Laserfiche WebLink
6Y1 c.tmp, <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54072 Office of Zoning Administrator ur m o 0 <br /> ' �. <br /> APPLICATION FOR — LAND USE — PERMITS m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <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. <br /> ]ISSN �8 -�i '�� ► <br /> OWNER Pkut^A `{ E} ANSQN TELEPHONE / I � 1_ (1�_ gc��'� <br /> rT LJ1-n`h 6 OO'1 m A <br /> ADDRESS 10'3+ CLEVEL.RN> RUC S, . 4(07 S) ( lug MtJ 5'6711 l ) r4-IEMERGENCY/FIRE NUMBER D 1-7 +- ROAD NAME j? <br /> LEGAL DESCRIPTION (see tax receipt) �3m �{ , �4 V' <br /> CONTRACTOR H44 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> C) �) <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISIONa o <br /> p / ( , + m <br /> STRUCTURE/ADDITION USE: SC BEEN Po R L 1`�" X )`-F <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z o <br /> o 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). r <br /> 2. Show the location of the well (W),septic tank(ST),and drainfield (DF). 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 `I <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be at$ned and 'W <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. a <br /> Nm <br /> 11 Z `c <br /> PLOT PLAN ° <br /> A ' < <br /> s <br /> 0 <br /> In <br /> 1 <br /> l <br /> _/ <br /> 0 <br /> N <br /> O Ji <br /> I7) <br /> O � <br /> O � <br /> a <br /> YJ <br /> �J <br /> Z <br /> m <br /> CONDITIONS OF PERMIT: ^ <.z 'z F. ' ; <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. =r=' ' MM <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. j p <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- 8 m� m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize thst this infor- E B E p <br /> motion 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I i <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providing in this ap- ; <br /> plication.1 agree to permit county officials charged with administering county ordinances or other authorized person to have p E <br /> access to theabo scdbed premises at any reasonable time for the purpose of Inspection. <br /> m e - <br /> SIGN HERE. <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR `J <br /> TOWNSHIP PERMITS MAY BE REQUIRED R m <br /> 88888888 ai <br />