Laserfiche WebLink
(eon) <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator DO r ; o 0 <br /> APPLICATION FOR LAND USE PERMITS a 3 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work z� H � <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- T <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y d <br /> OWNERj c TELEPHONE <br /> ;7,,, , 3 "S(SO:rI c v <br /> HOME ADDRESS �9/ A9 sG/�I/t;C Ali �✓DONe/'L�i S ygD� <br /> EMERGENCY/FIRE NUMBER /j�Sv/ ROAD NAME <br /> LEGAL DESCRIPTION(sae tax receipt) <br /> cc',4-- , <br /> (-O <br /> �_•f_ LST <br /> CONTRACTOR <br /> o <br /> i4 a <br /> TYPE OF PERMIT(S):DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION 0 <br /> N Or <br /> O <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabi ; Cod mmercial Business; Bedroom; Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 3 <br /> T 'R N <br /> TZ a <br /> 1. All required dimensions or distances to be shown or drawn to scale. 5 PFL <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings(NB) and indicate m : <br /> North (N). m 1 <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. s <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. (� <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be r <br /> signed and dated by the owner. <br /> i4 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- ° <br /> FORE A PERMIT CAN BE ISSUED. <br /> N �'- <br /> O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o' <br /> CONDITIONS OF PERMIT: v <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY p <br /> PERMITTED. <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 /> s. � Vt '1��c�lYejJ�p <br /> m n V m[ D Dp 17 <br /> m <br /> M q.c �. � � A $ <br /> 7. <br /> C hO o <br /> N O O f0 <br /> 6. i M <br /> P �[ <br /> o„ �2 m <br /> a <br /> m m <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my m <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I recognize <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether <br /> o ; o : <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: o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 3 2: <br /> authorized person to have access to the above scribed premises at any reasonable time for the purpose of inspection. m : i i : v m <br /> IG N <br /> SIGN HERE <br /> N ; <br /> ( ure of own bullding contractor) <br /> o <br /> ZONING ADMINISTRATORmap <br /> i : : '• <br /> -n <br /> N N U N N N m <br /> TOWNSHIP PERMITS MAY BE REQUIRED ( ' ° p " m <br /> If 00000 op) <br />