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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d m o O <br /> - APPLICATION FOR - LAND USE - PERMITS 3 - <br /> TO TJ-fE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and � � w o <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 a <br /> regulations of the State of Wisconsin. y �_ <br /> OWNER Bob Baker TELEPHONE 612-777-6246 J a F o <br /> o <br /> ADDRESS 7880 44th St Ct N Oakdale MN 55128 —" <br /> EMERGENCY/FIRE NUMBER co <br /> none ROAD NAME Lipsett Lake Access Rd ¢,I , <br /> LEGAL DESCRIPTION (see taxreceipq GL 3 NE'/4S6JY4 S13 T39N R14W a <br /> x <br /> m <br /> CONTRACTOR Donald Daniels MP 330 ' <br /> TYPE OF PERMIT(S); DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> n L <br /> SANITARY X PRIVY FILLING/GRA ING CAMPING UNIT SUBDIVISION o ° <br /> cabin �ltildi.0c� ���?rrl,r �bEc7cJ � y 0 <br /> STRUCTURE/ADDITION USE: o <br /> (Home/Cabin;Commercial Business;Bedroom; Deck{etc.) a <br /> U O � <br /> U' N <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). 'Ij (f( <br /> 2. Show the location of the well (W), septic tank (ST), and drainfield (DF). <br /> 3. Show dimensions in feet ofthefollowing:(a) building to all lot lines,(b)buildingto center line of road,(c)building `< <br /> measurement to the ordinary high water mark of lake, stream, or river. vo <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and X <br /> dated by the owner. O o C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSRE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 'tl 3c'1 <br /> + c <br /> PLOT PLAN A o a <br /> see attached C I 0. <br /> LI)tiZ 0 <br /> I <br /> C+ <br /> r - <br /> 0 <br /> CN <br /> C+ m <br /> 0 0 <br /> 0 � <br /> mA <br /> o a <br /> 0 <br /> 0 <br /> 0 <br /> r <br /> z <br /> N a <br /> m <br /> It <br /> n f <br /> n <br /> rarm� <br /> 2 g, c-N rn a 0 <br /> n 9 o a m m <br /> CONDITIONS OF PERMIT: m <br /> :5. <br /> ,2 c S 0 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. _o m Q I 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. =r» M <br /> 3, NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N 62 m <br /> m : O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my know) � $ <br /> : o - <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 application(including any accompanying schedule)and I further declare that I recognize that this infor- g p <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 0�8 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 a <br /> access to the above described premises at any reasonable time for the purpose of inspection- 3 g <br /> SIGN HERE <br /> (signature of owner or 'di con or) <br /> Fr : i <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED I�� '4y/ 2 un m <br /> U �8 c $ 8ai <br /> i <br />