Laserfiche WebLink
'-p. <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 10 m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> o J <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 A n, <br /> a 1h� <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances Ordinances and the laws and _ <br /> regulations of the State of Wisconsin. N m <br /> m <br /> OWNER AL +�(j�►►.I alE �E[JMLl,I�S/`I TELEPHONE <br /> N�� 1� O_ <br /> '/ m <br /> ADDRESS Z 2 2_(94 <br /> O`t tier m A/J �, &E'D,57pur S9Fi��-7 e <br /> EMERGENCY/FIRE NUMBER r7 '7 ©� ROAD NAME /7 Ea6mwjPr QQ 1 <br /> S_'R �'S <br /> LEGAL DESCRIPTION (see tax receipptt))p„L � 3 /6.0 2 w2oo, Ln-r I CSM V' 3 P t 2-4 <br /> CONTRACTOR SL L F ` <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_ ADDITION <br /> 47 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o °- <br /> STRUCTURE/ADDITION USE: 0M F f wAl c ee7nmk ak/�Is <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) z o <br /> 0 0 <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). g <br /> 3. Show dimensions infeet of thefollowing:(a) building to all lot lines,(b)buildingto centerline of road,(c)building -0 <br /> measurement to the ordinary high water mark of lake,stream,or river. Q <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. ON a W <br /> 71 z `v <br /> PLOT PLANo a <br /> Q <br /> M 0 <br /> C <br /> a , <br /> pQppoSEA C7 C <br /> ADOITIor-I <br /> s as' <br /> 4 O <br /> /Ex IsTtM4 N }2J <br /> o' \ <br /> i <br /> ExisTtal4 NouSE � <br /> 38 PaoPosED <br /> Cct4cli F <br /> Dill <br /> 3D/x35' <br /> � aim <br /> y PLOT 'TO 5cnt6 'pp �,C� v �'$� too <br /> CONDITIONS OF PERMIT: m - ' C <br /> m <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. e £ _ <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. y^, <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. o n O <br /> $E' <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 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- 9m «� m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- I V B g O <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I ill <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. y, <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have s m N m <br /> access to the above described remises at any reasonable time for the purpose of inspection. T 3 00 3f• <br /> N m A N <br /> N <br /> W <br /> SIGN HER <br /> p a: � <br /> tiding co r tor) <br /> (signature otoer 1 <br /> ZONING ADMINISTRATOR <br /> N N W N N N N m <br /> NSHIP PERMITS MAY BE REQUIRED <br /> 00 g 000 $ o N <br />