Laserfiche WebLink
Burnett County 7410 Co. f1d. K, No. 102, Siren, WI 54872 Office of Zoning Administrator rny Z <br /> m m o 0 <br /> APPLI ATION FOR - LAND USE - PERMITS3_ <br /> d 0 <br /> TO THE ZONING ADMINISTRA OR:The undersigned hereby makes application for a Permit for the work described and �2 m <br /> located as Shown herein. The u idersigned agrees that all work shall be done in accordance with the requirements of the m <br /> Burnett County Land Use Ordini ince, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of Wiscc nsin. o <br /> N m <br /> m <br /> c <br /> m <br /> OWNER (! ^i� �� TELEPHONE <br /> ADDRESS �� In>� Tj <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax rec(ipt) Cl <br /> CONTRACTOR "1 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p -� <br /> m a <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION�_ o <br /> r <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) ZC+ <br /> o ° <br /> 0 <br /> m <br /> D <br /> DIRECTIONS FOR PLOT PLA 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 thew II (W), septic tank (ST), and drainfield (DF). <br /> 3. Show dimensions in feet oft efollowing:(a) building to all lot lines,(b)buildingto center line of road,(c)building .� <br /> measurement to the ordinarV 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 aJ <br /> dated by the owner. o <br /> 0 ° <br /> NOTE: BUILDING/STRUCTURE LO TIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I 3 N <br /> �I Q <br /> PLOT PLAN Z0 n <br /> ° --- <br /> C ' <br /> M <br /> y <br /> Cg <br /> N <br /> � r <br /> N_ <br /> O <br /> 2 <br /> I <br /> M <br /> O c d r D 1:E <br /> CONDITIONS OF PERMIT: a N.: c 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o E �� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =N y <br /> 3. NO GRADING OR SHORE ND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. SMn m <br /> IF D <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <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 m M M <br /> tion contained in this application (including an accompanyingschedule and I further declare that 1 recognize that this infor- is g m <br /> PD (� 9 Y 1 9 p <br /> mation I am providing will be re led upon by the County of Burnett Wisconsin in determining whether to issue a permit. I E n-;J $ o <br /> 0 . <br /> further accept all liability which i iay be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication.I agree to permit count officials charged with administering county ordinances or other authorized person to haveO N o <br /> access to the above described premises at any reasonable time for the purpose of inspection. ° m b m <br /> M ' 3 o <br /> m m <br /> SIGN HERE S : - <br /> o : <br /> (sigr ature of owner or building contractor) (date) `e <br /> ZONING ADMINISTRATOR ml Rao " <br /> 1411 <br /> TOWNSHIP PERMITS MAY BE REQUIRED o � N N <br />