Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator 5. ; o <br /> APPLICATION FOR LAND USE PERMITS m 3, <br /> s <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for t� work � y <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with I other 3- <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. j. m <br /> OWNER '/ N� TELEPHONE <br /> G, W n v± <br /> HOME ADDRESS � '1 `�.' P !'SOV s'J q �I l �^ <br /> o� / (5 O <br /> EMERGENCY/FIRE NUMBER ROADNAME A)e1ZV4 <br /> LEGAL DESCRIPTION(see tax receipt) S S vv C_ / -�y,, OF 5f4/(54 <br /> J <br /> CONTRACTOR l <br /> v � <br /> G <br /> TYPE OF PERMIT(S): DWELLINGBUILDING GARAGE/ACCESSORY STRUCTURE--V--ADDITION »' <br /> N y , <br /> O IV <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISIONS Z a <br /> 9 0° <br /> STRUCTURE/ADDITION USE: <br /> WOO d 64)ed <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 R <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. �I <br /> O <br /> 3 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) I O a <br /> 1. All required dimensions or distances to be shown or drawn to scale. n <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate C W o. (� <br /> North (N). w <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerli e of m �1 <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or r er. UUj x <br /> 4. Show the location of the well(W), septic tank(ST) and drainfield (DF), and all distances to buil ngs, <br /> roads, lake, lot lines. (J <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. p <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans mint be N <br /> signed and dated by the owner. o) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION E- � ° <br /> FORE A PERMIT CAN BE ISSUED. IIIA <br /> N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o i <br /> 3. <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERM T <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 I' I ? <br /> PERMITTED. 11 9 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> f <br /> 6. <br /> m m v m D D y <br /> O, c =. <br /> 7. $ m K4 ff -g g 2- M <br /> < Loo. ; v o =m ; <br /> Ki <br /> m A Z : : 1 <br /> Z F = = y <br /> 8. ' — m <br /> Y6 c�� ' C <br /> s; <br /> o <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the bi at of my i <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and acq uracy of i N y O <br /> all Information contained in this application(including any accompanying schedule)and 1 further declare that I r Pcognize E o o <br /> that this Information I am providing will be rolled upon by the County of Burnett Wisconsin in determining whet er to Is- <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Informa Ion I am O p <br /> providing in this application. 1 agree to per it county officials charged with administering county ordinances or other E 3 2 <br /> authorized person to have access t o a de bed premises at any reasonable time for the purpose of Ins Pection. m ? m <br /> N <br /> H <br /> SIGN HERE Z—f1 C �� ` `• N i i <br /> (46ature <br /> �of"nor or building ctor) (data) <br /> ZONING ADMINISTRATOR '�/IIYIIG1flIG�c�ri g <br /> N N N N N N V7 m <br /> TOWNSHIP PERMITS MAY BE REQUIRED o o mo 0 0 0 0 o m <br /> i3fi! o0000000M <br /> I <br /> T— T� <br />