Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator ; 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work z� y <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- a <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y <br /> OWNER 1 TELEPHONE X5`3 <br /> HOME ADDRESS ,ot/^`O z <br /> I �h <br /> EMERGENCY/FIRE NUMBER ROAD NAME _ 1�,� n� <br /> / <br /> LEGAL DESCRIPTION(see tax receipt) )—tj-r ' 01�,m V, n, �(�3 <br /> CONTRACTOR f <br /> 0 <br /> � e <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION 8 ' <br /> o � <br /> SANITARY PRIVY FILLIN GRADING CAMPING UNIT SUBDIVISIONS <br /> � v <br /> y�� n <br /> STRUCTURE/ADDITION USE: <br /> re <br /> (Home/Cabin; Commercial Business;Bedroom;Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> 'n P m <br /> 1. All required dimensions or distances to be shown or drawn to scale. i <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB)and indicate m <br /> North (N). m �. <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. cSki R <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. I < <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. w <br /> U" g <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- ° <br /> FORE A PERMIT CAN BE ISSUED. <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o V <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT �J <br /> ISSUANCE. DQ <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> s. L �fI�flYI cTr1�s , <br /> rn I (nm-0mr �DD <br /> 7. <br /> x 4. 9a m $ <br /> 8. <br /> Sfe <br /> : 0Omam2 <br /> u, : O <br /> o ate : C <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my ' O <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of i 8Z y N' . O <br /> all Information contained in this application(including any accompanying schedule)and I further declare that I recognize o o <br /> that this Information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> o ; o ; <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett retying on this Information I am f 1 Op <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. ryrym ? y E <br /> SIGN HERE 4_y -54— <br /> signature <br /> — <br /> signature of owner or building contractor) (dela) <br /> ZONING ADMINISTRATOR \ 11,'YI �1ti1 <br /> + NN (nNNNN m <br /> TOWNSHIP PERMITS MAY BE REQUIRED . N . o N u u o m <br /> o $ $ 00000rA <br />