Laserfiche WebLink
1 J1 <br /> Office of Zoning Administrator <br /> N m O O <br /> Siren,WI 54872 �. 3 ; <br /> Bumett County 7410 Co. Rd. K, No. 102, m o <br /> APPLICATION FOR — LAND USE — PERMITS Q <br /> Ifor a Permit for the work described and m i' <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the 3 <br /> o <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and m m <br /> regulations of the State of Wisconsin. n O <br /> isirac ( c E t/1JE/(//JUGm m <br /> OWNER <br /> Ie/as, <br /> Contractor or Surveyor or Agent <br /> �/ase Address m <br /> Acigulks <br /> Uw/RiJ2 ✓ W l S �� �� - City State,Zip Code <br /> City,State,Zip pie <br /> Telephone <br /> Telephone <br /> Emergency/Fire No. and Road Name o <br /> Legal Description (as Indicated on tax statement) c <br /> o <- <br /> Permit(s)Applied for: <br /> rn[� Camping Un <br /> Addition Filling/Grading it °v <br /> Dwelling o 0 <br /> Sanitary Privy <br /> Subdivision I 1D <br /> Accesso_ ry_ Building <br /> Garage <br /> oVPl ha,(y Cr <br /> Structure Use: .4 I <br /> (family home/cabrrd,garage,addition, etc.) C <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> M v ' <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). 3 <br /> 2. Show the location of the well (W),septic tank (ST), and dreillfield (DF). <br /> an O N <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building o n <br /> measurement to the ordinary high water mark of lake,stream,or river. = I <br /> 4. H separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and C <br /> dated by the owner. fA <br /> M <br /> PLOT PLAN I <br /> O� <br /> m <br /> o - <br /> m <br /> A <br /> J <br /> NU) NNr >Da <br /> a Ha = <br /> a o 3 d <br /> o F ^ N <br /> Vic : <br /> $ E a ° <br /> I declare that this application(including any accompanying schedule)has been examined by me and taccut <br /> o the bacy of all informs <br /> est of my knowl- o m N <br /> edge and belief it is true,cocrrreecot^ ^^��Uding any accompanyiing schedule)and I furthe�rdeclarethe tlhat Idrecogn'zs that permit. <br /> I , g 0 g <br /> tion contained in this app' n a the County of Burnett Wisconsin in determining whether to issue a permit. 1 <br /> mation I am providing will be relied upointy of n m g m <br /> s ap- <br /> fu then ac l agree ralll to permit may <br /> officials eresult ofdhe C administering Burnett <br /> ordinances <br /> for other authorized person for have <br /> m 3 w <br /> access to the above described premises at any reasonable time for the purpose of inspection. m <br /> "? <br /> dat <br /> SIGN HERE y, <br /> (signature of owner or buildin co to 8 <br /> ZONING ADMINISTRATOR <br /> N N N N N O C <br /> TOWNSHIP PE MITS MAY BE REQUIRED $8 8 8 8 g£ <br />