Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator m m o 0 <br /> '-. <br /> APPLICATION FOR — LAND USE — PERMITS m <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and s � <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m c <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the Ialws and <br /> regulations of the State of Wisconsin. m ( l <br /> w m <br /> OWNERer TELEPHONE /41d_ <br /> m_ tD <br /> ADDRESSJ .UVJ cX7O//1 �T 3 �-- W yO�YJ !Al`/ /✓L/i S_.� O �+� <br /> (� <br /> EMERGENCY/FIRE NUMBER ROAD NAME 1 1 <br /> n� 1n1 1 \O e(� Rca-zA <br /> LEGAL DESCRIPTION (see tax receipt) -�� <br /> jt 5e StC 34-41- Ib BLULinetir Co. U1 (C <br /> L!) <br /> CONTRACTOR nn <br /> TYPE OF PERMIT(S): DWELLING/BUILDING x GARAGE/ACCESSORY STRUCTURE ADDITION <br /> 1 J`'tr' cf <br /> PRIFILLING/GRADING CAMPING UNIT SUBDIVISION o 'C C' <br /> (( <br /> �11 w STRUCTURE/ADDITION USE: yioYV�2 w �.�ll �-Cw ,,ai-cie J o <br /> (Home/Cabin;Commercial Business; Bedroom; Dec �etc.) Z 0 <br /> S <br /> 0 <br /> N J <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 dralnfield (DF). o �✓ <br /> 3. Show dimensions in feet ofthe following:(a)building to all lot lines,(b)building to center line of road,(c)building I 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 � <br /> dated by the owner. 0 c <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAND FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 o y <br /> PLOT PLAN r/ z c <br /> cv <br /> n <br /> Q" 0'T100 <br /> 0 <br /> W W <br /> ry m <br /> r �C v,nahiTl �$ ti <br /> LAO <br /> A to T <br /> I ST- H o <br /> f <br /> --- —- -- -f1Rv K t f2 O <br /> C. m <br /> CONDITIONS OF PERMIT: .'° -Z C g- <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F t �� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. r'il: o ` m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 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- 9i ; m <br /> tion contained in this application(Including any accompanying schedule)and I further declare that I recognize that this infor- I. nl p <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue permit. 1 (;? E E ; $� $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing n this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have ` p <br /> access to the above scribed premises at asonoble time for the purpose of inspection. 57 <br /> PE <br /> m i E <br /> �-'_ -�./. _..�. _._..T N . <br /> SIGN HER <br /> (signature off owner or building contractor) __ _. (date) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 3 1 •1 o a a b N Im <br /> sgssss91IM <br />