Laserfiche WebLink
Pfyl <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Admini4trator w -00o 0 <br /> 6 9. <br /> APPLICATION FOR LAND USE PERMITS _ — <br /> z s <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for th D work � y <br /> described and located as shown herein. The undersigned agrees that all work shall be done inaccor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with a I other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y <br /> OWNERTELEPHONE <br /> �/(Aw t L ERI(KSoN 7/9- 6ff- z7/ d r t <br /> HOME ADDRESS 7-2- 710 4*'FRAffr?R RD. �� �(,�(' � � _ _ <br /> EMERGENCY/FIRE NUMBERa17 q3 ROAD NAME <br /> LEGAL DESCRIPTION(see tax receipt) GO y S FG 3 7 T 38'N fP/Fl l✓ <br /> CONTRACTOR <br /> SELF o r' IL- 150 n.pe(z S o T <br /> o <br /> TYPE OF PERMIT(S):DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION 0 - <br /> w O <br /> O <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION- <br /> Z a <br /> STRUCTURE/ADDITION USE: D 5GK ' <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE R <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> a rn <br /> 1. All required dimensions or distances to be shown or drawn to scale. o a <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB)and indicate Mo <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 I <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. <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 mu t be <br /> signed and dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION E E- ° <br /> FORE A PERMIT CAN BE ISSUED. Q I ) <br /> 2 V� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMI (�J <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOREL JE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ? <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF rHE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> f <br /> 6. <br /> mto-o rnr Do 'a <br /> 7. A s'aM.0 P, fm <br /> m <br /> A N y. `2 N 00 m 3 <br /> = F Tt <br /> 8. ? = <br /> - Uorraw,e &m;#ef5o Seta* -ro 0*,//?. 6kSiG t- 3-a6-94, <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the be t of my m [ ; m <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and acc iracy of o, m <br /> all information contained in this application(including an accompanyingschedule and I further declare that I re o nize o m o : <br /> PP (' g Y 1 g m o <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whet r to Is- $ : o <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this informat n I am [ 0 : 0:: <br /> providing In this application. I agree to permit county officials charged with administering county ordinances r other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Ins action. m o y <br /> m <br /> SIGN HERE <br /> (sl s re of mnV pr building contractor) (date) o [ <br /> o i i <br /> ZONING ADMINISTRATOR <br /> N N n N N N n <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0 $8 o N S tmA <br />