Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54072 Office of Zoning Adminllistrator m m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS m <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work desci ibed and w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requireme s of the I <br /> Burnett County land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and _ <br /> regulations of the State of Wisconsin. m° <br /> c <br /> OWNER TELEPHONE n <br /> -bAr,) tClmb MlCHr4EL5 715 3ZZ ySfv m <br /> ADDRESS -2O530 L Av-C--t ✓oo k 7 - -IrrLEL h I rq <br /> J <br /> EMERGENCY/FIRE NUMBER 2 v 9 3 d ROAD NAME 1-e W 06 ;') 1 <br /> LEGAL DESCRIPTION (see tax receipt) -Z <br /> CONTRACTOR <br /> SFL'F <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> n L7 ' <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> 0 <br /> ' J <br /> N <br /> STRUCTURE/ADDITION USE: O <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z <br /> 0 0 <br /> v <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 dreinfield (DF). <br /> 3. Show dimensions Infest of the following:(a)building to all lot lines,(b)building to center line of road,(c building <br /> measurement to the ordinary high water mark of lake,stream,or river. G <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. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. in o y <br /> PLOT PLAN Z n <br /> A <br /> mjio <br /> C 4 ' <br /> Sem <br /> I <br /> C' Q c <br /> w� <br /> V N <br /> dye , /tee 6,3 ' �, (?eti� ll �f . ' 3. <br /> N <br /> / O y <br /> 22 �7 L <br /> h <br /> 771 <br /> s bnNv�nrDDOm <br /> c :E f m <br /> m. a S'� 6 a w m 11 <br /> CONDITIONS OF PERMIT: o -: ¢ C g 8' ; <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. a 0 <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 m <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best o my knowl- E 0E <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- «Mai ; m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize thm t this infor- <br /> mation 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 g� $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providinj I in this ap- i 3 ' <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized per on to have ` p <br /> access to the scribed promises at any reasonable time for the purpose of inspection. <br /> its- <br /> SIGN HERE �'�*-�� "I <br /> (signal o owner or b Id1 contractor) (date) <br /> ZONING ADMINISTRATOR [ I 8 E <br /> TOWNSHIP PERMITS MAY BE REQUIRED o N«««««« T <br /> NRS , N}5 m <br /> I <br /> 8 $ $ 8888$ ai <br />