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Burnett County 7410 Co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator U/ f o <br /> APPLICATION FOR — LAND USE — PERMITS – <br /> s p <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the $ o0 <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 /> C u <br /> n �y]�l q ,I O <br /> OWNER SILL �URAN1D TELEPHONE 71s �,WA- '/DO6 o A <br /> S <br /> ADDRESS !ao 0-1-00GY AXE SUPER In2__ , (A�, S-F��/W o� <br /> I I ROAD NAME SW SS r R AI L 1 <br /> EMERGENCY/FIRE NUMBER 1� <br /> LEGAL DESCRIPTION (see <br /> lltax receipt) '7-' yo N —R I4 W - 6OV LgTS r <br /> CONTRACTOR �j � <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_X ADDITION v <br /> O <br /> SANrrARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION °. <br /> STRUCTURE/ADDITION USE: STORM G S dEP 1 X ZV <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z <br /> P g �� <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 drainfleld (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 O <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 9 <br /> dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. o m <br /> g <br /> PLOT PLAN pbpNEy SAKE A p c <br /> LK <br /> O I <br /> 34 <br /> r S �► Q <br /> � <br /> �16 1 'M� <br /> �.SD' Tv LLT 0WE /Ar �c iN� I� <br /> �B 14' 3Fi o <br /> fo' <br /> pf <br /> IN <br /> m <br /> C <br /> V\ z <br /> 3 <br /> Q <br /> G+Ordy Shad" Pt( � + F <br /> 19 logCONDITIONS OF PERMIT: o g . ? 9 g <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. c tS i� i `• <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. E <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knOWI- <br /> wipe and bell It is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all inform&- <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this Triton- S <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I $ g i <br /> funkier 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 promises at any reasonable time for the purpoas of Inspection. -n <br /> ( <br /> 9- -7- <br /> SIGN HERE <br /> daul <br /> (signal owner or II Ing wntractod -1 T\17 f`' S <br /> i i g i <br /> ZONING ADMINISTRATOR r -- <br /> TOWNSHIP PERMITS MAY BE REQUIRE r -- I c <br /> rtil, , SEP - (' 1994 a 8alsa sF <br />