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9)) e0yAp <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m m a o <br /> APPLICATION FOR — LAND USE — PERMITS m <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and a <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> Burnett County Lard Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and <br /> regulations of the State of Wisconsin. w m <br /> m m <br /> c <br /> OWNER �•/�r1 C/ �, V.L.. SO AiyI TELEPHONE 7166 a5� _ 766 � O <br /> o <br /> ADDRESS OC O6 L. ALW-ye- RD <br /> EMERGENCY/FIRE NUMBER n O/ ROAD NAME <br /> LEGAL DESCRIPTION (see tax receipst t1/YCo-[rte �'Q!� sce13 7-:oo Al /L 1S 0 `] j" 4e)rd. <br /> CONTRACTOR a Q SLDS . Z', i <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-4111' GARAGE/ACCESSORY STRUCTURE ADDITION �� o <br /> c1 li <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> o < <br /> / � /� c.2 J{/fl H r <br /> STRUCTURE/ADDITION USE: �cT //7 i/ E o <br /> (Home/Cabin;Cor�mgfcjal Bu�i{tess;Bedroo ; Deck;etc.) Z <br /> ,5r 7C /7l/ o a 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). <br /> 2. Show the location of the well (W),septic tank (ST), and drainfield (DF). <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. C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSr1E VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a to <br /> / Z o <br /> PLOT PLAN S�R✓O o� <br /> ,g,aCk <br /> I 1P <br /> AO <br /> e12 4 Scp;A- AX �t,a <br /> 61 <br /> ate �vS� g Xin�� ��afm <br /> y <br /> CONDITIONS OF PERMIT: /Jitid S A'" o R L o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT SUANCE. o F <br /> �. — <br />