Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator w M o O <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work 0 is <br /> described and located as shown herein. The undersigned agrees that all work shall be done inaccor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other o F applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> a <br /> OWNER / IL 1' Cr v,NvI Ir TELEPHONE �j&/1C� <br /> J .! D m <br /> HOME ADDRESS 2-'&Zc1 C-` hico 4�— r{ JV' S 8'3o <br /> EMERGENCY/FIRE NUMBER 0 ROAD NAME HW 3 5 — <br /> Ci cid Loi 1, <br /> LEGAL DESCRIPTION (see tax receipt) N)tl) Y'4 N(.t.) Y'y SfiC- ZI 04kkA,1 t400 TZ%(.UjiV <br /> CONTRACTOR �l'�li'vSbv� GG�,S}v�GT-.e,n �ct pt.�C'v5o:� o <br /> � o � <br /> TYPE OF PERM IT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION 0 <br /> W O <br /> � r <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> STRUCTURE/ADDITION USE: fJYOO.h C ,rc e- 6%Ae vs.., <br /> (Home/Cabin; Commercial Business; Bedroom;Deck; etc.) <br /> CT <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE C R <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) r 3 N <br /> T Z T <br /> 1. All required dimensions or distances to be shown or drawn to scale. m o a <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings(NB) and indicate H <br /> North (N). y ' <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, IN <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans mus be l <br /> signed and dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION E- ° <br /> FORE A PERMIT CAN BE ISSUED. <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMI » <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY Z <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 /> o c N w D D F <br /> 7. <br /> N 0 to 3 <br /> -j f J TI(n ; ZI <br /> 8. P c 2 m <br /> of m D <br /> o <br /> m m p i 9 <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the be t of my m <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and ace racy of Xl y N? O <br /> oro o : <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I re ognize . : . o m o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whet' <br /> r to Is- o o <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Informal on I am <br /> providing in this application. I agree to permit county officials charged with administering county ordinances r other 3 i ig <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of insll action. t, !� <br /> a N <br /> SIGN HERE <br /> gnat of owner or Ilding contractor) ----- (date) <br /> � of <br /> o ; <br /> ZONING ADMINISTRATOR <br /> 1et vi T <br /> N N N N N N N <br /> TOWNSHIP P MITS MAY BE REQUIRED 0 0 0 0 0 0 0 o m <br /> ------- o0000000tA <br />