Laserfiche WebLink
0Yl cc" � <br /> Burnett County,7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator CA m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3 <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and w <br /> m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 a <br /> regulations of the State of Wisconsin. <br /> OWNERVq . <br /> �O <br /> TELEPHONE <br /> ADDRESSZU35 fgfKCIA � � VnI� _ e <br /> EMERGENCY/FIRE 1 <br /> NUMBER ROAD NAME (`� - J <br /> LEGAL DESCRIPTION (see tax receipt) N <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION v' p <br /> n L7 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> 0 <br /> " r <br /> STRUCTURE/ADDITION USE o R <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z <br /> c 0 <br /> SO`` o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> UV <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 drainfield (DF). o <br /> 3. Show dimensions in feet of thefollowing:(a) building to 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. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. in a m <br /> c <br /> PLOT PLAN n o n7C <br /> �r-Ilf <br /> M N <br /> c <br /> 1A ` <br /> I�fCAGi-ter '" <br /> o <br /> C� o <br /> N <br /> O <br /> J <br /> b <br /> O y <br /> N <br /> ) Z <br /> A O_ c-oW r rDi a o m <br /> CONDITIONS OF PERMIT: ? m y.i � c 8 0 <br /> fir <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT 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 PERMITTED. N: Q <br /> 1 declare that this application(including an accompanyingschedule has been examined b me and to the best of m knowl- o': C <br /> PP f 9 Y 1 Y Y ` m E <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- { «m« X11 <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- B g m <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I c`$ o <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- y <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have O NO <br /> access to the above described premises at any reasonable time for the purpose of inspection. m 6 <br /> p3 € v ° 9-` <br /> �- 2_ I� <br /> SIGN HERE E - <br /> (signatu of owner or bu Ac (date) <br /> s: <br /> o <br /> ZONING ADMINISTRATOR <br /> « fi««« T <br /> TOWNSHIP P RMITS MAY BE REQUIRED u, 8 N m <br /> 000 (C/1 <br />