Laserfiche WebLink
r <br /> Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Adminis rator m -0 -- 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> 0 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for thl Iwork y <br /> A <br /> described and located as shown herein. The undersigned agrees that all work shall be done in eeor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with al other 0 1 <br /> applicable County Ordi nces an the laws and regulations of the State of Wisconsin. <br /> OWNER ' TELEPHONE ,_ o <br /> w <br /> A <br /> HOME ADDRESS 70 <br /> 1/'IC <br /> _ <br /> G. <br /> EMERGENCY/FIRE NUMBER 2 ROAD NAME C�, -� „• <br /> tLEGALESCRIPTION(see tax receipt) - ^C/.CTOR V a C) o <br /> o <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION (� <br /> y ^ `11, <br /> O <br /> SANITARY PRIVY FILLING/ 3 RADING CAMPING UNIT SUBDIVISION � <br /> r o � <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) r 3 v <br /> 'n Z <br /> 1. All required dimensions or distances to be shown or drawn to scale. F) ° <br /> FL <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB)and indicate m y <br /> C <br /> North (N). In <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerli is of m <br /> road, (c) buildings) measurement to the ordinary high water mark(OHWM)of lake, stream or r er. r <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. ) <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans mu 3t be l <br /> signed and dated by the owner. <br /> iQ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATIONBE- <br /> FORE A PERMIT CAN BE ISSUED. N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. L <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERN IT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOREL NE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY 9 <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. <br /> Nrn -o(nr D0T <br /> 7. m mKwcoo ; 3 <br /> v o� <br /> n' o � �Z E —1 <br /> P <br /> Fo Trn : 9 <br /> 8. � 0 O <br /> t m m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the b let of my ' m: m <br /> in� : : O <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and a curacy of v, m u, <br /> om o : <br /> all Information contained In this application(including any accompanying schedule)and I further declare that I cognize E o m o <br /> that this information I am providing will be relied upon by the County of Bumett Wisconsin In determining wh her to is- . <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Inform tion I a O <br /> providing in this application. I agree to permit co H oMetals charged with administering county ordinance or other 3 : 8 <br /> authorized perso o ve acc s to the abov de cribed premises at any reasonable time for the purpose of i pection. <br /> SIGN HERE <br /> (al a -e ow r r building coiltreelorl t <br /> ZONING ADMINISTRATOR <br /> � �. � o � uNio N aaom <br /> TOWNSHIP P MITS MAY BE REQUIRED j o S 0 0 0 0 0 o in <br />