Laserfiche WebLink
Burnett county 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o 0 <br /> APPLICATION FOR - LAND USE - PERMITS >E <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and a <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the req uireme s of the <br /> Burnes County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the h iws and <br /> regulations of the State of Wisconsin. <br /> 0 <br /> w m <br /> w m <br /> c <br /> OWNER TELEPHONE a E <br /> ADDRESS ,D . '�O1` Af�(BUIZ W1 , 5LI$30 m A <br /> EMERGENCY/FIRE NUMBER ROAD NAME �1 <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR 1--- <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION I p <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION �^ o <br /> o < <br /> STRUCTURE/ADDITION USE: o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -0 <br /> Z o' <br /> o v <br /> W m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) WW <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). ^J <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). 11 a <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)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 sig ed and 0 <br /> 9 <br /> dated by the owner. O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE UED. 3 y <br /> PLOT PLAN A o cvv <br /> m n o <br /> C � <br /> W � <br /> 111 0 <br /> pTrlgC QED <br /> K y <br /> m <br /> n <br /> o <br /> m <br /> O y <br /> n � r <br /> 2 <br /> CONDITIONS OF PERMIT: v $w;: Z c- 9- <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. e £ NO <br /> 1 8 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. - N` y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N � i m <br /> g t O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of m e knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all Worms. T <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that If is infor- <br /> Mallon I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I Vit '$ <br /> n 8 8 <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 person to have p <br /> access to the above described premises at any reasonable time for the purpose of inspection. e <br /> m <br /> SIGN HERE <br /> (date) <br /> o i <br /> ZONING ADMINISTRATOR <br /> 8 <br /> wd. Mw H� <br /> TOWNSHIP PERMITS MAY BE REQUIRED N N 41 g Tm <br /> $ 8 $ 8$ rn <br />