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65 ) eomoJ <br /> Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator (n T o <br /> APPLICATION FOR LAND USE PERMITS u 3 <br /> 0 <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 actor- TL <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 Edward and Roberta Bitler TELEPHONE (715) 349-5908 d <br /> , <br /> HOME ADDRESS 23770 Old 35, Siren, WI 54872 <br /> U <br /> EMERGENCYIFIRE NUMBER 23770 ROADNAME Old 35 -S) l-b <br /> LEGAL DESCRIPTION(see tax receipt) DD <br /> CONTRACTOR Owner O T <br /> � o <br /> TYPE OF PERMIT(S):DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE X ADDITION <br /> H r- <br /> 0 <br /> 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> o v° <br /> m <br /> STRUCTURE/ADDITION USE: Garage <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) <br /> i <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR �1J <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> A S) <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> 0 c N <br /> T oZ =j - <br /> 1. All required dimensions or distances to be shown or drawn to scale. n < <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate C o 0 <br /> North (N). to <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <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, V <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. O �Z' <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be r <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. a <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. m <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT U} <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 <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 /> NN-afnr D lu <br /> Mim <br /> 7. 9 ma S. iCo <br /> f0 O P`2 <br /> 8. € rn <br /> n ! C <br /> o m m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my m <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> o� o : <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- o : o <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Information I am i 0: o <br /> providing In this application. I agree to permit county officials charged with administering county ordinances or other ' 3 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. m . <br /> SIGN HEREC7—�? <br /> (s a re of own r building contractor) (date) <br /> F Si <br /> ZONING ADMINISTRATOR <br /> N N nN N N r n m <br /> TOWNSHIP ERMITS MAY BE REQUIRED o 0 0 . . gag og m <br /> '08,098 000 <br />