Laserfiche WebLink
rtn <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator Z <br /> APPLICATION FOR - LAND USE - PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and m ° <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 <br /> regulations of the State of Wisconsin. 3 a �— <br /> o � 1J <br /> I N y <br /> OWNER <br /> L [ h LLIM TELEPHONE O <br /> ADDRESS / ty� }I {/ <br /> 1081 I o -r L fl u'{ cYQ�bVY'r, w' <br /> EMERGENCY/FIRE NUMBER ROAD NAME v I J <br /> O l 1 <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> D ; M_ _._DW ♦ 9 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_ ADDITION <br /> 0 <br /> SANITARY PRIVY FILLING/GRADINGCAMPING UNIT— OSUBDIVISION <br /> a <br /> /} <br /> �— Car /'oi� <br /> STRUCTURE/ADDITION USE: y r- <br /> o � <br /> (Home/Cabin,Commercial Business; Bedroom;Deck;etc.) v Azo <br /> P m � <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). C <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). j 67 —_ <br /> 3. Show dimensions infest of thefollowing:(a)building to all lot lines,(b)building to center line of road,(c)building C <br /> measurement to the ordinary high water mark of lake,stream, or river. S <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. r_ <br /> Q 0 <br /> NOTE: BUILDING/STRUCTURE LOCA IONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. <br /> 77 <br /> PLOT PLAN v <br /> Z <br /> n T <br /> C =n- <br /> z fn <br /> �CA, - <br /> O a P _IJ <br /> ?t { d <br /> Q m <br /> a U h ` � o <br /> a i 'K 1 <br /> 00 <br /> O o <br /> O <br /> r <br /> Q E <br /> !� ;-TCIO ` V <br /> 441 z <br /> N <br /> DuZr IQo�7r <br /> Y4i <br /> SO cc Miami r—a -0 <br /> CONDITIONS OF PERMIT* m a we a F m <br /> a' m g�Z c`r4 > > <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. z F' : gc : fO <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. u, ; r' <br /> 9,: M <br /> R0 m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 9J oo' m C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all intorma- m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- <br /> mation I am providing will be relied u y y g p v B <br /> upon b the Count of Burnett Wisconsin in determinin whether to issue a permit. I b o <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providing in this t. 1 o o <br /> Plication. I agree to permit county officials charged with administering county ordinances or other authorized person to have ni <br /> access to the above described premises at any reasonable time for the purpose of inspection. ' O 0 o <br /> m <br /> ar ' a Ao <br /> SIGN HER L w E H $ <br /> 0 : <br /> (sign of owner or building contra tor) (d te) ' " '- <br /> ZONING ADMINISTRATOR `S <br /> g : <br /> TOWNSHIP PER MAYBE REQUIRED o v N 0 0 m <br /> ro `"« m <br /> V <br /> 0000p <br /> 0 0 0 0 0 o o m <br />