Laserfiche WebLink
Y Ulv I.,u10HU I ER/SCANNED <br /> 1 11 <br /> arnett Count 7410 Co. Rd. K No. 102 Siren WI 54872 Office of Zoning Administrator m m c o <br /> APPLICATION FOR — LAND USE — PERMITS W 3 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and � c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the J <br /> Burnett County Land Use Ordinance, Sanitation Code,and with all other applicable County Ordinances and the laws and 3 0 <br /> regulations of the State of Wisconsin. '` o OD <br /> & <L N d <br /> OWNER (i A � / �L ��CTEPHONE <br /> / m <br /> ADDRESSL�dl7f7i <br /> EMERGENCY/FIRE NUMBER /y ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR yJ <br /> TYPE OFERMIT(S): DWELLING/BUILDING GARAGEIACCESSORY STRUCTURE ADDrTION v 4' <br /> n �J J <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> r <br /> STRUCTURE/ADDITION USE: Ej�l3,yj'i ��//!-� o g <br /> (Home/Cabin;Commer Tal Business; Bedroom; Deck;etc.) Z v <br /> 0 O <br /> 0 <br /> m <br /> a <br /> DIRECTIONS FOR PLOT PIAN 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 (D17. <br /> 3. Show dimensions in feet of thefollowing:(a) building to all lot lines,(b)buildingto center line of road,(c)building -1 SJR <br /> measurement to the ordinary high water mark of lake,stream,or river. 1 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 L <br /> dated by the owner. O o <br /> NOTE. BUILDING/STRUCTURE LOCATIONS MUSPl <br /> T BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a u! <br /> PLOT PLAN Z <br /> n 0 a <br /> III 71 <br /> o` <br /> C ` 0 <br /> TlACHE� M <br /> I <br /> 0 <br /> n_ <br /> o <br /> N <br /> O <br /> b <br /> v y <br /> N <br /> V <br /> Z <br /> I <br /> D U) N V t/IrDDp � <br /> D _ ti• a0 �: = D <br /> CONDITIONS OF PERMIT: ? 02 < . Z m o 0. 'o � <br /> I. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F : ,� <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. : n <br /> C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- m <br /> edge and belief it is true,correct and complete.I acknowledge that I 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- ,b1N <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 8 m 8 <br /> further accept all liability which 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 county officials charged with administering county ordinances or other authorized person to have N p <br /> access to the above described premises at any reasonable time for the purpose of inspection. g <br /> 1 J _ A m <br /> SIGN HERE <br /> EE a ` <br /> (signature of ownerroor,building c <br /> ontractor) },date)` x. <br /> ZONING ADMINISTRATOR /IrYI �lN+F�/')•iV <br /> TOWNSHIP PERMITS MAY BE REOUIRED SER - 41992 ««�� m <br /> N . Noo �Sm <br /> s ssssrn <br />