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On c� <br /> Burnett County'7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrptor 3 f o <br /> APPLICATION FOR LAND USE PERMITS w o <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the Nork T 0 �) <br /> described and located as shown herein. The undersigned agrees that all work shall be done in a cor- 3 e <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all ther y <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. m <br /> OWNER Vince & Deb Louwagie TELEPHONE --- m <br /> v <br /> HOME ADDRESS 1240 Bucher Ave Shoreview MN 55126 <br /> C r <br /> EMERGENCY/FIRE NUMBER none ROADNAME Glendening Rd 1 (a <br /> LEGAL DESCRIPTION (see tax receipt) GL 2 S5 T40N R16W Lot 5 CSM Vol 5 Pg 312 S ave_ <br /> _ V <br /> CONTRACTOR Daniels Plumbing & Heating Inc <br /> <_ <br /> TYPE OF PERMIT(S):DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION mn <br /> o <br /> V <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o v <br /> m n <br /> JC <br /> STRUCTURE/ADDITION USE: single family home <br /> (Home/Cabin; Commercial Business; Bedroom;Deck;etc.) o <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR m <br /> ILLEGIBLE PLOT PLANS VVILL BE RETURNED. <br /> A o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 0 3cn <br /> 'n Z <br /> <7 0 <br /> 1. All required dimensions or distances to be shown or drawn to scale. m <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB)and indicate <br /> North (N). m 1 <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerlit le of > <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or ri rer. <br /> 4. Show the location of the well (VV), septic tank(ST)and drainfield (DF), and all distances to build ngs, <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. C <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> co <br /> signed and dated by the owner. 8 <br /> 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION3E- <br /> FORE A PERMIT CAN BE ISSUED. 2. <br /> o I/vl <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERIVIT <br /> ISSUANCE. is <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHOREL NE. Z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY mb <br /> PERMITTED. W <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET 01 THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. nmvvraaov <br /> q'a '.a0 °a_� m <br /> n 7J �7. w cuio5M <br /> (n <br /> 1 <br /> Qc' i C) <br /> 8. o : n $ i C <br /> Fi '. m m <br /> o1 : <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the iest of my y G <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and a curacy of o <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize o o <br /> that this information I am providing will be relled upon by the County of Burnett Wisconsin in determining wh her to Is. <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this Infor ation I am w o <br /> providing in this application. I agree to permit county officials charged with administering coun �f -or <br /> authorized person to have access to the above described pi s do i'o'tl~ <br /> �^ m <br /> remises at any reasonable ti tri+e P <br /> SIGN HERE `� t ' ` i `• <br /> (signature of owner orb ilding actor) � o , g <br /> ZONING ADMINISTRATOR ' <br /> N " M " Nofn <br /> ON NOU7 UtN O <br /> TOW SHIP PERMITS MAY BE REQUIRED o 0 0 0 0 o b o nl <br /> 00000000N <br />