Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator CA m o a <br /> APPLICATION FOR - LAND USE - PERMITS3. <br /> 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 2 w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of Wisconsin. ma m <br /> O <br /> OWNER TELEPHONE /V�2- 484 -JrsfpRq.400JA Cao k <br /> 7c <br /> alaret�ce ,maps , m _ � <br /> ADDRESS ,,?..pSLJ <br /> � <br /> EMERGENCY/FIRE NUMBER Z9 fj z5 ROAD NAME \ I 0 P4 oe� �J <br /> 7 <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR s � <br /> b <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION_X O �j <br /> n � <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> J <br /> STRUCTURE/ADDITION USE: �C c <br /> v <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) 0 0 <br /> 0 <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). <br /> 2. Show the location of the well (W),septic tank (ST), and drainf laid (DF). <br /> 3. Show dimensions infeet of thefollowing:(a) buildingto all lot lines,(b)buildingto center line of road,(c)building <br /> measurement to the ordinary high water mark of lake,stream, or river. 0 <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. Q o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I 3 w <br /> c <br /> Z Q <br /> PLOT PLAN m50 <br /> n <br /> ,y < <br /> � <br /> C i <br /> � <br /> 4 <br /> m <br /> Ut �' <br /> I N <br /> I'D <br /> N <br /> J <br /> m <br /> ti <br /> / V <br /> 2 <br /> 1 <br /> G <br /> m g� 2am °-$ M <br /> CONDITIONS OF PERMIT: o m N;: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o M <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =r^ <br /> H <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. u, t7 2 m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 0 <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- w m m <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this infor- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o <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- d, <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have O o ; <br /> access to the above described premises at any reasonable time for the purpose of inspection. T 3 0 - <br /> n b N <br /> SIGN HERE <br /> u of o r building contractor) <br /> Ida /7 (� o <br /> g L! L/ LS <br /> sem. n ! <br /> ZONING ADMINISTRATOR <br /> tnwre�tn u+ -n <br /> TOWNSHIP PERMITS MAY BE REOUIR wL — 9 199,9 o N M on � M 8 0 m <br /> U 00000000tn <br /> J <br />