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ON COMPUTER/ CA NE6n iL,;DyYt <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 3 ?I o <br /> APPLICATION FOR LAND USE PERMITS <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 2 ccor- 3 0 <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 Norman & Joan Gill TELEPHONE ( 612 ) 544 -5163 ,0, I "- <br /> HOMEADDRESS 10215 38th Court No . Plymouth Mn. 55441-1669 <br /> 1 <br /> EMERGENCY/FIRE NUMBER NONE ROADNAME Redwing Terr. <br /> LEGAL DESCRIPTION(see tax receipt) lot 12 Redwing Addition Voyager VillageU� <br /> CONTRACTOR Dennis Doriott Custom Carpentry <br /> 0 <br /> 0 <br /> O <br /> TYPE OF PERM IT(S): DWELLING/BUILDINGXX GARAGE/ACCESSORY STRUCTURE ADDITION 0 <br /> N 0 <br /> O <br /> V <br /> SANITARY—7 <br /> FILLINGIGRADING CAMPING UNIT SUBDIVISION o <br /> SANITARY-7 a <br /> STRUCTURE/ADDITION USE: <br /> S <br /> (Home/Cabin; Co mercial Business; Bed)oom; Deck;etc.) <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. n <br /> O <br /> A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 0 B w <br /> m z i <br /> 1. All required dimensions or distances to be shown or drawn to scale. m P <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate C o <br /> North (N). to l 1 <br /> In <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of <br /> �J <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM)of lake, stream or ri/er. <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to build ngs, <br /> roads, lake, lot lines. i <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. m <br /> ig <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION13E- <br /> FORE A PERMIT CAN BE ISSUED. N 2 <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: <br /> n <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> l Cj <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 9 <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 /> 6. <br /> M oQ = �20ofm <br /> 7. m m g d H 0. <br /> EF E M <br /> b <br /> w N O <br /> O - <br /> ci '= m <br /> 8. <br /> o : m <br /> Q <br /> o : M <br /> I declare that this application (including any accompanying schedule) has been examined by me and lot <br /> st of my <br /> O <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and a curacy of o o <br /> all information contained in this application(including any accompanying schedule)and I further declare that I cognize O m b : <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining who her to is- <br /> o , o , <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this inform tion I am w <br /> providing in this application. I agree to permit county officials charged with administering county ordinance i or other3 : 2 <br /> 3 y <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of In spection. m <br /> N <br /> SIGN HERE `S �— <br /> ( not a of owner or I ng contractor) (data) o <br /> o i <br /> ZONING ADMINISTRATOR y,,+y,ma y,j' T <br /> m <br /> ONUt O (T NtPO <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 0 (mA <br />