Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m c c <br /> APPLICATION FOR - LAND USE - PERMITS3. <br /> m O <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m 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. w m <br /> N <br /> OWNER TELEPHONEO/C 146 0 <br /> f <br /> ADDRESS 30a )q Hwy 35-J -7-7 JAA/BI'i Ie✓ Wr.j <br /> l <br /> EMERGENCY/FIRE NUMBER 'R © �] ' n ROAD NAME Ham` 35 rT 77, +rte <br /> LEGAL DESCRIPTION (see tax receipt) c� / �? <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING I r GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> c <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> STRUCTURE/ADDITION USE: V((Yl1/Y!� �w�Jc+v,�y (-1y,►.a(TJ�N o 0 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z <br /> o ° <br /> 0 <br /> 3 <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 North (N). <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. 0 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. on 3 m <br /> PLOT PLAN <br /> W10 w <br /> 5-1>-ti+P r� M <br /> S Art `+nl 0 P 1 <br /> _33 _ �✓ �j s I <br /> IIIIIo�J\ <br /> N I <br /> O <br /> �4, <br /> S � � <br /> fYy z <br /> /j N N V f r D D O <br /> R , n P Af, 11 oc . mmnD <br /> S7Ae N�M1Ar�i�l 1 • �Y / �/) \ N — a vs a N a <br /> CONDITIONS OF PERMIT: �1 i S /GGC�4�CLi' 9 . �. •2 H o 3 <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHI AYS OF PERMIT ISSUANCE/ (, z o m ,2 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALO RELINE. o ° i ` N m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALL ED. �" � m O <br /> g o c <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o i m m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this infor- _uNi <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 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 <br /> access to the above described premises at any reasonable time for the purpose of inspection. 3 $ � <br /> M € A m d <br /> H m 8 \ <br /> SIGN HERE - W 67 <br /> (si fur of own- r ilding contractor) (date) <br /> To s <br /> NING ADMINISTRATOR "^� 8 i �f <br /> TOWNSHIP PERMITS MAY BE REQUIREDo o o m <br /> 88888889x) <br />