Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, Will 54872 Office of Zoning Administrator to v z <br /> m m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and � w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m C <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. o <br /> N N <br /> 0A _776 -7- m = o <br /> OWNER gMpS C. cl--7�1lt-¢SA TELEPHONE <br /> ADDRESS X 9.5 �s?S7 /��tli.7.Nr.4 ?U� J7 AuL r .44" <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> rpq��a4evt a�3 y �CtNA)ion) <br /> Cf'l� '1 a -4� Xiriu<i.y acrd-ro S3$' n <br /> LEGAL DESCRIPTION (see tax receipt) Lt! Yccst.3&. is. U. aVc>v <br /> 07 / -CM V P/Fr ( u f Lb I <br /> CONTRACTOR b 1f. <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> (� <br /> SANITARY PRIVYo FILLING/GRADING CAMPING UNIT S 0 = \ <br /> ^ r <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z <br /> o ° <br /> a <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 dralnffeld (DF). <br /> 3. Show dimensions in feet of thefollowing:(a)buildingto all lot lines,(b)buildingto 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. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED, 7I 3 to <br /> PLOT PLAN �+ z <br /> J/�E'MC (Z C4 Y,'ft o n <br /> arZOQ / fn C o <br /> c <br /> fAC <br /> su <br /> yF _ NIB <br /> 3C <br /> a <br /> 04N <br /> A I \'Awy_ <br /> i N <br /> oR <br /> , / fn tnv (or D DO V <br /> x[J7l � �PIZ/l�lj 117Y m o ° . mv ° aFm <br /> v,� o =a oN <br /> D a m 31 <br /> CONDITIONS OF PERMIT <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F tnT� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. : �= vi m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. oG) O <br /> 8 E : <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- S : �o m 3 a <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa :o•n m w O <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. 1 8 8 <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 ;w0 N O <br /> access to the above described premise reasonable time for the purpose of inspection. "3 8 A <br /> A N <br /> 71 �� o� A : <br /> SIGN HERE _� � m 8 <br /> (si tura of owner or b ' contracto <br /> ZONING ADMINISTRATOR <br /> I <br /> TOWNSHIP PERMITS MAY BE REQUIREDX 1 5 1.79EJ l �q , <br /> �. ivI 9dn o o i$ m <br /> 8'�18t8888v, <br />