Laserfiche WebLink
E))�l -) <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator w T 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> a <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> described and located as shown herein. The undersigned agrees that all work shall be done in a ccor- T a <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. H » <br /> 21 <br /> OWNER TELEPHONE <br /> HOME ADDRESS Q r I r ,S-3 , <br /> r, LL`lll <br /> EMERGENCY/FIRE NUMBER ROAD NAME i <br /> LEGAL DESCRIPTION(see tax receipt) .� C C�� , a '��� �• �, �0� <br /> CONTRACTOR r o <br /> � o <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION 0 -^ <br /> m <br /> � o <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION v <br /> STRUCTURE/ADDITION USE: osmt'• I s I �— �� <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE CR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) A <br /> O B 3 <br /> T P m <br /> T Z ii <br /> 1. All required dimensions or distances to be shown or drawn to scale. m o n <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate m <br /> North (N). w <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerlinB of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. P_ a' <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, Al <br /> roads, lake, lot lines. W <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. I <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans mus be <br /> signed and dated by the owner. m <br /> 8 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION E- G <br /> FORE A PERMIT CAN BE ISSUED. 81 <br /> 2. <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 ? <br /> I � <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF rHE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> f <br /> 6. <br /> o c m w 9 a In <br /> In <br /> 7. <br /> Z <br /> 2; m <br /> of w " ' O <br /> o . <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the be t of my O <br /> knowledge and belief It is true, correct and complete. I acknowledge that I am responsible for the detail and acc racy of r'n'm oef, G <br /> oo <br /> all information contained in this application(including any accompanying schedule)and I further declare that I re ognlze o : <br /> o m o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining wheth r to is- <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 n E o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances r otheri 3 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of insl iection. ri <br /> H <br /> SIGN HERE <br /> N ; <br /> (signature of owner or bullding contractor) (date) o <br /> —71 <br /> ZONING ADMINISTRATOR ! <br /> N N n N N N N m <br /> TOWNSHIP PERMITS MAY BE REQUIRED o `n x 0 0 0 0 0 <br /> oS 000000410 <br />