Laserfiche WebLink
i <br /> nett F ountp7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d a 0 0 <br /> APPLICATION FOR — LAND USE — PERMITS m o <br /> .O THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 2 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 3 a <br /> regulations of the State of Wisconsin. H ,� <br /> m ,p <br /> c <br /> OWNER TELEPHONE o. <br /> m <br /> ADDRESS a L/99f G e e c-. v� �.�, P d . S i�-�„ , u.l< 5072-- <br /> EMERGENCY/FIRE <br /> 072--EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipt) Q <br /> r - <br /> CONTRACTOR C <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> o < <br /> '^ r <br /> STRUCTURE/ADDITION USE: o ° <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) Z 71 <br /> o ° <br /> 3 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) DO ` <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). I�} <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,(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 signed and X <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSfrE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 o rn <br /> PLOT PLAN Z <br /> n n <br /> w. Ifl OQ i��r ary ®n C <br /> I / M tri <br /> G � <br /> I — <br /> 0 <br /> Q <br /> v N <br /> n <br /> 0 <br /> ° <br /> N (W <br /> O /1 <br /> H <br /> .. r1 <br /> z <br /> S <br /> I <br /> IIID-�l`jJ' <br /> I <br /> 0 ° ` > > a F m <br /> CONDITIONS OF PERMIT: <br /> v .2 goo 0. 0 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. a E r'z D <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED.' m n OC <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- m <br /> edge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all informs- t Iw m <br /> tion contained in this application(including any accompanying schedule)and I further declare that f recognize that this infor- `�' <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $ r^ $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this aR- N <br /> plication. I agree to permit county officials charged with administering county ordinances or other authorized person to have 110 M p <br /> access to the above described premises at any reasonable time for the purpose of inspection. (�]�3 8 i4 <br /> M 83 y N <br /> N <br /> SIGN HERE / a <br /> (signature of owns uilo, contr lId( (d x <br /> V` <br /> ZONING ADMINISTRATOR <br /> TOWN IP PERMITS MAY BE REQUIRED `AL 3 ( ^N N(fPulp 1 J N 0 0 0 m <br /> v <br /> 8 8 $ $ $ $ N <br />