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w AY"M of awjft A <br /> Bel>rMtt Cmft 7410 Co. at K, MO. 10%SkiMti VA 54M • V„^•7 �••^�^7 <br /> APPLICATION FOR — LAND USE PERMITSwort , _ <br /> To THE ZONING ADMINISTRATOR:Tess undsraiprtsd helsby mdtes appy► <br /> located as shown Iterekt The undersigned egress that all work sfa1M do done in acoOMU noeMt n uk ►� a <br /> Burnett County Land Use Oftsnenee,Saftkatlon Code,and wO NM other Wokmble Cm*y » a . <br /> regulations of the State Of WboonOM t ' s <br /> (612)Ji*�l1 j*7- t wh i <br /> OWNER pAn1Y1;E L. ROSSOW/LINDA D. LEMAY T�� (61 2)48 -2 16 h <br /> _. s <br /> ADDRESS 295 TOPPING STREET, ST. PAUL, MN 55117 <br /> EMERGENCYOP-' NUMBER V075 ROAD NAME • FONTAINE ROAi7 _ <br /> LFGAL DESCAIPf10N Metaxreoeipq`. <br /> L <br /> CONTRACTOR � <br /> TYPE OF PERMIT(%: DVVELLIrrC� ULDA GARAGE/Abdit 0WY tat'fat,161URE <br /> SANITARY PRIVY FILLING/GRADING X CAMwNO t1Nrr SUBDIVISION `- <br /> a' r' <br /> .�,xr� xx+r+ nncotxtLE CHANGE TO WALKOUT o <br /> STRUCTUREIADDITION USE: V <br /> (Home/cabin;Commercial Business;Bedroom;Dock;oto.) c $ <br /> 01RECTIONS FOR PLOT PLAN 0AAWiNO:. (Aeflet br top view) <br /> 1. Show the location arid size bf all existing buildings (EB) and alt.row,bunding (NS)and IndlertN North <br /> 2. Show the location of the well (VVI,septic tank(ST),and draiMleid (DF). <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to Center line Of road,(C)bugdittq <br /> measurement to the ordinary high water mark of lake,stream,or river. O <br /> 4. It separate plans are submitted by an architect,engineer,builder,contractor,ate.,the plans must be signed and 9 <br /> dated by the owner: O <br /> NOTE: SUI DING/STRUC'1URE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICAUM BEFORE A PERMIT CAN BE SSUED. <br /> PLOT PLAN f9H,��S 970w <br /> N <br /> n N <br /> .. SGn�E.v /ro2�Lr � <br /> tdl- ti ,, � oti Tti � D��r <br /> Eft fsf' <br /> yi►0R o R'+ <br /> Gp6f� ... <br /> /1'EIMeI►ts eMfE rid <br /> u. a 40 <br /> 3S WAY <br /> "IFp; Q <br /> r' Ivnikoi+• , ,ah �" <br /> s + <br /> _. O- u io " <br /> i1Clio <br /> � <br /> � Alk GyGatrd- adv at(4�IN Oat{ *N' O14LWA alp <br /> �wroo.T4 30/ . -- M <br /> CONDITIONS OF PERMR3. AIi S /� P/ eN�5/�G o � rN EY .�►�Z gQ <br /> t. DRIVEWAY MUST MEET DRIVEWAY REOUIREMENTS WITHIN 60 DAYS OF PERMIT I"NUAN s � � -k <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. D �k L�rPI Y ; m <br /> 3. NO GRADING OR SHOREIAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 'i he i42�/C ` �? <br /> F j; C <br /> 1 declare that this application(Including any accompanying schedule)has boon examined by me and to the best of my knaM• $ <br /> edge and belief It Is true,correct and complete.I acknowledge that 1 am responsible for the detell and accuracy of all Informs- m <br /> tion contained In this application(Including any accompanying schedule)end I further declare that I recognize that this Intoe <br /> motion I am providing will,be rolled upon by the Count of Burnett Wisconsin In daterminl whether to Issue s Osumi).1 <br /> further accept all liability 41ch may be a result of the County of Bumett relying on this informatloM tae provlding In this sD I i :• 8 <br /> plication.I agree to permit county officials charged with administering county ordinances or othet Wthorzed person to haus <br /> access to the above described Premises At any obis time for the purpose Of Inspectionn, 3 <br /> SIGN HERE <br /> t w � <br /> pit re of Owner 9r Tiding contractoP) (dote) ; P <br /> ZONING ADMINISTRATOR <br /> Ci <br /> TOWNSHIP PERMITS MAY BE REDUIftED ., ?��,�,f'�68� m <br />