Laserfiche WebLink
cvyl <br /> Burnett County.7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator co ` m of o <br /> APPLICATION FOR — LAND USE — PERMITS <br /> m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m c <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and R <br /> regulations of the State of Wisconsin. <br /> C m <br /> OWNER &2 / 1�j/I TELEPHONE E <br /> � 'V ISL- O _ � <br /> ADDRESS CJS ZNO AV' SE- PLAI cV1�W JS 9(aq <br /> EMERGENCY/FIRE NUMBER ROAD NAMEI ,0 ;a > 06�`Q r =Ij <br /> U ' J <br /> LEGAL DESCRIPTION (see tax receipt) <br /> i <br /> CONTRACTOR 4) <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT - SUBDIVISION o 'C. <br /> m <br /> STRUCTURE/ADDITION USE: i _ 1 a1 I:C— o g <br /> (Home/Cabin;Commercial si ss; Bedroom;' eck,etc.) '(� ! Z <br /> - IiG'-�C I 1 ( - P a <br /> ,. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) J <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 drainfleld (DIF). Q 5 <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. M O <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. C 9 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSrrE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. on .7I a N <br /> PLOT PLAN o 'o <br /> C <br /> 04 <br /> I <br /> � C <br /> C� <br /> o <br /> G <br /> 0 <br /> o Xl <br /> m <br /> O � y <br /> N <br /> Z <br /> l� <br /> f <br /> o c m o a g <br /> '�� ' am am m <br /> CONDITIONS OF PERMIT: g z- Z w o n <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o -c <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ' 1 9 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. tpii m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the beat of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- ' y!o);"E M <br /> tion contained in this application(Including any accompanying schedule)and I further declare that 1 recognize that this infor- Q ' g a vI i C <br /> matlon I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 g a 8 <br /> further accept all liability which may be 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 /> m <br /> access to the above described premises at any reasonable time for the purpose of inspection. P i <br /> T E i i 3 $x <br /> m v A ° <br /> SIGN HERE <br /> (signature of o mer orb it p tract <br /> ZONING ADMINISTRATOR <br /> TOWNSHI ERMITS MAY BE REQUIRED I <br /> APR Z 3 X{ ~o o m <br /> ~ m <br /> u u N 888 to <br />