Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Adfnil,�iatrator m <br /> APPLICATION FOR - LAND USE - PERMITS <br /> m = <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes - '- <br /> g by application for a Permit for the work tlesc ibed and � v <br /> located as shown herein. The undersigned agrees that all work shell be done in accordance with the requirem nts of the m n—r-, <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and �_ (} <br /> regulations of the State of Wisconsin. w m ) <br /> OWNER n _� <br /> (T, TELEPHONE m � FO <br /> ADDRESS <br /> EMERGENCY/FIRE NUMBER ROAD NAME ccc' <br /> 1) <br /> LEGAL DESCRIPTION (see tax receipt) <br /> 1 <br /> CONTRACTOR n <br /> TYPE OF PERMIT(S): DWELLING/BUILDINGGARAGE/ACCESSORY STRUCTURE ADDITION I p �. <br /> o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o (rte <br /> STRUCTURE/ADDITION USE: -mSAW �� LJ �I o o ( r <br /> (Home/Cabin;Commerci usiness; Bedroom;Deck;etc.) I <br /> o <br /> 0 <br /> m <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). .°r. <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c 1 building <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 sI ned and 9 <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE SSUED. 1I v rn <br /> PLOT PLAN o n <br /> C <br /> M <br /> , <br /> 0 <br /> n <br /> J ° <br /> 0 li <br /> O � <br /> N <br /> IO <br /> f <br /> e Dg� '-�'nN � m � <br /> CONDITIONS OF PERMIT: .1 m z c 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o 0 0 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. —Ng33 <br /> 3, NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. LAA m <br /> is <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl. - 0 C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of a II mforma- rn <br /> am a; <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- B <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue permit. I i g� $ <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 pare 3n to have ; 0: o i <br /> access to the above described premises at any reasonable time for the purpose of inspection, m <br /> m <br /> Mi i N <br /> SIGN HERE <br /> (signature of owner o b ildine t oh (date) H' <br /> i <br /> ZONING ADMINISTRATOR E $ f <br /> TOWNSHIP MITS MAY BE REQUIRED <br /> � $ $$ $$ y <br />