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Burnett CountK7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator L� o/'�z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- <br /> m c �. <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other 3 0 <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. N m <br /> c m <br /> OWNEReLavh �.., TELEPHONE o <br /> HOME ADDRESS 1q3 <br /> EMERGENCY/FIRE (NUMBER ��1� 11��111JJJ RO'A,DI/NVAME <br /> WY— <br /> LEGAL DESCRIPTION(see tax receipt) 70V L()l 2til=L p � (h�� ���(,(_,� <br /> CONTRACTOR (`� I 1 �\/ r `/ 7 -.5v <br /> �,1 -lLf 7r o <br /> TYPE OF PERMIT(S): DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE ADDITION < <br /> N <br /> O <br /> SANITARYPRIVY FILLING/GRADINGt--�CAMPING UNI,T� r�S,UrB�D,IVISION <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) M <br /> O 3 <br /> -n P m <br /> 1. All required dimensions or distances to be shown or drawn to scale. o n <br /> 2. Show the location and size of all existing buildings(EB)and all new buildings (NB)and indicate m 4 y: <br /> North (N). 0 o� <br /> C <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or river. <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. <br /> coa <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- 0 <br /> FORE A PERMIT CAN BE ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ( n <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> 5. OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> f <br /> 6. <br /> rn co <br /> 7. M � 5. : C � $? � <br /> o mo ; '? 00 <br />