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Bumett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator 0 Z <br /> APPLICATION FOR — LAND USE — PERMITS 3. <br /> d o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and w <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m a <br /> Burnett County Land Use Ordin nce,Sanitation Code, and with all other applicable County Ordinances and the laws and rl <br /> regulations of the State of Wisconsin. m <br /> w m <br /> OWNER O <br /> Monte Bute TELEPHONE n E <br /> 0 ' <br /> ADDRESS P214 Un.r_veA,sit Ave. N.E. Minneapoki�, MN 55418 <br /> EMERGENCY/FIRE NUMBER ROAD NAME E. Ye,e,eOW Rivet Road <br /> LEGAL DESCRIPTION (see taxrec ipt) 1 1„ <br /> Lot 8 Second Add. to PtaAdUn,a RivV, Piners Sec-tion 18, U <br /> CONTRACTOR T40N, R16W, Town ob Oakland j <br /> J <br /> TYPE OF PERMIT(S): DWELLINGj 3UILDING GARAGEIACCESSORY STRUCTURE ADDITION p <br /> n O <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION ° <br /> 0 <br /> N � <br /> STRUCTURE/ADDITION USE: Sanita.Ay Onbf a a <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z <br /> o ° <br /> 0 <br /> m <br /> DIRECTIONS FOR PLOT PLAI I DRAWING: (Aerial or top view) <br /> 1. Show the location and slzc of all existing buildings (EB) and all new buildings (NB) and indicate North (N). <br /> 2. Show the location of thew all (W),septic tank (ST), and drainfield (DF). _Q 5 <br /> 3. Show dimensions In feet of 1 he following:(a)building to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the ordina y high water mark of lake,stream,or river. 0 <br /> 4. If separate plans are submi ted by an architect,engineer,builder,contractor,etc.,the plans must be signed and A <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1t a N <br /> c <br /> PLOT PLAN A o n <br /> m N <br /> 1 <br /> C> <br /> C 1Z <br /> SEE ATTACHED o <br /> o <br /> 3. c_ <br /> m � <br /> o � <br /> - <br /> 7 <br /> Z <br /> f <br /> xin� > <br /> � 8 ¢mm <br /> CONDITIONS OF PERMIT: <br /> o mg�z� 0 <br /> 1. DRIVEWAY MUST MEET D IIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o F �-4 <br /> 2. REMOVAL OR CUTTING TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. a y� ' 9 <br /> 3. NO GRADING OR SHOREi AND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N C o N m <br /> ge ;o: o <br /> I declare that this application(4 eluding any accompanying schedule)has been examined by me and to the best of my knowl- m C <br /> edge and belief it is true,correc and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- T <br /> tion contained in this applicati (including any accompanying schedule)and I further declare that I recognize that this infor- i i i <br /> mation I am providing will be r lied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I o'$ <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication.I agree to permit cour ty officials charged with administering county ordinances or other authorized person to have ; O N m �' <br /> access to the above described 3remises at any reasonable time for the purpose of inspection. <br /> �i 93 O N O <br /> m m <br /> UJade hho Pm r—rte ,`l f " f <br /> SIGN HERE <br /> (si nature of owner or building contractor) 1 j <br /> ZONING ADMINISTRATORMAY 3 1 MX�' p x <br /> TOWNSHIP PERMITS MAY BE REQUIREDygio <br /> �N jN og `go� N <br /> w <br /> 0 <br />