Laserfiche WebLink
cTA CZ�. <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m o O <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> 0 <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 <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 n (} t <br /> regulations of the State of Wisconsin. <br /> c <br /> m <br /> OWNER Atten StockeA TELEPHONE n <br /> o m <br /> m <br /> ADDRESS 4468 MaAole0 Avenue NoA,thpoA.t, PL 34287-2829 " <br /> EMERGENCY/FIRE NUMBER ROAD NAME (UhtapeAtno Pinez `� n <br /> LEGAL DESCRIPTION (seetazreceipt) Lof 2, CSM Vot. 2, Po. 39, Section 1 , T40N, R15W, Town <br /> CONTRACTOR o„ Jackson I <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION a <br /> - 1 <br /> n O <br /> SANITARY )( PRIVY FILLING/GRADING CAMPING UNIT -o 0 <br /> STRUCTURE/ADDITION USE: Stn-LtajwLf ��LGr 4dAS 1 C-7ZIn/7�Y'3'GCL�CiI K�� ° <br /> (Home/Cabin;Commercial siness;Bedroom; Deck;eta) Z <br /> o ° <br /> a <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). U) <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). (3) 5 <br /> 3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building d <br /> measurement to the ordinary high water mark of lake,stream, or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 9I 3 m <br /> c <br /> PLOT PLAN o n <br /> m o <br /> H <br /> SEE ATTACHED N" <br /> N <br /> O <br /> 7 <br /> m <br /> v � <br /> N IIN�� <br /> I <br /> 1 <br /> JJ <br /> G <br /> 33bn �V Enr DDO a <br /> C M.> > 0 of m <br /> t °2.aw C m m <br /> CONDITIONS OF PERMIT: ? N.: Q CS 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. c F 0 - Q -i <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =t^ Xl <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> �n E 62 j m <br /> o : aE O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best ofmy knowl- o' <br /> edge and belief it is true,correct and complete.1 acknowledge that I am responsible for the detail and accuracy of all informa- r^m> Im <br /> tion contained in this application(including any accompanying schedule)and 1 further declare that I recognize that this infor- B o ; p <br /> matfon I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o'$ 0 <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing inthis 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. r 3 'oo <br /> m m A N <br /> SIGN HERE Wade RU{1hhOQm 6/25/93 <br /> (signature' of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR `JI'Tl I Iaf1,f.Gk�fT <br /> Fn 'n <br /> TOWNSHIP PERMITS MAY BE REQUIRED N N m <br /> 0 0000 <br />