Laserfiche WebLink
1 "" <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Ad inistrator m ; e <br /> APPLICATION FOR - LAND USE - PERMITS 0 3. <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and m <br /> located as shown(terein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and 3 n <br /> regulations of the State of Wisconsin. y d <br /> w io <br /> / c <br /> OWNER Crr� /�.�OlT TELEPHONE o f <br /> q <br /> ADDRESS / 7 2 9d Ve_r 14 e�J /7I PY <br /> EMERGENCY/F✓IRENUMBER ROAD NAME <br /> LEGAL DESCRIPTION <br /> (see tax receipt)�U Ya,y 11'E 6_ 6 ��yyy iAi� �/r, ��fj7",N� <br /> CONTRACTOR /''i /Zf J�- Z Cf/ /Oh/✓L,Yr , f�/6 m <br /> TYPE OF PERMIT(S): DWELLINGG//jB�UIILLDING (' GA/RAGE/ACCESSORY STRUCTURE ADDITION O 1 t I <br /> SANITARY I/ PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> o < (� <br /> _ 0 �Jw\ <br /> STRUCTURE/ADDITION USE: ° <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) z o <br /> o 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 drainfield (DF). <br /> 3. Show dimensions in feet 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. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSrrE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a N <br /> 11 z `a <br /> PLOT PLANM o a <br /> rn � a <br /> Q <br /> " -3s - �°9 <br /> n <br /> _ <br /> o <br /> N <br /> S <br /> o c m m o C, :E m <br /> 00 M <br /> o ma °TCN o C <br /> CONDITIONS OF PERMIT: 5. 'm_' : '� m o = m <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. _ m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED." ' ' O 3 O <br /> $ ncC <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- I o m m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $ m $ <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- N <br /> plication. I agree to permit county officials charged with administering county ordinances or other authorized person to have i i i O u, p <br /> access to the above described premises at any reasonable time for the purpose of inspection. M 8 9 <br /> �fi�,�WVt(/r�'- N H O <br /> SIGN HERE m <br /> (signal re of owner or building contractor) F ate) <br /> I_r <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED I SEP 1 o o rn <br /> M <br /> 88 8888rmn <br />