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Burnett County 7410 Co. Rd. K, No. 102, Sinn,W154472 Office of Zoning Admlnl strator N o 0 0 <br /> APPLICATION FOR - LAND USE - PERMITS ' <br /> ° r <br /> TO THE ZONING A[iMINISTRATOR:The undersigned hereby makes application for a Permit for the work tlesc had and Qlocated as shown herein. The undersigned agrees that all work shall be done in accordance with the requireme s of the <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the aws and . <br /> regulations of the State of Wisconsin. m m <br /> E o <br /> $ O <br /> E <br /> OWNER LaDonna Lyon TELEPHONE (612)384-6220 m m <br /> m <br /> ADDRESS RR /1 Box 228 Hinckley, MN 55037 (� <br /> EMERGENCY/FIRE NUMBER ROAD NAME North Shore Drive r -7 <br /> , 1 <br /> LEGAL DESCRIPTION (see tax receipt) Lot 14, North Shore Island View Subdivision, T38N, R18W <br /> Town o oo ver S� , <br /> CONTRACTOR ) <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> ° Ll <br /> SANITARY B PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION a <br /> STRUCTUREIADDITION USE: Santa <br /> v <br /> (Home/Cabin;Commercial Business;Be oom;Deck;etc.) a 0 <br /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) I`! <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate No It (N). r <br /> 2. Show the location of the well (W),septic tank (ST),and dralnfield (DF). ° <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(()building O <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 s gned 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 o rn <br /> 11 Z o <br /> PLOT PLAN 0 ° <br /> � o <br /> _ <br /> -' rl <br /> r) <br /> SEE ATTACHED <br /> o' <br /> _ <br /> o <br /> G <br /> _ <br /> b A <br /> O � <br /> w <br /> � Z <br /> L <br /> i <br /> 3 � ,t -Ma <br /> c Cm g . 70 <br /> CONDITIONS OF PERMIT: c Q a Z 8 r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN e0 DAYS OF PERMIT 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 PERMITTED. <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowb ";l.': 2 : N N m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy f all Informs- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize tI iat this infor- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to las s a permit. I vE <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providl ng in this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized pi Proon to have <br /> access to the above described promises at any reasonable time for the purpose of inspection. m <br /> $ <br /> Wade Rufsholm 4/10/95 <br /> SIGN HERE <br /> (signature of ow orinq c t It (date <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED P ' n <br /> �e88888--��� 88�8 u <br />