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IN <br /> Burnett County 7410 Co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR — LAND USE — PERMITS m o 00 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v a <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the $ D <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. a <br /> ` Lr'o <br /> OWNER Oak Ridge Partnere TELEPHONE (715)259-3346 K f <br /> m1 <br /> ADDRESS 31453 Webb Lake Drive Danbury, WI 54830 a <br /> EMERGENCY/FIRE NUMBER 31453 ROAD NAME N. Webb Lake Drive <br /> LEGAL DESCRIPTION (see tax receipt) NW NW, Section 9, T41N, RAW, Town of Webb Lake V <br /> 11 <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> O <br /> SANITARY B PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> N <br /> STRUCTURE/ADDITION USE: Sanitary Only v n <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) o o (� <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 linea,(b)building to center line of road,(c)building -q <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> jv� <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. C) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. Z v <br /> O o I <br /> PLOT PLAN <br /> 01 DIP <br /> t <br /> I <br /> SEE ATTACK <br /> o' <br /> O ti <br /> w <br /> Z <br /> D <br /> 1 <br /> f <br /> g 2. <br /> IF 3 <br /> CONDITIONS OF PERMIT: o ? Q <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. ; <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ? p <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. , a <br /> 1 declare that this application(Including any accompanying schedule)has been examined by me and to the best f my knowl- g i r <br /> 7 <br /> edge and belief it is true,correct and complete.1 acknowledge that I am responsible for the detail and accuracy of all informs- �; «m , ; r <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that thio Infor- <br /> motion I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. 1 <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. <br /> to lthe abovedescribed promises at any��ith nable time for he punty rpose of ordinances <br /> Inspection. <br /> Wade <br /> authorized person to nava <br /> mT <br /> m <br /> Wade Rufsholm 8/25/94 <br /> SIGN HERE (date) <br /> (signature of owner or it Ing contract <br /> g <br /> Wit; <br /> ZONING ADMINISTRATOR !"I <br /> TOWNSHIP PERMITS MAY BE REQUIRED « <br /> - 9 ,8 8 <br />