Laserfiche WebLink
op, e4wp <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o 0 <br /> E <br /> APPLICATION FOR — LAND USE — PERMITS m T <br /> TO THE ZONING'ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and o c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the 3 C <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 /> m m <br /> OWNER GQ V <br /> , <br /> F �' JO,Jj ISQr4 TELEPHONE <br /> r� 1, + / E <br /> O ' <br /> ADDRESS 30399 Hwy 35- ORNBURV , Wk S"183o m <br /> EMERGENCY/FIRE NUMBER ROAD NAME 1 <br /> n1 � <br /> LEGAL DESCRIPTION (see tax receipt) V I <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> 0 <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION ISION o h <br /> � l�J <br /> STRUCTURE/ADDITION USE: 'Sant °- <br /> (Home/Cabin;Commercial Business;Bedroom;Dec ,etc.) Z v <br /> 0 0 <br /> v <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)building C� <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. H separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 <br /> dated by the owner. 8 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. in 3 to <br /> PLOT PLANn <br /> �I rt e Alf <br /> ce'-wer- of5'�4ckc L <br /> %S onlY' ari-J�Vt1/ DfI� w 1 <br /> Am A c.to E n h/ ,/�'///�/_C/� I� h <br /> �° <br /> l?aoe <br /> IN <br /> R � <br /> 4N <br /> Z <br /> r� r <br /> CONDITIONS OF PERMIT: v g y : •z m o <0 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F T� <br /> 2. R�IJfOPAr'OR-LOTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOAEUNE. XI <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Ii: O : O <br /> gt <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> C_ <br /> edge and belief It is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- <br /> tion contained in this application(including an accompanyingschedule)and I further declare that I recognize that this infor- <br /> mation <br /> ` a m <br /> PP i 0 Y g a°o O <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. <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 person to have <br /> access to the above described premises at any reasonable time for the purpose of Inspection. 0 : <br /> r : 380 <br /> q m A a <br /> SIGN HERE _ _ 13 ~ ~ <br /> (aignatu of own b I n� to � � I, $ - a <br /> ZONING ADMINISTRATOR <br /> rn <br /> TOWN HIP PERMITS MAY BE REQUIRE R r'�'1(�(,J,x' ~ rn <br /> -� yJ III NNlN,4100 <br /> �I88 $8 $ m <br /> u <br />