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Bu <br /> mett-County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator0 r l 0, <br /> APPLICATION FOR — LAND USE — PERMITS3. <br /> d <br /> TO o THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and y <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 a <br /> regulations of the State of Wisconsin. ° <br /> OWNER MaAtf Wyatt TELEPHONE (612) 774-6469 a <br /> O � <br /> ADDRESS 309 Jenks St. Paut, MN 55101 <br /> EMERGENCY/FIRE NUMBER ROADNAME SrJiAit Lane Road <br /> LEGAL DESCRIPTION (seetax receipt) pcP. G.L. 1 , Section 11 , T37N, R1 8W, Town ol� Trade Lake <br /> L <br /> CONTRACTOR I <br /> _ V <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE_ ADDITION v <br /> n 0 <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> '^ r <br /> STRUCTURE/ADDITION USE: SanitaAy O2U o <br /> (Home/Cabin;Commercial Business:Bedroom; Deck;etc.) Z T <br /> 00 <br /> m <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 (OF). CIQ_ <br /> 3. Show dimensions Infest of the following:(a) building to all lot lines,(b)building to center line of road,(c)building *(:�) <br /> measurement to the ordinary high water mark of lake,stream, or river. 0 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and M <br /> dated by the owner. o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 a rn <br /> PLOT PLAN o 0 Q <br /> v <br /> fA o <br /> (A _ <br /> M <br /> i <br /> O <br /> 1 <br /> SEE ATTACHED <br /> N <br /> O <br /> O -y <br /> N <br /> Z <br /> 1 � <br /> Dr1�(n'O rnr D DO y <br /> M c �. N 0 0 <br /> n > 0 g m m <br /> > <br /> CONDITIONS OF PERMIT: <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F In �� . <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. - s <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 32 m <br /> of f nBE ' C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl. <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs. a+m>: m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor. i s B o ; p <br /> mation 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o'$ o <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providing in this ap- <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have 0 N v <br /> access to the above described premises at any reasonable time for the purpose of inspection. 3 0 0 <br /> (1)Q.de RL!�l�20�.h7RL!�l�10�.R7 `:II <br /> SIGN HERE <br /> (si u e of o or building contractor) U (date)C <br /> C o : <br /> ZONING ADMINISTRATOR <br /> TOWNSH PERMITS MAY BE REOUIRED N m <br /> 0 . 9W <br />