Laserfiche WebLink
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 3. <br /> d <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and rA <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirementsof the N <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and 3 a <br /> regulations of the State of Wisconsin. N m <br /> m � <br /> r 1 n O <br /> OWNER <br /> o 111 5 Q W A y \lp J SI-e r TELEPHONE (Z4 g' (a O O m <br /> ADDRESS <br /> EMERGENCY/FIRE' NUMBERROAD NAME ' <br /> 5�7s1a G�ee2 Rd �x-r <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR -?r <br /> �J <br /> �r"\¢.'C SON G O N ST <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION V p <br /> o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o = <br /> > <br /> STRUCTURE/ADDITION USE: (.rift 16 0 ° <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) _ <br /> 0 0 <br /> a <br /> z <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 <br /> dated by the owner. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. in o m <br /> PLOT PLANo a <br /> Gra.er Ra �Krt" A <br /> 3t.a3 0 -7�-�h y. <br /> f X�ST sli\ m s> — <br /> �`r 13 Oil <br /> 5h1v0e5 15, TO <br /> OtiW _ <br /> Z rn4o5ure a q i <br /> To otltyt Fx o <br /> IL)f ST > <br /> 3 IY� <br /> M11 win -umi- 'D <br /> o c0 0m <br /> CONDITIONS OF PERMIT: ? < <br /> 0, Z C _ 3 <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. 1 Q <br /> 3, NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. : n <br /> C C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- g m `D m <br /> edge and belief it is true,correct and complete.I acknowledge that 1 am responsible for the detail and accuracy of all informs <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 51 <br /> I . <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing it 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 describe premises at any reasonable time for the purpose of inspection. <br /> ��(' A <br /> U "t w m <br /> SIGN HERE ` � m <br /> 43 <br /> (si at of own uilding contractor) rji .r� <br /> r'. o <br /> ZONING ADMINISTRATOR 7 - 2, • . g <br /> TOWNSHIP ERMITS MAYBE REQUIRED j t !r u o�n o o K m <br /> AUG 10199? 9889999sy <br />