Laserfiche WebLink
Burnett County 7410.Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator c m o 0 <br /> APPLICATION FOR - LAND USE - PERMITS 3 <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the -3:2 C <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. ii7 o <br /> u <br /> /, �ry \ '�A 7/ fr/ c <br /> OWNER a fhb.-✓d� �', 1)L`Efv 4' TELEPHONE ( 6 �p (moo — /(�G fC� a 0 <br /> go <br /> ADDRESS 3(J 7s- 6 1 J 3i_ �f' 7 i va.,",_o" t 5-7le-3® ��� <br /> 4 - g <br /> EMERGENCY/FIRE NUMBER A 7 c-" 0 ROAD NAME <br /> }k <br /> LEGAL DESCRIPTION (see tax receipt) S' 2 2 / f q/ / /?//c) (,, 4Gr S, 0 A Q <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> CD 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION a <br /> (� �-a ;:eCh' 'a ! Q LS'7t e-C-S— o r <br /> STRUCTURE/ADDITION USE: � � ^E' kr � �` �"t$/ �� 9. <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z o <br /> 0 a <br /> CD <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 Nort r . <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). to <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line dived,(c)b ilding en <br /> measurement to the ordinary high water mark of lake,stream, or river. 0 <br /> (.A <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor c.,the plans must be sign d and M v\ <br /> dated by the owner. ( � 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED/ R ON fr-E VERIFICATION BEFORE A PERM CAN BE .-UED. 11 Is u 1`,' <br /> PLOT PLAN . ° a <br /> N. -I X o t <br /> i <br /> "S <br /> cn <br /> ti o I ( A <br /> fk- C// Y <br /> VVV ditcx a r i• <br /> es ibia fig, NI <br /> o 1 <br /> rik,4-4.4g s <br /> Set —1 tle3A._______J <br /> U c7,s I <br /> ` ` t _ 4,- Shelf_ lam <br /> ,I .1 h Vic.-►,.-4 ,7I►` z <br /> . <br /> /2. 0ori s,.. -/( .,.0 -4 <br /> / i( fto` <br /> \. <br /> tiv.2.4,74. "A s U..Q34-* <br /> \'' i..(1 <br /> i,1'r', <br /> mO'c� PrA A'. i'f <br /> CONDITIONS OF PERMIT: < y. g 8 g 2 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. c f 5 • ""I <br /> 2. REMOVAL; OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ 3 <br /> 3. NO GRADING OR SHORELAND ALTERNS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. e_ GI g O <br /> C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- «o« R <br /> tion contained In this application(including any accompanying schedule)and I further declare that I recognize that this infor- i� B 0 C <br /> mation I am providing to be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 8 i $ <br /> further accept all lisbnity 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 <br /> access to the above described premises at any reasonable time for the purpose of inspection. T <br /> f o o <br /> C42'af ,-? 0 <br /> SIGN HERE {' 10 «43 <br /> (signature of owner or building Contractor) (date) <br /> ZONING ADMINISTRATOROCT {f� t� g <br /> TOWNSHIP PERMITS MAY BE REQUIRED o v"'+ v^'+ $^'', c^'n v^'+ $' rr <br /> $ 888g 'g <br />