Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m ; o a <br /> APPLICATION FOR - LAND USE - PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR:The undersigned here makes m <br /> g by application for a Permit for the work described and Q <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and _ n <br /> regulations of the State of Wisconsin. w m° <br /> w m <br /> c <br /> OWNER o O <br /> Q,(�ALP [y TELEPHONE / _ G/ ? - t(Sy- l Z) r m <br /> ADDRESS ME.NdOTN N�� RIS g f <br /> ?..2 z, �ie.in. CroNE DI/" N/U lao <br /> EMERGENCY/FIRE NUMBER 195- 7.5- ROADNAME NO' Rif ,I� RGI <br /> V <br /> LEGAL DESCRIPTION (see tax receipt) ^_1 I E_ I . 1 <br /> CONTRACTOR rel W <br /> !�-IZ ' / <br /> TYPE OF PERMIT(S): DWELLINGI/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> nL) <br /> SANITARY PRIVY (LUNG/GRADING CAMPING UNIT SUBDIVISION <br /> 0 IC <br /> 0 <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;CommercialBusiness; B-91 oom;Deck;etc.) Zv (t1 <br /> 0 0 <br /> m <br /> } <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). I o <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (OF). <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. G <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and M <br /> dated by the owner. o 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 o N <br /> c <br /> PLOT PLAN <br /> O ,n SOF f1RL� c a <br /> n1 o <br /> H ' rj <br /> m C <br /> r <br /> / O I� <br /> N <br /> l rIV� b <br /> I <br /> O <br /> Q z <br /> o <br /> m o c m m n F m <br /> am <br /> ic <br /> CONDITIONS OF PERMIT: = _, m ,2 $ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o £ .;,'z -1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. - t^ I m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. . . . m C <br /> c : <br /> $ ' m m M <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- .(� o O : In <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- <br /> mationI am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $ m $ <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.I agree to permit county officials charged with administering county ordinances or other authorized person to have 00 0 <br /> access to the above described premises at any reasonable time for the purpose of inspection. m 8 R <br /> 3 x : <br /> m <br /> A m <br /> SIGN HERE <br /> gn ure of ow r r building contractor) (date) `: o _ x <br /> O <br /> ZONING ADMINISTRATOR <br /> N� T <br /> TOWNSHIP PERMITS MAY BE REQUIRED N N N O N . O 6)O m <br /> 88888 8a) <br />