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&n cZyy\-P . <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator 0 m -. c <br /> APPLICATION FOR — LAND USE — PERMITS <br /> m <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and m c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the $ <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and _ <br /> -A <br /> regulations of the Stale of Wisconsin. w d <br /> m m <br /> n O <br /> OWNER Can2U2e Schnank TELEPHONE (775( 425-5678F <br /> o ' <br /> m � <br /> ADDRESS 1574 Go.1!6 View Dnive Riven Eatts, WI 54022 m <br /> EMERGENCY/FIRE NUMBER ROAD NAME CountyRoad Z <br /> 1 <br /> LEGAL DESCRIPTION (see tax receipt) paAcef in G.L. 2, Section 28, T37N, R78W, Town o{ <br /> 1 <br /> CONTRACTOR Ticade Lake <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGEIACCESSORY STRUCTURE ADDITION p J <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> m r- <br /> STRUCTURE/ADDITION USE: Sanitanc7 Onty <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z o <br /> o v <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). Q <br /> 2. Show the location of the well (Vit,septic tank (ST),and drainfield (DF). g <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 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. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUS! BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I 9 N <br /> 'f1 Z a <br /> PLOT PLAN 0 <br /> C _ <br /> fn U1 <br /> 1 <br /> I N <br /> o. <br /> s <br /> CO <br /> O y <br /> SEE ATTACHED H <br /> �1 <br /> z <br /> V" <br /> F <br /> m0 c u m o a F m <br /> g > > n pa M <br /> CONDITIONS OF PERMIT: a Z m $ =0 a'o 3 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z m o m Q : -1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. f o T M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Yrii O m <br /> g ic ` C_ <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- `: a m 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- o <br /> i : m <br /> yy��O RL[ <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- ? S m a , p <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. g a 8 <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 " <br /> access to the above described premises at any reasonable time for the purpose of inspection. re Q <br /> r E 3 A r, <br /> 01 D A01— : <br /> SIGN HERE <br /> Wade Ru hhotm g 8 s <br /> (signs re f owner Iding contractor)- i w : E <br /> ,. i <br /> ZONING ADMINISTRATOR - <br /> - <br /> TOWNSHIP PERMITS MAY BE REQUIRED 00' o 0 7i m <br /> 8 <br /> 888 y <br />