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7410 Co. Rd. K, No. 102, Sirs", WI 54872 Office of Zoning Administrator mr v M. <br /> Bumstt County LAND USE — PERMITS m <br /> APPLICATION FOR — <br /> TO THE ZONINGADMINISTRATO :The undersigned hereby makes application for a Permit for the work described and � a <br /> the m c � <br /> located a3 shown herein. The u reigned agrees that all work shall be done in accordance <br /> dinanceh the s anitl the awsrements�and o <br /> Burnett County Land Use Ordinan ,Sanitation Code, and with all other applicable County N m <br /> w p <br /> c O <br /> regulations of the State of Wisconsin. n ? <br /> �im TELEPHONE 2 m m <br /> OWNER N ° <br /> ADDRESS 9 J e N <br /> a N s Mnl ��3 3 oc <br /> ,l rs ROAD NAME <br /> f Q <br /> EMERGENCY/FIRE NUMBER �( J <br /> `S <br /> LEGAL DESCRIPTION (see tax recei t) 9411 Z <br /> lffr .fa <br /> CONTRACTOR AW e p <br /> ADDITION <br /> GARAGE/ACCESSORY STRUCTURE <br /> TYPE OF PERMIT(S): DWELLING/B ILDING ° <br /> FILLING/GRADING CAMPING UNIT <br /> SUBDIVISION <br /> SANITARY <br /> PRIVY I N <br /> o <br /> z l <br /> STRUCTURE/ADDITION USE: ° <br /> Deck;etc. o 0 <br /> Home/Cabin;Commercial Busines Al edroom; ) m <br /> ------------------- <br /> ------------ <br /> I } <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) all new buildings (NB) and Indicate North (N). o <br /> 1. Show the location and sizeof all existing bnkbuildings <br /> and) and <br /> (DF). <br /> 2. Show the location of thew II (W), Pt ( T), O <br /> 3. Show dimensions Infest of he following:(a)buliding to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the orcilray high water mark of lake,stream, or river. O O <br /> 4. If separate plans are subm ed by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 ° <br /> dated by the owner. c' <br /> c <br /> TIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. ? � <br /> NOTE: BUILDING/STRUCTURE L ? a n <br /> m' I <br /> PLOT PLAN <br /> f <br /> N I <br /> 0 <br /> s <br /> fake. FR°^tF o <br /> Sa S 14 - m <br /> z <br /> 16 �rO AJ <br /> L � <br /> yx ,2-X 1s�az�� &L <br /> '�✓ 2 o b <br /> CONDITIONS OF PERM EQUIREMENTS WITHIN 60 DAYS <br /> I. DRIVEWAY MUST MET DRIVEWAY WIDTH ROF PERMIT ISSUANCE. <br /> 2. REMOVAL OR CUTT G OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE, QQ E . . <br /> 3. NO GRADING ORS ORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. M N <br /> me and to the best of my knowl- : Q <br /> arc ion(including any accompanying schedule)has been examined by e that I raze that this informs, <br /> 19 : <br /> I declare that this apP orrect and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- $ <br /> edge and belief n is true, I and <br /> tion contained in this eP lication(includingany e County ofnBurnett WisconsiinU n determining rther rwhether <br /> am providingnpthisrIi $ <br /> motion I sm Providing w II be relied uponrm <br /> person to have p <br /> further accept all Ifabilit I(rchich M result of oun Y officials chargedhwit�admin sterinptcounI Ordinancesorother authorized peY <br /> plication.I spree to De reason le time for the Pu�Se of inspection. 3F <br /> cess to the above de ribed Premises at any [ <br /> ac <br /> t w <br /> SIGN HERE (sign of owner r ulldinq contractor) <br /> 1 8E t <br /> ,I r.w�e.MSM <br /> ZONING ADMINISTRAI OR u <br /> TOWNSHIP PERMITS MAY BE REQUIRE g g g 8818 <br />