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As Indicated on tax statement) I <br /> 0 <br /> for. o < <br /> g Sanitary Filling/Grading Camping Unit y _ <br /> Privy Moving Subdivision o <br /> 0 <br /> ire Us Z <br /> o <br /> (family hometcabin, garage,type of addition,etc.) <br /> r � <br /> :tions for plot plan drawing: <br /> ,how the location and size of all existing buildings(EB)and all new buildings(NB)and Indicate North(N). <br /> Show the location of the well (W),septic tank(ST),and drainfield (DF). o <br /> J.Show the location of any lake or flowage - if within 1000 It. and the location of any river or stream-if within 300 ft. <br /> 4.Show dimensions in feet of the following:(a)building to all lot lines,(b) building to center line of road,(c)building to ordi• <br /> nary high water mark of lake, river or stream, If applicable. <br /> 5. If,separate plans are submitted by an architect,engineer, builder,contractor,etc.,the plans must be signed and dated by 0 <br /> the owner. 0 <br /> 9 <br /> a <br /> PLOT PLAN DoT .4 1 N IF o v <br /> rn <br /> (1 1 0 <br /> XJ � <br /> 15� r <br /> y1 1 /08,C> `, <br /> 2q•-X+0o <br /> L zg�O <br /> M (n-0V)r DDco 97 <br /> C Q M'> 4)0 CL C t <br /> -tH RV IF, m a� •am a1 <br /> <i °' cuio5 <br /> rni 42 1, opo <br /> P S- � ` <br /> ' b�` 2 m <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- o i E ` i ': X <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- a l i m <br /> tlon contained In this application(including any accompanying schedule)and I further declare that I recognize that this inform 8' `• <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I 1 a i <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 county officials charged with administering county ordinances or other authorized person to have <br /> access to the above described premises at any reasonable time for the purpose of inspection. T <br /> SIGN HERE <br /> r d' <br /> (sig-nattuurreof"-o n or building contractor) (date) <br /> ZONING ADMINISTRATOR 1T�LJ_G�.�� � t�`� ` g` $ <br /> Vn 1 fn -1 <br /> IV NOK) -�-`N <br /> TOWNSHIP PERMITS MAY BE REQUIRED ("° " 991 m <br /> 888o888v� <br />