Laserfiche WebLink
e4" <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator 5 T0 0 <br /> APPLICATION FOR — LAND USE — PERMITS <br /> Y d <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the �v <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and <br /> regulations of the State of Wisconsin. rn m <br /> u m <br /> OWNER 7::yM 0 qTA 0 TELEPHONE 7�5' . 29'+ _ 3 r _ >; <br /> o ' <br /> m_ <br /> ADDRESS <br /> EMERGENCY/FIRE NUMBER ROAD NAME s\� <br /> LEGAL DESCRIPTION (see tax receipt) <br /> (T <br /> CONTRACTOR (<L <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGEIACCESSORY STRUCTURE ADDITION I o g <br /> SANITARY PRIVY `���^FII OLLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> m r- <br /> STRUCTURE/ADDITION USE: ^^ ° � <br /> (Home/Cabin;C mercial Business;Bedroom;Deck;etc.) Z o <br /> P v <br /> m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) QJ <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NS) and Indicate North (N). <br /> 2. Show the location of the well (W),septic tank (ST),and dralnflaid (DF). <br /> 3. Show dimensions in feet of the following:(a)building to all lot Imes,(b)building to center line of road,(c)I wilding <br /> measurement to the ordinary high water mark of lake,stream, or river. <br /> 4. B separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be sigi tied and <br /> dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE IS 3UED. In <br /> Z <br /> PLOT PLAN <br /> 'a j <br /> 0 ' 's <br /> M � o <br /> C q� <br /> , <br /> i s <br /> I N <br /> 0 <br /> N <br /> o <br /> N_ <br /> A <br /> 1 � <br /> IllrY�f--`_ <br /> is <br /> m <br /> EMS g <br /> CONDITIONS OF PERMIT: <br /> .6 �'i z <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z m o: Q ; : -1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. c 7N7 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. �' i G7 R m <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of My knows- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of al informs- •+m N m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- i g d g : O <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue permit. I $'� $ <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 i O,: p: <br /> access to the above described premises at any reasonable time for the purpose of Inspection. ' 3 <br /> d �- N w <br /> SIGN MERE V� <br /> -4610WJ06 of aw I n (date) <br /> ZONING ADMINISTRATOR ` $ i <br /> TOWNSHIP PERMITS MA BE REQUIRED N N�'N£5 m <br /> 8 '8 '8 vmi <br />