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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator Cn d "Mo 0 0 <br /> APPLICATION FOR LAND USE PERMITS 5 3. <br /> Q <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work m <br /> m c <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- <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. D y N <br /> OWNER/N�S.Z Q ' TELEPHONE <br /> l o � m <br /> HOME ADDRESS 6•/u 73 <br /> /G i/O — f/ 'Y�iz �J Q/j, - U SG u c r L — <br /> EMERGENCY/FIRE NUMBER ,Z O O -7 7 ROAD NAME /��� � ,?/i' <br /> LEGAL DESCRIPTION(sae tax receipt) .4 97— <br /> CONTRACTOR 7—CONTRACTOR <br /> TYPE OF PERMIT(S):DWELLING/BUILDING GARAG CCESSORY STRUCTURE ADDITION <br /> mrCT <br /> 0 <br /> SANITARY PRIW FILLINGIGRADING CAMPING UNIT SUBDIVISION <br /> - <br /> Z � <br /> STRUCTURE/ADDITION USE: Q (Y <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) n <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) p <br /> -n P m <br /> 1. All required dimensions or distances to be shown or drawn to scale. n P <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings (NB) and indicate m y: <br /> North (N). (a Di <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. r <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. l <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 J <br /> signed and dated by the owner. (fl m <br /> P iQ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- ° <br /> FORE A PERMIT CAN BE ISSUED. ? <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> N _ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT J <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 Z <br /> PERMITTED. ( � � <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE IOU <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. a <br /> 9 O c N WOi O.f m <br /> 7. <br /> _ M <br /> A m3E � c05C <br /> G <br /> 9 N `z m 0 0 n <br /> M O N,2 -4 <br /> f T m <br />