Laserfiche WebLink
06 __" f / <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator N : 0 0 <br /> APPLICATION FOR — LAND USE — PERMITS <br /> s <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 $ <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. m <br /> m m <br /> OWNER n TELEPHONE n £ <br /> ADDRESS <br /> � m <br /> EMERGENCY/FIRE NUMBER n.,,.. ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt)-�1 I I <br /> CONTRACTOR _ r eQn <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION -'o ° <br /> <. <br /> w � <br /> STRUCTURE/ADDITION USE: o <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z �) <br /> o ° <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 drainfield (DF). <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,( )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 signed 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. 11 o m <br /> c <br /> PLOT PLAN n Z <br /> 4o <br /> ��� s m 9 <br /> V , s � a� � o <br /> Z <br /> ° <br /> 0 <br /> w <br /> 2 <br /> i <br /> IIJ) <br /> G <br /> g <br /> CONDITIONS OF PERMITS a m g Z c s ' <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o E �'z i —4 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. —NN M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. �y' ' O'[i i m Lr ccI declare that this application(Including any accompanying schedule)has been examined by me and to the best o my knowl- o i <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of ill informs- i •+ •+ m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize ths I this mfor- <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I ? $1 $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providin in this <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized per, n to have - <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> In <br /> w - <br /> SIGN HERE <br /> (signature of owner or buildings contractor) (date) <br /> ZONING ADMINISTRATOR l E $ <br /> www+�MNp� TI <br /> TOWNSHIP PERMITS MAY BE REQUIRED o N g S) R 8 m <br /> $$ $ $$8 $$ umi <br />