Laserfiche WebLink
Cc Cent[) <br /> Bumett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator rnIt m c c <br /> APPLICATION FOR — LAND USE — PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and � a V� <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 /> r tf ca v <br /> OWNER 16 '(1 r'1_IS�-,`� L has TELEPHONE o. £ <br /> ADDRESS V1L1� MY) m <br /> EMERGENCY/FIRE NUMBER 7(YROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING VV GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION O o <br /> o �. <br /> J (rte <br /> a r <br /> STRUCTURE/ADDITION USE: o 0 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;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 No h (N). <br /> 2. Show the location of the well (yi),septic tank (ST),and drainfield (D17. <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(d)building <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be s gned and M <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a y <br /> c <br /> PLOT PLAN an o 'n <br /> o <br /> C I = <br /> a � <br /> C � <br /> �� <br /> � , s ��-3� <br /> N <br /> O <br /> IJ <br /> O <br /> J <br /> m <br /> O � <br /> r I <br /> Z <br /> F <br /> b'9 &0 >0 m <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. c `z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. y' <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best ol my knowl. <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of kit informs- ;i m"' T <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize th this infor- a 8 <br /> motion 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $r$ $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providin in this ap. <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized per on to have : E O` p <br /> access to the above described premises at any reasonable time for the purpose of inspection, e <br /> m $ ! <br /> m <br /> SIGN HERE ` '• <br /> (signature of owner or building contractor) (date) - - <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED `= 8 <br /> oNa �N � am <br /> $ $ $ $$$ $ $ rmn <br />