Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m 'ao 0 <br /> APPLICATION FOR — LAND USE — PERMITS 0 <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 lst <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. <br /> 0 <br /> m' <br /> n O <br /> OWNER L TELEPHONE rl G f <br /> AllCl7Ic�c f F� Q '741Y1 <br /> m <br /> ADDRESS RT' PAI Y-1 <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (seetaxreceipt) Ln <br /> �A'CA 9_,� 3 <br /> CONTRACTOR (' / r I 0 -15- <br /> TYPE <br /> 1JTYPE OF PERMIT(S): DWELLING/BUILDING Mme' GARAGE/ACCESSORY STRUCTURE_ ADDITION p <br /> n 17 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> `^ r <br /> STRUCTURE/ADDITION USE: C+13 ou, o <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) z <br /> 0 0 <br /> m I `' <br /> V' <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) (0 <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). j <br /> 3. Show dimensions infeet of thefollowing:(a) building to all lot lines,(b)building to center line of road,(c)building (y <br /> measurement to the ordinary high water mark of lake,stream, or river. -1 <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 3 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED.911 <br /> 7I a rn <br /> PLOT PLAN 0 <br /> fAt t m a 3 <br /> Q C <br /> �j <br /> O � o <br /> v > <br /> -de <br /> o / 3 <br /> a a° 130f , <br /> z <br /> I ' <br /> Am <br /> �✓ -�...� m O c�d r o a� 17 <br /> n =$� 2. amm <br /> DITI S OF PER T:K1eyers -4 <br /> D C l V C'- W !a Q c $ �ro r. <br /> J m o ` <br /> MEET DRIVEWAY WIDTH REQUIRE TS z .2 WITHIN M-, MYS..OE-RERM1T-13SUA o > <br /> 2. REMO ETATf CTED ALONG SHORELINE. F a N: M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. '�" ` 62i <br /> $ E <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- —0 a m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 85 g ; p <br /> .motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $� $ <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 charged with administering county ordinances or other authorized person to have O 0 <br /> access to the above described premises at any reasonable time for the purpose of inspection. N 0 <br /> „ 2 A 0 <br /> N � A N ; <br /> SIGN HERE ' """ 0 $ <br /> (signature n bui In r I t 1 =- Ni <br /> p <br /> ZONING ADMINISTRATOR ' $ E E <br /> T WNSHIP PERMITS MAY BE REQUIREDL� i 7 Lj <br /> 000080 <br /> n <br /> 00000 <br />