Laserfiche WebLink
Burnet(;County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator m T 0 0 <br /> APPLICATION FOR LAND USE PERMITS 542 <br /> 3 0 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 Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNER_5/ TELEPHONE <br /> �/ Irl /�sc%lsa xl 7i5-- 33-7- e/lAp d <br /> HOME ADDRESS �I 730 <br /> / +C 2 ' -,r m <br /> EMERGENCY/FIRE NUMBER ROAD NAME ffN /Z xxwy <br /> LEGAL DESCRIPTION(see tax receipt) <br /> CONTRACTOR <br /> 0 <br /> o <br /> TYPE OF PTTO : DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> N <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISIONO <br /> STRUCTURE/ADDITION USE: ll LRe W de _ r i-a f i <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 OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> -n P CO) <br /> TZ <br /> F) <br /> 1. All required dimensions or distances to be shown or drawn to scale. o <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings(NB)and indicate y <br /> North (N). m l <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. (P <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, J <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. d <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. M <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- l�J a <br /> FORE A PERMIT CAN BE ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. n {\1 <br /> CONDITIONS OF PERMIT: o I�11 11 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT W <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 Z <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 /> f <br /> 6. <br /> N(n V yr p <br /> A <br /> am <br /> 7. _ <br /> m 05. `2 mo m <br /> 8. m <br /> a i c <br /> 0 ' <br /> o : : Z <br /> 1 declare that this application (Including any accompanying schedule) has been examined by me and to the best of my -- : : G1 `• <br /> : i m <br /> �� : <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 : o o <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to is- <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 p <br /> providing In this application. I agree to permit county officials charged with administering county ordinances or other , 3 ig <br /> authorized person to ve access to the above described premises at any reasonable time for the purpose of inspection. <br /> SIGN HERE r-— �9� '• d' <br /> (signature of owner or building contractor) <br /> ZONING ADMINISTRATOR T <br /> Z ti <br /> TOWNSHIP PERMITS MAY BE REQUIRED " '000000 o <br /> i; '000000 0 <br />