Laserfiche WebLink
( I J <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator Cn d m o a <br /> '- 3 <br /> APPLI ATION FOR — LAND USE — PERMITS d <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v <br /> located as shown herein. The urclersigned agrees that all work shall be done in accordance with the requirements of the o <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. y m <br /> c <br /> 0j0 <br /> OWNER, TELEPHONE E <br /> ( 7, 5-) 4/4a-OsY05 <br /> ADD SS 1 l tD i <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> 4 � <br /> LEGAL DESCRIPTION (seetezrecept) �u10 41 y� 1503/.54] 'i 3£f1 6S7 '1 00 n �— <br /> /� <br /> CONTRACTOR I ✓ <br /> TYPE OF PERMIT(S): DWELLING/ UILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> n 0 Vt I <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° — <br /> n' <br /> STRUCTURE/ADDITION USE: f'I o g J <br /> Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z o , <br /> O o <br /> 3 <br /> DIRECTIONS FOR PLOT PLAb DRAWING: (Aerial or top view) <br /> 1. Show the location and size A all existing buildings (EB) and all new buildings (NB) and indicate North (N). <br /> 2. Show the location of the wi I (W),septic tank (ST), and drainfield (DF). <br /> 3. Show dimensions In feet oft a 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. Q <br /> 4. If separate plans are submitl ed 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. 1I o m <br /> 71 .Z `c <br /> PLOT PLAN P o <br /> m o <br /> co <br /> rn � <br /> r <br /> Q� <br /> AO O ° <br /> G °. <br /> o � <br /> OL <br /> �J <br /> 6L ani <br /> D r D D 0 'M <br /> CONDITIONS OF PERMIT: e � ? 03 ro <br /> I c� � <br /> i. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br /> 2. REMOVAL OR CUTTING O TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. rn <br /> 3. NO GRADING OR SHORE ND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. m <br /> 1 declare that this application(i cluding any accompanying schedule)has been examined by me and to the best of my knowl- o <br /> edge and belief it is true,correc and complete.1 acknowledge that 1 am responsible for the detail and accuracy of all informs- m <br /> tion contained in this a licatio (including an accompanyingschedule)and I further declare that I reco nine that this infor- 8 B o <br /> PP (� 9 Y fl G <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 o� o <br /> further accept all liability which may be a result of the Count of Burnett relying on this information I am providing in this n <br /> P Y Y Y Y 9 P fl aP' u, <br /> plication. I agree to permit cou y officials charged with administering county ordinances or other authorized person to have <br /> access to the above described remises at any reasonable time for the purpose of inspection. <br /> m ng' 0 <br /> m <br /> o ? <br /> SIGN HERE S Rn r< — � <br /> (si(nature of owner or ilding cont dt <br /> �,-- —'` • ( ae) <br /> (.I _ _ _ . <br /> 0 ' <br /> ZONING ADMINISTRATOR r <br /> we <br /> TOWNSHIP PERMITS E REQUIRED L\ I MAY 3 o m <br /> g '0 <br />