Laserfiche WebLink
rtt County 7410 Co.Ad. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m u o 0 <br /> APPLICATION FOR - LAND USE - PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and o c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <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. <br /> O <br /> OWNER 'GZO U E iJ TELEPHONE 7s 1 3 <br /> Jam_//1111 l / o ' <br /> ADDRESS <br /> FF <br /> EMERGENCY/FIRE NUMBER 5 �/� ROAD NAME a,!' � IC/V <br /> LEGAL DESCRIPTION (see tax receipt) <br /> C7" <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION �1 O <br /> n 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISIONo o Q <br /> m r J <br /> STRUCTURE/ADDITION USE: ° o <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z o <br /> o c <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 <br /> 2. Show the location of the well (W),septic tank (ST), and dralnfield (DF). V' <br /> 3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)b Aiding I J <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 sign lid and 1 <br /> dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSrTE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I o ur <br /> in z co <br /> PLOT PLAN ° n <br /> 0 o <br /> C <br /> Afio(,)fEo <br /> I <br /> 1 <br /> G <br /> °1 3 0) <br /> ; ' <br /> 0 <br /> V" <br /> N <br /> r I� <br /> D <br /> I� <br /> G <br /> %'L '� m <br /> CONDITIONS OF PERMIT: m g 'z C� g <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F �� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. ' L7 25 : m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of y knowl- <br /> edge and belief it is true,correct and complete.1 acknowledge that I am responsible for the detail and accuracy of all informs- N ro m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that t is infor- B p <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a 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 <br /> access to the above described premises at any reasonable time for the purpose of inspection. T <br /> m <br /> SIGN HERE <br /> (dale) <br /> ZONING ADMINISTRATORIV <br /> TOWNSHIP MRS MAY BE REQUIRED d � 1 8 m <br /> 8 88 $8vi <br />