Laserfiche WebLink
Burnett Cobnty 7410 Co. Rd. K, No. 102, Siren,WI 64872 Office of Zoning Administratord o 0 <br /> APPLICATION FOR LAND USE PERMITS 6 1. <br /> z s <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work � <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- 3 <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordiiinn{ances and the laws and regulations of the State of Wisconsin. <br /> 7 H m <br /> OWNER ' I k l e C I LwPYI ( TELEPHONt�/ / 't� /cY� <br /> HOMEADDRESS <br /> TTto �_ ajl &m /'IVC . J . <br /> yV D \ <br /> EMERGENCY/FIRE NUMBER ROAD NAME rJ CSA v� <br /> LEGAL DESCRIPTION(see tax receipt) /O V /S R//}S`—�sff—.fY� <br /> CONTRACTOR ` Lr/ L r�Uti� <br /> o <br /> o <br /> TYPE OF PERMIT(S): ELLING/BUILDING--"RAGE/ACCESSORY STRUCTURE ADDITION a <br /> N ^ ^e <br /> SANITARY PRIW FILLING/GRADING CAMPING UNIT SUBDIVISION o / „ <br /> STRUCTURE/ADDITION USE: r J OM(� �" Sofu�—__j o / ) v 1 <br /> (Home/Cabin;Commercial Business; Bedroom; ck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR J <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In Y ,1 <br /> O IOW <br /> A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O a <br /> -n P 0 <br /> nZ C <br /> 1 .All required dimensions or distances to be shown or drawn to scale. 5 <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings (NB)and indicate o <br /> North (N). y <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. 9J <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. Cj C <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. Cn <br /> d � 2 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- �1 ° <br /> FORE A PERMIT CAN BE ISSUED. l <br /> o e <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. m � <br /> CONDITIONS OF PERMIT: o <br /> a <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT l� <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. I <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 /> f <br /> 6. <br /> rnmvn a0M <br /> S o. c M � 3E m <br /> 7. m � gmcooss � <br /> 8. <br /> � 2 : m <br /> E nom ' C <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m ` I O <br /> PP ( g Y ) Y Y <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of ? $', m O <br /> all Information contained in this application(including any accompanying schedule)and I further declare that I recognize o o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Information I am 0 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 3 3 ` 8 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. m ? 5 ? y E <br /> SIGN HERE Lql� <br /> (y4 n um of owns Iding contractor) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAYBE REQUIRED <br /> 5TAkc � y <br />