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0111 6D)A <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator ,N, '0 o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> z <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work � y <br /> described and located as shown herein. The undersigned agrees that all work shall be done inactor- 3 <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNER TELEPHONE <br /> /^p <br /> HOMEADDRESSI AO V_22R' <br /> Py7AA) 550 <br /> EMERGENCY/FIRE NUMBER ROAD AME <br /> �3-Seo-96 <br /> LEGAL DESCRIPTION (see tax receipt) Jp� <br /> C 7r�. <br /> iP SLC h, / / <br /> n �} bvbe-�{ m � 1+� W <br /> CONTRACTOR P I <br /> m c) <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-X—GARAGE/ACCESSORY STRUCTURE ADDITION <br /> m O <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> o 'o <br /> STRUCTURE/ADDITION USE: Y .0 �- A X /y X09,(' d <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. O n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) p 3 �1 <br /> m p <br /> 1. All required dimensions or distances to be shown or drawn to scale. 0 P i <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings (NB)and indicate m H'— <br /> North (N). In oQ <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of m I �` <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. D v I 0 <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, CD <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. N <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. o ) <br /> N V" <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 — D <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> F <br /> 6. <br /> 9 Nc � N�n DOm <br /> 7. c y g <br /> ? � 08. 3 <br /> Zfes : y: <br /> o M <br />