Laserfiche WebLink
, <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54072 Office of Zoning Administrator U) l 0 0 <br /> APPLICATION FOR — LAND USE — PERMITS ' <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v m o <br /> 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. , m <br /> a m <br /> OWNER (� TELEPHONELAI $ O <br /> -�MACS f `�A 0. G arena n 15- (Q 5(,a 3 to m <br /> tL <br /> ADDRESS 3 1 w N&L / ,� p e , <br /> EMERGENCY/FIRE NUMBER 3 oo d1 ROAD NAME tW,nC'ONO e� <br /> ,� ec f�TNt % (0W <br /> LEGAL DESCRIPTION (sae tax receipt) %-ooT�3o E;flHtJSens lZt V<-{� R(ZK, �UJ,SS elll(1>n�P <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o o <br /> '^ r <br /> STRUCTURE/ADDITION USE: oe-c-V, on home. s <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) = o <br /> 0 0 <br /> z <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 dralMleld (DF). <br /> 3. Show dimensions In feet of thefollowing:(a)building to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the ordinary high water mark of lake,stream,or river. <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. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1A a to <br /> 11 Z a <br /> PLOT PLAN O o. <br /> e. <br /> A s <br /> See Seu,cr,;�L At Cq-q,ev., a-�kUcl <br /> C I <br /> a � <br /> a <br /> OO <br /> 0 <br /> /U <br /> l d��bTl�w' o t�///n� <br /> I� <br /> g ��2.1>&E m <br /> a y <br /> CONDITIONS OF PERMIT: �' Z C`B g ; <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 0 <br /> I declare that this application(including an accompanyingschedule has been examined b me and to the best of m knowl• ' C <br /> PP ( g Y 1 Y Y <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs. « « ; m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I 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 <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have <br /> access to the above described premise$at any reasonable time for the purpose of Inspection. r <br /> i <br /> a <br /> SIGN MERE r, <br /> I <br /> � � N: <br /> p nap ow er or building co tor) h I <br /> --ydate)-. ? € iE <br /> ZONING ADMI STRATOR <br /> AM 7. 6 19MI N M�+NM,M� T <br /> TOWNSHIP PERMITS MAY BE REQUIRED ' m <br /> J.—_ 888888 $18 m <br />