Laserfiche WebLink
Burnett Coynty 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d m o a <br /> APPLICATION FOR — LAND USE — PERMITS - <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and � <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 U, <br /> regulations of the State ofiscons'n. <br /> N <br /> C ) <br /> OWNER TELEPHONE <br /> ( Yl o <br /> ADDRESS ,1 -7 't,3, m <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) NIS <br /> CONTRACTOR . f SG' �( Sy �A At to t lC— <br /> TYPE OF PERMIT(S): DWELLING/BUILDINGGARAGE/ACCESSORY STRUCTURE ADDITION o <br /> n O <br /> SANITARY PRIVY FILLING/GR40ING CAMPING UNIT SUBDIVISION 0 �( <br /> o <br /> 4 w r- <br /> STRUCTURE/ADDITION USE7 CCS ( V1 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) z o CJ <br /> m <br /> 3 <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). r <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). o <br /> 3. Show dimensions infest of thefollowing:(a)building to all lot lines,(b)building to center line of road,(c)building -q <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. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSrTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 71 5 y <br /> �I z `o <br /> PLOT PLAN \ o a <br /> iS <br /> C q S <br /> J t <br /> / M <br /> 3U -E�us ��^�V � r( <br /> ie _ 5-tw� old- <br /> � <br /> floc T.00Ioxc <br /> e (S a V F- ct� <br /> Itr i �� Pct o✓a j <br /> td Oe` <br /> 7:7 <br /> mc�N �cnia � � <br /> VrV m D—. bay r = M <br /> CONDITIONS OF PERMIT: \/ _': Z T$ ro �_ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F �Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N: 9 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. o2 i p <br /> o : ig <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o : C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor. a g p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 $(2 <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- <br /> plication.I agree to permit county officials charg d with administering county ordinances or other authorized person to hav O N p <br /> access to the above descr' ed premises at any0lbasonable time for the purpose of inspection. m 3 00 ' <br /> Q A N <br /> SIGN HERE $ <br /> ( ' na re of Nw r building actor) ! - -- (date) I - <br /> ZONING ADMINISTRATOR <br /> - ; <br /> TOWNSHIP PERMITS MAY BE REQUIRED ! o d N <br /> ' ):0 0 0 0 0 0 o S <br />