Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d " a o <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> TO THE ZONINd ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 2 6 o <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 6 <br /> regulations of the State of Wisconsin. H o <br /> m � <br /> c <br /> ON( '(.� n—� TELEPHONE 2 �- F5� - 33 IC m o <br /> OWNER /' f �IY]/� I V,[� � <br /> V l9 fff I ' o ' <br /> j'' p <br /> ADDRESS 2_4M ULy 0hilgoty <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> t IQj <br /> LEGAL DESCRIPTION (see tax receipt) DQ1 <br /> i <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> n o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o <br /> STRUCTURE/ADDITION USE: o °^ <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z v <br /> 0 0 <br /> 9 <br /> 2 <br /> } <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 in feet of the following:(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. <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 ONSRE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. an o N <br /> on <br /> PLOT PLAN 0 <br /> o a <br /> in y <br /> CLO <br /> d <br /> I <br /> 0 <br /> N <br /> u <br /> n <br /> Z <br /> A is 8 nm m <br /> MKl� 2. Hao <br /> CONDITIONS OF PERMIT: = m Z Sc g <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o Foi <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =r» <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. I 1 t o m <br /> O <br /> C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o of <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- OCA " «r m d' m <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this infor- B g p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. o o <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 w N m <br /> access to the above described premises at any reasonable time for the purpose of inspection. 3 <br /> -n 8 R. <br /> SIGN HERE - - <br /> (signat re of owner or b 'ding c ntract to <br /> yp p : <br /> ZONING ADMINISTRATOR <br /> MM MMM -n <br /> TOWNSHIP PERMITS MAY BE REQUIRED o N N d m <br /> �Y_.__ o o a o 0 8 U) <br />