Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o oz <br /> APPLICATION FOR - LAND USE - PERMITS . <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes m "�+ <br /> 9 by application for a Permit for the work tl scribed and � m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requir ants of the <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and he laws and _ <br /> regulations of the State of Wisconsin. o <br /> w m <br /> c <br /> OWNER TELEPHONE <br /> 43 <br /> O � <br /> ADDRESSex <br /> m <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) �M1 <br /> --------------------- <br /> CONTRACTOR ry \ <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> n <br /> SANITARY PRIVY0 <br /> FILLING/GRADING CAMPI G UNIT SU DIVISION o 0 <br /> 7 f. <br /> f y <br /> STRUCTURE/ADDITION USE: WAnn% �^ a <br /> (Home/Ca 'n;Commercial Busine s; Bedroom;Deck;etc.) <br /> Z 'o <br /> 0 0 <br /> m <br /> } <br /> DIRECTIONS FOR PLOT PLAN 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 (DF). a <br /> kA <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building R) <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 <br /> dated by the owner. C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I 3 y <br /> PLOT PLAN Z g <br /> o <br /> n <br /> M <br /> 0 <br /> o � <br /> n' v <br /> Z <br /> 1 \ <br /> 2. m <br /> m a <br /> CONDITIONS OF PERMIT: v �Z; fir C� S' . ; <br /> 1. 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. rn E `: ' 0 <br /> PP (including Yaccompanying 1 y y - C <br /> I declare that this application meludin an schedule has been examined b me and to the best 1 m knowl- <br /> edge and belief it is true,correct and complete.1 acknowledge that I am responsible for the detail and accuracy c all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- }S i m <br /> O <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability whit ay Dear It of the County of Burnett relying on this information I arrl providing in this ap- <br /> plication. lagree to permit count ffici ch rged ith administertng county ordinances or other authorized reon to have p <br /> access to the above described prell ata re sable t e for the purpose of inspection. e <br /> m <br /> a <br /> SIGN;HERE « ` ` w <br /> «: <br /> (signature of owner or building contr or) (date) <br /> ZONING ADMINISTRATOR 1' Y • ' $ ': <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> tn <br /> 888888882mii <br />