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Ourneft County 7410 Co. Md. Kr No. 102,Siren, Wl 341172 Office of Zoning Administrator c <br /> APPLICATION FOR — LAND USE -- PERMITS <br /> TO THE ZONiNG ADMINISTRATOR;Tr*undersigned hereby makes eppPlcaWn for a Permit for the work described end <br /> located as Shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the S <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 /> OWNER If }�(� S{�V TELEPHONE LZ <br /> O <br /> ADDRESS <br /> AW. 5537YSO <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipU (�� <br /> CONTRACTOR &rk )r,'e t'lcj )I d 1l /6 k) Lof 3 CSm 0//5 ?7j z <br /> 26 <br /> TYPE OF PERMIT(S); DWELLINGIBUILDING GARAGEJACCESSORY STRUCTURE ADDITION t7 <br /> n O <br /> SANITARY PRIVY FILLINQ/QAADINO CAMPING UNIT SUBDIVISION p ° <br /> H r <br /> STRUCTUREIADDITION USE: C 0)LI o <br /> a <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) co' <br /> — 0 <br /> DIRECTIONS FOR PLOT PIAN DRAWING: (Aerial or top view) I <br /> 1. Show the location and size of all existing buildings (ES) and all new buildings (NB) and Indicate North (N). it r <br /> 2. Show the location of the well (W),septic tank(ST),and drainfield(DF). ° <br /> 3. Show dimensions In feet of the rolloning:(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. <br /> 4. if separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plana must be signed and <br /> dated by the owner. Q <br /> NOTE: BUILDINWTRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. v <br /> 7z <br /> PLOT PLAN ° <; <br /> At <br /> i <br /> �g V <br /> i <br /> f <br /> 1336 r <br /> l � � <br /> '16b <br />