Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administratorm o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3_ <br /> m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v m <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 a <br /> 0 <br /> regulations of the State of/Wisconsin. N ? <br /> L:7 t2A�A N. V14tc A O N AJ C- a f <br /> OWVRO(PlegePrint) 31 7 ContractLo�rorSuryeyor Agent o <br /> l X c o d . <br /> Adtlres Address <br /> City, State, Zip Code City, State,Zip Code <br /> lis- ckc -3147 7i5 — a%ra� - tis"d'3 <br /> TelephoneTelephone <br /> Emergency/Fire No. and Road Name <br /> Legal Descri tips as indicated on tax statement) NE '/y NWVY) SEC. 20� TON R IbWi <br /> fxpcEPT�N�/f dy4kr as Dr SeLf6r'? w RE< e20�D rN Ye4. . 313 QP rtEca2oi s� <br /> r �(�cPPC Im EG' CP Dards . #! NdTr Ca . tj o <br /> Pe mi s A lied tor. <br /> 0 <br /> N = <br /> Dwelling Addition Filling/Grading Camping Unit S <br /> v <br /> n Z o <br /> Accessory Building Sanitary Privy Subdivision, °_ } <br /> Garage -4 <br /> r / <br /> Structure Use: A/ <br /> (family home/cabin, garage, addition, etc.j Uj <br /> DIRECTIONS FOR PLOT PLAN DRAWING: M <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). 0 <br /> 00 <br /> 2. Show the location of the well ,septic tank S (DF). o m <br /> (VV) p ( T),and drainfleld <br /> 3. Show the location of any lake or flowage- if within 1000 ft. and the location of any river or stream-if within Z c <br /> 300 ft. I <br /> 4. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building m o I� <br /> to lake, river or stream, if applicable. <br /> 5. If,separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and C <br /> dated by the owner. m <br /> PLOT PLAN <br /> 1 <br /> m <br /> 0 <br /> o YC <br /> z <br /> �UJ - Orale wt /nit meef urtdt� i- 7� rAla,o--J st;4,kd44 <br /> � D <br /> m O' $ '- am a a <br /> 00 � 33 <br /> $ T <br /> Si m <br /> m <br /> N ? i 3 ' C <br /> 8 : E 0- <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 3' <br /> mm : m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible forthe detail and accuracy of all informs- <br /> tion contained in this application(including anyaccompanying 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. 1 <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 m <br /> access to the above described premises at any reasonable time for the purpose of inspection. ` 8 H <br /> is re of own w S <br /> SIGN HERE <br /> ( 'Iding contractor) �4 !�/] L� [ o '. x <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP RMITS MAY BE REQUIRED ''! ,i �1AY 3 0 1991 N �:0 8 m <br /> 888 888m <br />