Laserfiche WebLink
Bi' n y <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Admirilstratior m : 0 0 <br /> � � f <br /> APPLICATION FOR — LAND USE — PERMITS m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work desci ibed and Q w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the require m sof 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. w m <br /> w m <br /> OWNER LBVern 4 Vernan TELEPHONE E <br /> ADDRESS tvr tQJ— <br /> (� <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR rano _ 5 f— �- <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAG ACCESSORY STRUCTURE ADDITION p <br /> n <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o <br /> o <br /> w = <br /> STRUCTURE/ADDITION USE: ii <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z <br /> o 0 <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 Noh (N). 1191) <br /> 2. Show the location of the well (W),septic tank (ST), and dralnfield (DF). <br /> 3. Show dimensions in feet of the following:(a)building toall lot lines,(b)building tocenter line ofroad,(c building c <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 sl ned and 9 <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE LED. an a y <br /> PLOT PLAN o n <br /> C <br /> cs(-� In c> <br /> N <br /> O <br /> w_ <br /> Z <br /> ai Mo <br /> 2. e m <br /> CONDITIONS OF PERMIT: 'o 2.: ,z C 8 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br /> G _N <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. — MI <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. rQ" : O m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my know]- O i C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of I III informa- « ? 33 <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this infor- iS B -0 : In <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <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- <br /> plication. I agree to permit county officials charged with administering county ordinances or other authorized pero n to have p <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> m <br /> M w <br /> SIGN HERE E <br /> (signature of owner or building contractor) (date) f « <br /> ZONING ADMINISTRATOR T1,412LOf $ <br /> TOWNSHIP P RMITS MAY BE REOUIREO ««�«««�' -t <br />