Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m o <br /> APPLICATION FOR — LAND USE — PERMITS m <br /> �- <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 $ D <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. ra m <br /> EERIE-, <br /> �^ <br /> OWNER DAVID 1/t R lJ TELEPHONE <br /> ADDRESS 1/ 00 W I d STC &/ c-1 - ST- PA 0 t_ N, 5511 rj m <br /> EMERGENCY/FIRE NUMBER ROAD NAME 0 <br /> LEGAL DESCRIPTION (see tax receipt) C <br /> CONTRACTOR , <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION S p <br /> O <br /> SANITARY <br /> PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> o < <br /> r <br /> STRUCTURE/ADDITION USE: 0 0 <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z o <br /> o v <br /> m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) Z4 <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 (VY),septic tank (ST), and drainfield (DF). C:' <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. <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I o m <br /> 7I Z `o <br /> PLOT PLAN ° n <br /> C <br /> a � <br /> M ' = <br /> f�dC10 ?� <br /> F y <br /> a <br /> m <br /> v � y <br /> Z <br /> f <br /> m9 o c m o a F <br /> - rn <br /> CONDITIONS OF PERMIT: m• Z w o m' 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. p ZQ : 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 92 i M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. - Yn O m <br /> I declare that this application(including an accompanyingschedule has been examined by me and to the best of my knowl- g '• E m m ; C <br /> p ( g Y ) - ; , 71 <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- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 8 a 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 : O i <br /> access to the above d premises at any reasonable time for the purpose of inspection. ° a - <br /> �t : 3 $ ,°r <br /> m : v A a <br /> SIGN HERE - - <br /> (signature of owner or building cwntracto <br /> ZONING ADMINISTRATOR <br /> � i <br /> TOWNSHIP PERMITS MAY BE REQUIRED O }cewX(~Nm <br /> ,3 u v, m ra !o - m <br /> 888888 u) <br /> d <br />