasonable lime or the purpose of inspection. v 0 , <br /> SIGN HERE - N <br /> (signet e o owner Idi contractor) C:7'( a el.. S E '$ S <br /> i u - �' <br /> O j R i <br /> ZONING ADMINISTRATOR �y + E E 1 8 <br /> TOWNSHIP PERMITS MAY BE REOUIRED u n u m <br /> �t <br /> '.. 0 <br /> 0IM <br /> oy <br /> en <br /> 0 <br />