Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m z <br /> APPLICATION FOR — LAND USE — PERMITS e f <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q ° <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m <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. <br /> N <br /> C � 1 <br /> OWNER ,ems �� TELEPHONE n _ O <br /> �S 6/z yy3 f <br /> ADDRESS ���,] /S i-l�G $ L-✓C�oeQ R (� C jkg Kew 404/ 3 1 e 0 <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> k'jC3 <br /> LEGAL DESCRIPTION (see tax receipt) ) c ni?. ^c 1 /e'IF (—S/A. ✓ 13 P 171 <br /> ,1 <br /> [PRT ed-5 :R,3; 'ZF-!q <br /> CONTRACTOR /rr Se <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION n o <br /> T— o <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z <br /> o ° <br /> 0 <br /> m <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 ('VV),septic tank (ST),and drainfield (DF). o <br /> 3. Show dimensions In feet of the following:(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. O O <br /> 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. � 03 <br /> PLOT PLAN ? ' Q f o c <br /> o. <br /> �i 5 <br /> qty ^ 1 <br /> ° <br /> 2!0 <br /> see z4 ti. S0 � <br /> �+ JI co <br /> 2 INJC) <br /> be , �0 <br /> At i �f o�fi <br /> Z <br /> ^ ltouzd ht r <br /> U-3+6 e <br /> AOUW> n <br /> CONDITIONS OF PERMIT: v m;P 8 C 0 t . 9 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMITISSUANCE. o f '_ ? g 8 (3i <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. -')J 0 <br /> L;: <br /> g : e : . <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- = C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> T <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- , G <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue apermit. 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 �` i ` <br /> o: <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> w <br /> SIGN HERE <br /> (sig u of owner r building contractor) ` <br /> (date) <br /> ; <br /> ZONING ADMINISTRATOR ' p <br /> 8 <br /> MAY24 995 <br /> URNS»»»"» m <br /> TO PERMITS MAY BE REQUIRED F o N 8 N <br /> �I ! 88888888 y <br /> i. _ i <br />