Laserfiche WebLink
7410 Co. Rd. K, /102 <br /> Burnett County siren, 111 54872 Office of Zoning Administrator d az o a <br /> APPLICATION FOR - LAND USE - PERMITS . <br /> 0 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and w ;' 1 <br /> located as shown herein.The undersigned agrees that all work shall be done in accordance with the requirements of the Bur- m <br /> nett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and regula- 3 a <br /> tions of the State of Wisconsin <br /> N m <br /> VIedO "t� l <br /> WNER(Pie Contractor or Surveyor or Agent <br /> / m <br /> grass Address <br /> City,State,Zip CodeCity, State,Zip Code ) <br /> 7 <br /> Telephone Telephone <br /> Permit(s)Applied for: <br /> New Building Filling/Grading <br /> Addition Moving _ <br /> Sanitary Camping Unit o <br /> Privy Subdivision m »' <br /> Structure Use: � <br /> (family homelcabin, garage,addition,etc.) Z <br /> 0 0 <br /> m <br /> Directions for plot plan drawing: (� <br /> r a\ <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(W) septic tank(ST),and drainfield (DF). <br /> 3. Show the location of any lake or flowage-if within 1000 ft.and the location of any river or stream- if within 300 ft. <br /> 4. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building to lake, <br /> river or stream, if applicable. <br /> 5. If,separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and dated by <br /> the owner. 0 <br /> 6 a de legal description (on the side or this form) as on tax statement. 3 <br /> PL'O �LAX� v m <br /> Z Q <br /> o a <br /> 0 <br /> sb <br /> d� 1 0 <br /> AQ aN <br /> Z <br /> Tit ✓,r _ (�(� o Z <br /> i I <br /> 100 <br /> M NVNr-DDW101 <br /> �\ ^ N' Z o 0 <br /> Z O 1 <br /> m <br /> s O <br /> o � : C <br /> I declare that this app t' n (including any acco �nying schedule) has been examined by me and to the best of my o <br /> knowledge and belief it i e,cairect and complete.I acknowledge that I am responsible for the detail and accuracy of all (� 1 m <br /> N': n <br /> information contained in application in I I further declare that I recognize that a : G <br /> th6a Atow ing w' r I' byitLqunty of Burnett Wisconsin in determining whether to issue a oo <br /> permit.I furth un y i in ormation am providing <br /> int is application. I agree to permit county officials charged with administering county ordinances or other authorized <br /> person to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> m <br /> m <br /> SIGN HER <br /> - <br /> (sig a of owner,#j uilding con actor) (date)/ Y✓1 `: o o <br /> ZONING A 11NISTRATOR <br /> (^A`L-- <br /> TOWNSHIP PERM4 MAY BE REQUIRED NNON��rJm <br /> 0000000 <br />