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.Ott County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator 0 z <br /> 0 m O o <br /> APPLICATION FOR — LAND USE — PERMITS 3 a <br /> HE ZONING ADMINISTRA OR:The undersigned hereby makes application for a Permit for the work described and w <br /> ated as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> urnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of Wisconsin. = l <br /> OWNER Bob and Judy P itiptsb TELEPHONE m O <br /> 62)631-9431 <br /> o m <br /> ADDRESS 1810 Oakcneaz Avenue Rasevitte, MN 55113 m t� <br /> EMERGENCY/FIRE NUMBERr' <br /> ROAD NAME Bayview Dhive <br /> LEGAL DESCRIPTION (see taxrec"Pt) Lot 7 CSM Vol. 7 Pg. 159, Section 21 , T37N, R18W, <br /> CONTRACTOR <br /> Town oy Tnade lake ty <br /> �/ <br /> — <br /> TYPE OF PERMIT(S): DWELLING —`CBUILDING /V GARAGE/ACCESSORY STRUCTURE ADDITION r _ <br /> O <br /> n o <br /> SANITARY_� PRIVY FILLING/GRADING CAMPING UNIT SUBDIVI ON o l <br /> RQ��� 0 V <br /> /s1l.0 �'j, n <br /> STRUCTURE/ADDITION USE: Sa nitaAl 7 'r B g <br /> (Home/Cabin; Commercial Business;B droom;Deck;etc.) z T <br /> 0 9° \ <br /> DIRECTIONS FOR PLOT PLAIN 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 thew II (W),septic tank (ST), and dreinfield (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 ordinaiy high water mark of lake,stream, or river. n <br /> 4. If separate plans are submi 0 ed by an architect,engineer,builder,contractor,etc.,the plans must be signed and 0 <br /> dated by the owner. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a N <br /> PLOT PLANz c <br /> � O n <br /> m1 y <br /> o <br /> C ' <br /> Lv <br /> SEE ATTACHED " <br /> n <br /> 0 <br /> o <br /> 0 <br /> O y <br /> N t} <br /> V <br /> Z <br /> I <br /> G <br /> RX � � 0ag= § In <br /> m 9 g� 2 a m Q m <br /> CONDITIONS OF PERMIT: o' _i Q c 9 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z m o: <br /> fes ; �y <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORE ND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N 2 n In <br /> D <br /> I declare that this application(including an accompanyingschedule has been examined b me and to the best of m knowl- � 0. n <br /> PP (� 9 Y 1 Y Y fie' o f '. m is C <br /> lY: <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- d,m T <br /> tion contained in this applicatio (including any accompanying schedule)and I further declare that I recognize that this infor- <br /> motion I am providing will be re led upon by the County of Burnett Wisconsin in determining whether to issue a permit. I g'$ <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 oho>rized person to have;'. <br /> access to the above described Promises at any reasonable time for the purpos ^ dog <br /> . _ Aoe <br /> V HERE Wade RuAzhotm 4119194 <br /> A <br /> (sig ature of owner or building contractor) AP date) <br /> ' ADMINISTRATOR J <br /> g : Xi : <br /> TOWNSHIP PERMITS MAY BE R _ —_—� <br /> N N 4xN <br /> .. O N Ut Ck Ut �m <br /> $ 588vmi <br /> d. <br /> 0 <br />