Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator Q) -00 ,� <br /> � 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 <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <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. H o <br /> c <br /> OWNER Geohoe ModeAzon TELEPHONE (715) 349-7318 0 <br /> ADDRESS 23950 ToRandeA Road #2 S2A.en, WI 54872 m <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> I <br /> LEGAL DESCRIPTION (see tax receipt) nCy. SE 114, NW 114, Section 10, T378N, R17W, Town o�j <br /> CONTRACTOR an ce <br /> tZ <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> 0 <br /> SANITARY X PRIWFILLING/GRADING CAMPING UNIT SUBDIVISION O —� <br /> o <. <br /> r <br /> STRUCTURE/ADDITION USE: .SanT.tO✓CGf ()neU <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) Z 1 V <br /> o <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 (N/), septic tank (Sri, and drainfield (DF). �__= 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 I <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 N <br /> PLOT PLAN 1A Z <br /> a <br /> o a <br /> M <br /> 0 <br /> C <br /> 0 <br /> SER ATTACHED <br /> N <br /> O <br /> O <br /> m <br /> � y <br /> I <br /> Z <br /> ab <br /> N <br /> D g) U)V WrDDO <br /> cam.> > 0af m <br /> m — g� am m <br /> CONDITIONS OF PERMIT: v m ;: C .ro <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o E 0 �Q 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N = y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N g m <br /> of nL O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- i 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- rn aXI <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- p! o G <br /> malion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o� o <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 N" o <br /> access to the above described premises at any reasonable time for the purpose of inspection. m 8 m <br /> m 7 A : <br /> SIGN HERE Wade. Ru. hn0A.n1 . _ <br /> (signature of owner or buildin c ntr <br /> ZONING ADMINISTRATOR 11 UW <br /> y 'nTOWNSHIP PER ITS MAY BE REQUIRED I p N N m <br /> !' o o � <br /> 0ooN <br />