Laserfiche WebLink
0-14 <br /> %/LLQ" 7 i <br /> Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator C ;-- 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> z o <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work N <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- `D <br /> 3 FL <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other <br /> 0 <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNER �� / <br /> l I� rils i Lam . L,Nt� TELEPHONE 7i %'--6 �$ IY7� m_ m <br /> CD <br /> 1 <br /> HOME ADDRESS � � � 0 � �,/t �/ f��� ��cR <br /> EMERGENCY/FIRE NUMBER 2 ` v /,�G� S /` ,` ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) I \ L /ln <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION X 0 <br /> N .Ori <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> - <br /> i& <br /> CD <br /> o v° <br /> STRUCTURE/ADDITION USE: 1,1"C 4&C PorI-c.tlyl <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. ,t <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> T P 0) <br /> T O a <br /> 1. All required dimensions or distances to be shown or drawn to scale. p <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings(NB)and indicate m 9j y. <br /> North (N). m <br /> � <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. w Xt <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, (� <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 must be 1 <br /> signed and dated by the owner. pQ c <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- ° <br /> FORE A PERMIT CAN BE ISSUED. <br /> N <br /> 7 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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 /> OHW��M��OFF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. /J <br /> 5. A&Sc6&� po--r Q,-rj 1 Yd� A-,,,j 0-l tLn- G,&e- <br /> �h0 ni Shit d iv rd <br /> 6. Dac-Ik A",(rj , n,,w4- b.e rema.ed 4,, aor�p1� w U,d H��t <br /> con ccn-. ( <br /> _. <br /> 7. CL <br /> 00 <br /> O �f0 <br /> $. P _cn m <br /> (� CL C_ <br /> �! Qi CD m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my M <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of Rt <br /> 9 P 9 P Y 0nw0 ; O <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize o o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether 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 information I am 0: o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 8 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m ; ; y <br /> SI( HERE rr't^"' C� "_ Yd ' r� ` E E <br /> ( na re of own or uilding contractor) <br /> ZONING AD INISTRATORg ' <br /> ininj'i»iU1 roni»—' m <br /> TCn <br /> OWNSHIP PERMITS MAY BE REQUIRED f j 1 i c o 0 0 0 0 PM <br /> iia 0000000 <br />