Laserfiche WebLink
In-,) ( -. <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS — <br /> s <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q w � <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 _ <br /> regulations of the State of Wisconsin. m <br /> m <br /> 0 <br /> OWNER Dave AndeAzon TELEPHONE (715) 327-8222 <br /> ADDRESS 1670 Hwy. 48 FAedeAic, W1 54837 g <br /> EMERGENCY/FIRE NUMBER ROAD NAME Jamtbon Road } <br /> I � <br /> LEGAL DESCRIPTION (seetaxreceipt) Lot IA, CSM VoK. 1 , Pg. 162, Sec.31 , T40N,R16W, Town o� J <br /> 0a Kan <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> 1 <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION0 °C. <br /> r <br /> STRUCTURE/ADDITION USE: San{,tAA11 UwCy o ° <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z a <br /> 0 0 <br /> « <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 drainfteld (DF). <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building -N <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 M <br /> dated by the owner. () S' <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. an o m <br /> 11 Z `a <br /> PLOT PLAN A o Z <br /> M o <br /> C <br /> m <br /> c� <br /> m <br /> s <br /> 0 <br /> SEF ATTACHED c IQ j <br /> N <br /> r I� <br /> Z <br /> i <br /> S N(n v41 � g rD ? ,a oc o. m <br /> °. an� mnOw nm � <br /> CONDITIONS OF PERMIT: M- .Z w c 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ �2 M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> tWP (including Yaccompanying 1 Y y g': n 5 i ? C <br /> I declare that this application includin an schedule has been examined b me and to the best of m knowl- o 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- � �a : ` yy!!G1 i M <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this Infor- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I14 $ « $ <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 O <br /> access to the above described premises at any reasonable time for the purpose of inspection. « <br /> -n ` 3 <br /> m m A s <br /> SIGN HERE Wade Rubbho—tm 3/16/93 '« `• « € <br /> (signal o owner or contractor) (date) <br /> a <br /> E $ € xi <br /> ZONING ADMINISTRATOR <br /> a±N T <br /> TOWNSHIP PERMITS MAY BE REQUIRED xN1 0 .'o m <br /> 8 889 ,0 <br />