Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator Eo 0 <br /> APPLICATION FOR - LAND USE - PERMITS 3. <br /> TO TF1E ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and c <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 n <br /> regulations of the State of Wisconsin. = o <br /> w d <br /> N � <br /> C <br /> OWNER4 4/S ' / J� TELEPHONE /�J ?i5 _�pi/� O I 1 O <br /> ADDRESS Il3n%[D/JG ^ f7Z�19T' ST OA/- <br /> �YlYlf/ S SD�� <br /> EMERGENCY/FIRE NUMBER7?2 �7 ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) / J <br /> CONTRACTOR A o/Z7X 4 fA f�/� j'_ ,C <br /> TYPE OF PERMIT(SS)):I�DWELLIN/G/BB1UILDING /GCA,RLA.GE/ACCESSfR—Y STRUCTURE ADDITION `� p <br /> CD <br /> � N <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o` <br /> STRUCTURE/ADDITION USE: t�,t}I i-J / i��✓Z 9 �/C,"I <br /> 0 <br /> (Home/Cabin;06mmercial Business; Broom;Deck;etc.) Z v <br /> 00 <br /> a <br /> Cb <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 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 -q <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. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. o CA <br /> PLOT PLAN ,5'Z! 7/'.90— e-o Z `CL <br /> o a <br /> 5 <br /> fe cy y <br /> L <br /> C <br /> SU J j <br /> Cn <br /> L CD <br /> 1 <br /> N <br /> A <br /> Z <br /> 30 <br /> n9 r�lnv�nr DDOV <br /> c �<._ n CL F m <br /> CONDITIONS OF PERMIT: '0 ��—, ,z c 8 <br /> 1, DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z (D O. �Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. o ; 2 <br /> o : : is <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o' mid C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- (� d'w d' T <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 8 B 8 : p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. <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. T 3 00 <br /> (D mn m : <br /> SIGN HERE _ _ �+ o <br /> (sig tur of owner uilding contractor) I _ (date) ? x <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRE' � T <br /> ii'' <br /> N N W N N N V m <br /> I. O Vn Un (n (n NON m <br /> 0 o M <br />