Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 702, Siren,WI 54872 Office of Zoning Administrator m 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> z s <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work � N <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - �\ <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y 0 <br /> OWNER -r-I ,.-%oTHY �q TELEPHONE <br /> `i•' � 770 ?O�'3 m r� <br /> m <br /> HOME ADDRESS Zyfa 1)7jv / <br /> EMERGENCY/FIRE NUMBER ROAD NAME /�Ojv /OINc �Dr <br /> LEGAL DESCRIPTION(see tax receipt) 't ✓ _Z36_ P 5"1(o Yro4/S6 S <br /> 9 2 K I G2E . S20 <br /> .I-YO -/4 - 2?-0 O17oc> l07- / CSM V I P 2_T__ <br /> CONTRACTOR ` C rm Go✓ <br /> /�S -- �Sfln/Dt4G,E� G'ows-iP c i/o✓ 01 H/o 5`9 .nurt/7Y <br /> GJE6srE,e W�SGONf/.fJ Si`�93 0 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE_,C],_ADDITION 0 .<i <br /> N O <br /> O <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION <br /> Z o <br /> STRUCTURE/ADDITION USE: tO/}RACE <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> O 3 <br /> T P to <br /> 1. All required dimensions or distances to be shown or drawn to scale. 21 o a <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings(NB)and indicate m <br /> North (N). C o <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s) to centerline of m 4- <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. <br /> ill ll) <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, S <br /> roads, lake, lot lines. I C <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. Ci <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. Q <br /> C) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 2. <br /> CONDITIONS OF PERMIT: o <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT 2 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> 5 OHHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 6. Src( Ear y PL�f/�l \?7g F <br /> 0 C '=. W DD m <br /> 7. a FL �A $gym <br /> - <br /> � m � 01 a'° E =. M <br /> 9 <br /> Amo .0a3 <br /> u[ �2i m <br /> C <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my ' m <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of y p <br /> all Information contained in this application(Including any accompanying schedule)and I further declare that 1 recognize '• <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to is- <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Information I am <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorizetlv <br /> person to have access to the above described premises at any reasonable time for the purpose of Inspection. <br /> SIGN HERE <br /> otu of owner or Ing contractor) J. <br /> ZONING ADMINISTRATOR /19 <br /> S <br /> [ L <br /> TOWNSHIP PE ITS MAY BE REQUIREDI!1 ' .0 N�o N N ,r"n o m <br /> �' �)+I o0 . 0 . ggoN <br />