Laserfiche WebLink
9(l (t wl <br /> ZO <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 <br /> Office of Zoning Administrator 5 m f <br /> APPLICATION FOR - LAND USE - PERMITS <br /> m g r 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 ail work shall be done in accordance with the requiremems of the `� <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and o - <br /> regulations of the State of Wisconsin. m <br /> O <br /> OWNER R" y��� �/s ,e / TELEPHONE m <br /> ADDRESS / ((� 7� f_�/!- C <br /> EMERGENCY/FIRE NUMBER a g a 3 / ROAD NAME d; L�o p N S o AJ Lr\ t\d C> <br /> LEGAL DESCRIPTION (seetaxreceipt) cs'm L) /p.]/y c 'mJ ipJ39 s.zy 7c/o N04 rJ C 4r h9' cl <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o Z <br /> n O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION °- <br /> � m r <br /> o � <br /> STRUCTURE/ADDITION USE: Z 46U/ Al'y O nl/N c <br /> (Home/Cabin;Gairnmercial Busi ss;Bedroom;Deck;etc.) = o <br /> IIIA 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). � r <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building O Q� <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and CR <br /> dated by the owner. 0 <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED FOR ONSFE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. Z c <br /> PLOT PLAN n c <br /> Ct <br /> a Z <br /> M <br /> ( 0 <br /> o <br /> o © I X7 <br /> m <br /> � y <br /> r <br /> Z <br /> \ I� <br /> C <br /> M (p'D rDDO13 <br /> m <br /> g2.me .m <br /> o gcg8'm � <br /> CONDITIONS OF PERMIT: o I Z ; =1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. stn: i 9 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. . O <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- ,o', , a O N? 33 <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- �, : G <br /> lion 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 $1a $ <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 agre9 to permit county officials charged with administering county ordinances or other authorized person to have {Y Ro <br /> access to the above described premises at any reasonable time for the purpose of inspection. T '• )(-; <br /> ID i e <br /> SIGN HERE contractor) (date) '�QT <br /> (signature of n ` 8: <br /> ZONING ADMINISTRATOR ga N a�N w d,'j T <br /> WNSHIP PERMITS MAY BE REQUIRED C`�0 N N N g m <br /> ' 8888888m <br />