Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, W1 54872 Office of Zoning Administratorm o 0 <br /> APPLICATION FOR — LAND USE — PERMITS <br /> N— O <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 m <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and j �:- <br /> regulations of the State of Wisconsin. <br /> m m <br /> C <br /> OWNER TELEPHONE (OIZ-3,35— E <br /> ADDRESS IZO� 1'Pdx �t..A,Cfc 003r 1`�c�rJ . 53`{03 <br /> EMERGENCY/FIRE NUMBER 3 / 9 [_ ROAD NAME W1AL1.�,1?n <br /> Loi r r-sm V. vo . per, Gov, L-m7 5 <br /> LEGAL DESCRIPTION (see tax receipt) .-e <br /> ! `tl0 jy(n d �I W /m >c. 40r, •VJ --4=)N <br /> CONTRACTOR440 <br /> r-�rc / <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p - <br /> o < <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o` <br /> l lN 0 \� <br /> STRUCTURFJADDITION USE: 4�roO 0 <br /> o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o o �tii <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). <br /> 2. Show the location of the well (W),septic tank (ST),and draintield [DIF). o <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. 0 <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I a N <br /> PLOT PLAN 0 c <br /> �cc fTl ;D --'5hk€ T c o <br /> 0 <br /> I <br /> r� <br /> 0 <br /> N <br /> O <br /> (J� <br /> f <br /> 9 NfA vtn �D D � <br /> CONDITIONS OF PERMIT: o c, m a 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. e o m o m 0 3 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> — m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Yn O <br /> $ C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- m <br /> lion 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 g <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 <br /> access to the abov desc premises at any reasonable time for the purpose of inspection. '• flA Y <br /> �1 m SIGN HERE <br /> sign roof owner°s It Ing contractor) (date) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP Pfla <br /> E ITS MAY BE REQUIRED !"n 0%iN N 0 o o� m <br /> `' 88888888 rn <br />