Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m -0 c o <br /> APPLICATION FOR - LAND USE - PERMITS 3 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and a <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 3 Q �.a1 <br /> regulations of the State of Wisconsin. / 0 0 <br /> e lerte' i)7� f1 i m �I <br /> . �-qm <br /> OWNER -I -^�^T#t q _ TELEPHONE w / n �,: <br /> p m <br /> p m <br /> ADDRESS <br /> EMERGENCY/FIRE NUMBER I ' ROAD NAME` <br /> J <br /> LEGAL DESCRIPTION (see tax receipt) <br /> (IJ <br /> CONTRACTOR O!1_� _ r. C7 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING o1 GA AGE/ACCESSORY STRUCTURE ADDITION p <br /> 0 (t <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o -� <br /> o < <br /> r <br /> STRUCTURE/ADDITION USE: o 0 <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z o 2`l <br /> o <br /> a <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 drainfield (DF). o <br /> 3. Show dimensions in feet ofthefollowing;(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 a <br /> NOTE: BUILDING/ STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 a rn <br /> PLOT PLAN Z <br /> 0 <br /> o o. <br /> M o <br /> Oche& eSffL w ) <br /> m <br /> V. 19 7- 1 ' �- <br /> N <br /> J m <br /> � n <br /> 0 <br /> 0 <br /> o \1 1 <br /> O � <br /> H <br /> Z <br /> X <br /> V <br /> m --0 - a�' g.gm <br /> CONDITIONS OF PERMIT: o' m S.: Q c8 gro <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. o 0 N y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N 2i o c 1 m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o' C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- a y m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- tom: a p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o`$ <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 O N o <br /> access to the above described premises at any reasonable time for the purpose of inspection. m m <br /> 3 m <br /> SIGN HERE ~ ` f rM <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR $ X <br /> P <br /> bMdf h m <br /> TOWNSHIP PERMITS MAY BE REQUIRED o � o 0 <br /> o $ o $ U) <br /> N <br /> 0 <br />