Laserfiche WebLink
en � gyp, <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Admi Iipistrator m v z <br /> APPLICATION FOR — LAND USE — PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makesapplication fora Permit for the work desZ <br /> Into and Z <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the require Ms of the � $ Uj <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and th laws and _ <br /> regulations of the State of Wisconsin. - <br /> v <br /> i m <br /> b <br /> OWNER ° nj <br /> _ TELEPHONE 1�. / �7 ,1J O <br /> C J 6, yr.. <br /> ADDRESSm \m <br /> f/- ,ice e Gv 5 VY3 m <br /> EMERGENCY/FIRE NUMBER 2 ,9e,;,2ROAD NAE - <br /> LEGAL DESCRIPTION (see tax receipt) i7 Q / VIP <br /> CONTRACTOR . <br /> C- <br /> 1.2 2/�GcC� <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE X ADDITION <br /> 0 <br /> SANITARY PRIVY FILLING/GRADING 13 <br /> _ <br /> CAMPING UNIT SUBDIVISION o <br /> a <br /> STRUCTURE/ADDITION USE: '^ r <br /> a o <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) v <br /> 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 Nort (N). <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). r <br /> 3. Show dimensions In feet of thef011Owing:(a)buildingto all lot lines,(b)building to center line of road,(c)building0 <br /> measurement to the ordinary high water mark of lake,stream, or river. a <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be sit ned and 2 <br /> dated by the owner. <br /> 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSrTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED, an c <br /> PLOT PLAN Z <br /> Ao a <br /> N <br /> O <br /> C <br /> JJ <br /> to <br /> I 11 <br /> O <br /> 0 <br /> O <br /> N � <br /> J) <br /> Z <br /> I <br /> F <br /> m. Dg� � n� mM <br /> CONDITIONS OF PERMIT _ <br /> < w': •z � <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. c E i -.z rn <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. rn - 33 <br /> D <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of nnknowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs. r m- ' M <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that th s infor- $ g ` m <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue armit. I 8 <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in his ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have <br /> access to the above described premises at any reasonable time for the purpose Of inspection. m <br /> m <br /> SIGN HERE J <br /> (signature of owner or building contractor ) Q a,: <br /> (date <br /> ZONING ADMINISTRATOR J I v� <br /> 8 . <br /> TOWNSHIP PERMITS MAY BE REQUIRED N N~ N « <br /> ou, r„ fS� v, i��5m <br /> 88888 88 a, <br />