Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,W154872 Office of Zoning Administrator m <br /> APPLICATION FOR LAND USE PERMITS <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- O <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other o C <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. H m <br /> 2 tis I /� �, (cr � � //?-3-9^(7 <br /> OWNER TELEPHONE L v 1 m <br /> HOME ADDRESS - l o I O Cr-e J:J V I tLl" V I E- /'1 (�i�iJ. S•�/�"� <br /> EMERGENCY/FIRE NUMBER ,.._. _.. /jROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) et�(�nts K I "� T✓t� /`V - - - <br /> CONTRACTOR 4 <br /> g — <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION <br /> N Q <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION a <br /> c 'o <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR l — <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. C <br /> A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) T 3 <br /> Cn <br /> Z c <br /> 1. All required dimensions or distances to be shown or drawn to scale. n P n <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings (NB)and indicate m <br /> North (N). Cd <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of m I <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. LP <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. 5bu) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- Q <br /> FORE A PERMIT CAN BE ISSUED. U <br /> S' <br /> 2. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. m <br /> CONDITIONS OF PERMIT: N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. d <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ? <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> f <br /> 6. <br /> s tnmv=�, $ m <br /> : Z H o =S <br /> c -.( <br /> 7. R' cm ' s y <br /> m m <: z <br /> nioE L°Z <br /> O <br /> 8. r: On 0 <br /> I declare that this application (including an accompanyingschedule has been examined me and to the best of my <br /> PP ( g Y ) �' m m <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> oo o : <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize o m b <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Is. <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Information I am E ? a): <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 3 <br /> authorized pe ave access to the above described premises at any reasonable time for the purpose of Inspection. <br /> B <br /> SIGN HER _ w <br /> (signature of owner Ilding eontreetor) (date) <br /> i <br /> ZONING ADMINISTRATOR l lm ��'(11GIc�/l - ': <br /> m <br /> TOWNSHIP PERMITS MAY BE REQUIRED o o N o 0 -n SooSS000N <br />