Laserfiche WebLink
,t)fl.c� <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator E m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 2 w <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. you <br /> TELEPHON y m <br /> OWNER E G y � � �Ut 61,S) <br /> � m <br /> ADDRESS N 3 -7 nSC eo l a, wf 54ODC m <br /> EMERGENCY/FIRE NUMBER ROAD NAME (1 1 C <br /> LEGAL DESCRIPTION (see tax receipt) /v W `f� N w-4- s-3 (, -r_q o Q 1- i-I W <br /> -r1` .il <br /> CONTRACTOR S C <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_K: ADDITION o <br /> n 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° - <br /> 0 <br /> /n� N <br /> STRUCTURE/ADDITION USE: 7' O <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) �j z <br /> o ° <br /> a <br /> � \ m <br /> N } <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). r <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (D17. oC 4 <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 f A <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. Q o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 'tI a to <br /> 71 z `o <br /> PLOT PLAN o a <br /> F <br /> M <br /> 0 <br /> C I <br /> t� 4— <br /> 52C �c�� m <br /> f <br /> e <br /> N <br /> N <br /> O <br /> O o4 <br /> R r <br /> b M <br /> O / y <br /> n' <br /> N 2 <br /> f <br /> n C.n j a 0 - <br /> m -6.4!M2 vm M <br /> lirCONDITIONS OF PERMIT: o ?. `z 9,2 : ro <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <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 n m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my know[ <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all inform In <br /> in contained in this application(including any accompanying schedule)and I further declare that I recognize that this into O <br /> "on I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. <br /> accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap <br /> 1 agree to permit county officials charged with administering county ordinances or other authorized person to have <br /> -he above described premises at any reasonable time for the purpose of inspection. m <br /> r 3 <br /> m <br /> w fP <br /> (signature of owner or buiKrr c trac (d e) x <br /> \q <br /> 0 <br /> m <br /> TOWNS PERMITS MAY BE REOUIRED o N 0 N m <br /> 00 0 0o0M <br />