Laserfiche WebLink
M z�/ <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator o <br /> APPLICATION FOR — LAND USE — PERMITS <br /> b G <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and M a <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the $ <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. o m <br /> c g <br /> $ O <br /> OWNER ' P)Pn�ooe Co <br /> TELEPHONE _ <br /> m 10 <br /> ADDRESS M yj <br /> CIO <br /> 1 <br /> EMERGENCY/FIRE NUMBER ROAD NAME r IO .-RA ' l <br /> w I <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> (Ane-- <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> m <br /> SANITARY <br /> PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o o <br /> 0 <br /> r <br /> STRUCTURE/ADDITION USE: ° o <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) oZ d <br /> 0 <br /> } <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). r <br /> 2. Show the location of the well (W),septic tank (ST),and dralnfleld (DF). g <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building -q <br /> measurement to the ordinary high water mark of lake,stream,or river. Q <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 <br /> dated by the owner. Q <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. IN v rn <br /> 11 Z o <br /> PLOT PLAN A oA16(8 Z <br /> o <br /> a <br /> 0 <br /> o <br /> o <br /> r <br /> Z <br /> CONDITIONS OF PERMIT: <br /> gg�,z�6gi <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. M <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. ` �' O O <br /> Xi <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- ai ii <br /> edge and belief it Is true,correct and complete.I acknowledge that 1 am responsible for the detail and accuracy of all Informs. "', : T <br /> tion contained in this application(Including any accompanying schedule)and I further declare that I recognize that this infor- a O <br /> motion 1 am providing will be rolled upon by the County of Burnett Wisconsin in determining whether to Issue a permit. <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providing In this ap- <br /> plication.1 agree to permit county officials charged with administering county ordinances or other authorized person to have o• <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> i Y i <br /> SIGN HERE <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR \ i' — `• 8 <br /> M. N <br /> TOWNSHIP PERMITS MAY BE REQUIRED o ' ffi Ii5 m <br /> $ $ 8 $$ $$$ v) <br />