Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3. 0 <br /> 0 <br /> TO THE ZONING ADMINIST TOR:The undersigned hereby makes application for a Permit for the work described and m <br /> located as shown herein. The indersigned agrees that all work shall be done in accordance with the requirements of the m a <br /> Burnett County Land Use Ordii iance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 0. <br /> regulations of the State of Wisconsin. S60 7 9 o S m <br /> (JP A <br /> n O <br /> OWNER Oa `` TELEPHONE '7 S" 2-S9 7 LSU p £ <br /> ADDRESS 9033 cm lrO 4UC. N er-oo N C@ry1N _S-SLI43 m I n <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> �{ B (� <br /> LEGAL DESCRIPTION (see tax re eipt) U 0 NQ 9�r I a 9 k ( I,re. Co rt°P, #3I <br /> I I <br /> CONTRACTOR , I e Q Jes Co N s4r-,A ,o N k, � A C. N o u lc <br /> TYPE OF PERMIT(S): DWELLIN /BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> o O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> w � <br /> STRUCTURE/ADDITION USE: 40me., o <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z o <br /> o � <br /> m <br /> D <br /> DIRECTIONS FOR PLOT PUN DRAWING: (Aerial or top view) <br /> 1. Show the location and sh a of all existing buildings (EB) and all new buildings (NB) and indicate North (N). r <br /> 2. Show the location of the 1 veil (W),septic tank (ST), and drainfield (DF). <br /> 3. Show dimensions in feet the following:(a)building to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the ordin iry high water mark of lake,stream, or river. 0 l� <br /> 4. If separate plans are subn itted by an architect,engineer,builder,contractor,etc.,the plans must be signed and v" <br /> dated by the owner. o <br /> NOTE: BUILDING/STRUCTURE LC CATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 3 rn <br /> 1I Z `v <br /> PLOT PLAN ° n <br /> M <br /> N 1 2-o f C <br /> N <br /> M <br /> too Qu ; Id ;�, � 41xy21 <br /> 6Gragc <br /> .-7 2.0 Cr�cludes CW1�y ) <br /> to o,qq on <br /> I <br /> aye �dr•�h � <br /> Rxio <br /> I `10 o <br /> o � <br /> N <br /> 7 8 B-KcH <br /> _.� <br /> z <br /> A M Tv �R UOp� <br /> Oc�Wrn a� In <br /> m It g 2.am em �J <br /> vO 5 <br /> m <br /> CONDITIONS OF PERMIT: < o , Z C 6i <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o f 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ( d, =y'La+, M <br /> 3. NO GRADING OR SHO LAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. `^' O1 62 fl: m <br /> I declare that this application including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,torr ct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- m <br /> tion contained in this applica ion(including any accompanying schedule)and I further declare that I recognize that this infon p <br /> Mallon I am providing will b4 relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 <br /> further accept all liability whi h 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 co inty officials charged with administering county ordinances or other authorized person to have ? O N p <br /> access to the above descritH J premises at any reasonable time for the purpose of inspection. 3 b m <br /> v a <br /> SIGN HERE --%�---. <br /> ( i _tur of owner or ing contractor) (date) <br /> ZONING ADMINISTRA Inx <br /> TOWNSHIP PERMITS MAY BE REOUIREDo ur�pNp 1 Im <br /> m <br /> iL. OOO tFO in <br /> n <br /> O <br />