Laserfiche WebLink
6i► ems, <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 OfRce of Zoning Administrator NoIt i 0 0 <br /> APPLICATION FOR — LAND USE — PERMITS <br /> m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v o <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 $ r <br /> regulations of the State of Wisconsin. w <br /> a m <br /> OWNER •� TELEPHONE � <br /> f <br /> YO /J cJ O A <br /> m <br /> m <br /> ADDRESS <br /> EMERGENCY/FIRE NUMBER ROAD NAME �;•KP. 229Zg- <br /> LEGAL DESCRIPTION (see tax receipt) r LO+' �„ G. C -,Y _, YGI �=,+ <br /> CONTRACTOR A'A '�✓9 V <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> 0 L1 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT_ SUBDIVISION o 0 <br /> 0 r <br /> STRUCTURE/ADDITION USE: C GIy o <br /> (Home/Ca in, ommercial Business;Bedroomol eck;etc.) Z <br /> 0 0 <br /> a <br /> m <br /> a <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 dralnfield (DF). <br /> 3. Showdimensions Infest ofthefollowing:(a)buildingto all lot lines,(b)buildingto center line of road,(c)building <br /> measurement to the ordinary high water mark of lake,stream,or river. 0 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 3 va <br /> �_ Z a <br /> PLOT PLAN o n <br /> M <. <br /> /J. C w <br /> III <br /> SCC r'ie'a' W W <br /> I <br /> m <br /> hJ I, <br /> IN 1 <br /> o � <br /> w` 1v�r I <br /> z <br /> m <br /> CONDITIONS OF PERMIT: ' Z 1 S g '_ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. a E 0 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ` 1 =m M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. p1 i 1 O m <br /> o <br /> I declare that lois application(including any accompanying schedule)has been examined by me and to the best of y knowl- S o : <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of I informs- E N m . m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- 9 B `8 ; p <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 <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 officiate charged with administering county ordinances or other authorized person to have p <br /> access to the above described promisee at any reasonable time for the purpose of inspection. ' <br /> SIGN HERE M E <br /> ( na re of ow building contractor) (date) <br /> ZONING ADMINISTR:;��TOWNSHIWERMITS <br /> '• g '• <br /> 8_ y, <br /> MAY BE REQUIRED o �, C08 <br /> 'N S5 m <br /> 8 8'8'8 vmi <br />