Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator W ' - o <br /> f <br /> APPLICATION FOR — LAND USE — PERMITS m <br /> TO THE ZONING ADMINISTRATOR:The here undersigned g by makes application for a Permit for the work described and q mV <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirem ms of the <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. o [� <br /> C ? b <br /> OWNER {� TELEPHONE /£ <br /> ADDRESS 6 \ a f <br /> O til 0 1 I <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) �CIT � L - Q - 6� CSrt'I / V) <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o <br /> 1 re � / <br /> STRUCTURE/ADDITION USE: [= C Gl o 2 1A <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;ete.Tj Z o r <br /> V` S <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 (N),septic tank (ST),and dreinfield (DIF). <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,( )building <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 signed 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 ISSUED. 7I c u, <br /> PLOT PLAN t Z <br /> C <br /> � j <br /> Cs <br /> 0 <br /> _ <br /> o <br /> a I <br /> r 2 <br /> M $ in�r6'�f aov <br /> CONDITIONS OF PERMIT: c8 ga. r. <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. 2 e d': Z : —I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. e <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. r" : Q m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my know[- ': o <br /> �S O <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all infonna. i « « <br /> tion contained in this application(including any accompanying schedule)and 1 further declare that I recognize that this infor- i B p <br /> mation I am providing will be relied upon by the Gounty of Burnett Wisconsin in determining whether to issue a permit. 1 $ 8 <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.1 agree to permit county officials charged with administering county ordinances or other authorized per n to have p <br /> access to the above described premises at any reasonable time for the purpose of Inspection. <br /> T <br /> SIGN HERE - « <br /> (sign tura of ow r r ding e n ac q <br /> i <br /> ZONING ADMINISTRATORIUD <br /> - <br /> �� MMM MM«• 'Tt <br /> TOWNS IP PERMITS MAY BE REQUIRED t, ✓) . rNJ i$ m <br /> U $ $ $ 888 fn <br /> ,gyp he -se,T , , I - pis <br />