Laserfiche WebLink
ems• co"-p , <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator u m o o <br /> APPLICATION FOR — LAND USE — PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes m ° <br /> g by 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 <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. rA m <br /> w m <br /> C <br /> OWNER TELEPHONE /71 _.I23 VA a f <br /> ADDRESSii{rrr�����7 % J� cK�G•� �Si l �CiG C-rJl S7�S� I� <br /> EMERGENCY/FIRE NUMBER ROAD NAME -y-�r— <br /> LEGAL DESCRIPTION (see tax receipt) • <br /> AG .fI l�L-JC/PLT o26 7_5/,9A/ � �j <br /> CONTRACTORa.,v <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> N <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> o <. <br /> 0 <br /> STRUCTURE/ADDITION USE: A-/ (O o ° <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) z <br /> o ° <br /> v <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 dralnfield (DF). 6 <br /> 3. Show dimensions Infest 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 M <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 a y <br /> c <br /> PLOT PLAN ' �p)9 o n <br /> N e NI <br /> A <br /> _ <br /> y _ <br /> ( I <br /> Loi 10 <br /> a6eve <br /> P <br /> l — m <br /> �u� 1�u <br /> be ll 0o pr <br /> ° <br /> /Wif 461112 o <br /> T <br /> C <br /> E DO <br /> Ga`r(�;vr T f <br /> 51djl!E /38 �- <br /> m_ D w p m y = M <br /> CONDITIONS OF PERMIT: 12 w o 03 n' 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. 0 m' o ' °Z : 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. c f T N y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. ' Yn Q : m <br /> m c E C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- g ': ! m m . <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- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 8 a 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 above described premises at any reasonable time for the purpose of inspection. m'�'P f <br /> ' : 9 8 x <br /> Ao : <br /> SIGN HERE 0� `^"�� �C o 8 <br /> (sign owner b ilding contractor) nx P <br /> S <br /> ZONING ADMINISTRATOR N 07179 7 1 ` 8 . ' <br /> LM <br /> M 2 5 iwi","" m <br /> TOWNSHIP PERMITS MAY BE REOUIRII <br /> h v v v w o o m <br /> E -_ <br /> $ 8888888w <br />