Laserfiche WebLink
�� co ' <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d M0 a <br /> APPLICATION FOR — LAND USE — PERMITS3. <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the 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. �, o <br /> m m <br /> c <br /> OWNER " TELEPHONE a <br /> n-7 �C LLO W5 �j \ �j ✓p ' IQQ'� m_ <br /> ADDRESS Z'► / 4-7 Ell ln16E2 f D . VJLOSTCI� 1W I- S"�V t...J — <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> I <br /> LEGAL DESCRIPTION (see tax receipt) 0 <br /> CONTRACTOR 77 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION o o<- C <br /> J <br /> u r <br /> STRUCTURE/ADDITION USE: o' ° <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z <br /> o ° <br /> 0 <br /> m <br /> a <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). �J <br /> 2. Show the location of the well (W),septic tank (ST), and dralnfield (DF). <br /> 3. Show dimensions infeet of thefollowing:(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. *-4 <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. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a N <br /> PLOT PLAN o n <br /> M <br /> 0 <br /> C <br /> an <br /> p�fi A c <br /> I <br /> i m <br /> ° <br /> 0 <br /> ° s� <br /> l7 y <br /> N <br /> Z <br /> a <br /> ro ave <br /> e _F,42. a0M <br /> 33 D-.. m <br /> CONDITIONS OF PERMIT: c m.; ,z C8 S <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F - <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. - =N: y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. O 0 m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- B g In <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 co i 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 <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have ; O N v <br /> access to the above described premises at any reasonable time for the purpose of inspection. 3 $ 3F ' <br /> V A N <br /> fo <br /> SIGN HERE <br /> (signaturi of owner or building co act ; (date) ; <br /> ZONING ADMINISTRATOR " [ [ <br /> `nwFn 'n <br /> TOWNSHIP PES MAY BE REQUIRED m <br /> 00 00000 <br /> 00 l0006rn <br />