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TYPE OF PERMIT(S): DWELLING/BUILDING O GARAGE/ACCESSORY STRUCTURE ADDITION <br /> SANITARY_ - PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> N <br /> STRUCTURE/ADDITION USE: �JC2�CZG7--P o o <br /> (Home/Cabin;Com cial Business;Bedroom;Deck; etc.) Z <br /> 0 <br /> a <br /> m <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). <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)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 MUST BE STAKED FOR ONSrTE VERIFICATION BEFORE A PERMIT CAN o N <br /> PLOT PLAN <br /> z /oRee+L o <br /> m 0 <br /> IF <br /> as o <br /> / I N <br /> Z0 X Zy <br /> ?. <br /> v � <br /> Ic� i <br /> Z <br /> rh <br /> CONDITIONS OF PERMIT: c <br /> < m <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o £ 00 i W.4 1 <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 /> € N E): 2 m <br /> o f ig O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl. o': m C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- N <br /> tion contained in this application(including an accompanyingschedule and I further declare that 1 recognize that this infor- <br /> mation <br /> m <br /> PP ( 9 Y 1 9g : m <br /> I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I `$ 0 <br /> further accept all liability which may be a result of the Count urnett relying on this information I roviding in this ap (n <br /> plication. I agree to permit county officials charged with a inisle ing county ordinances or otter a ho ized person to have N <br /> access to the abo ascribed premises at any reasonab time r the purpose of inspection. <br /> m m N <br /> 2 <br /> p <br /> SIGN HERE - <br /> (signalur f ter ui q tor) (dat ) E <br /> _ 2/� o � E <br /> ZONING ADMINISTRATOR ✓OX <br /> N NNN+N6lNN -n <br /> OWNLIP PERMITS MAY BE REQUIRED m <br /> o o o o o o 0 o U <br />