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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zonin�irif in titrator m ; o' <br /> APPLICATION FOR — LAND USE — PERMITS 3 <br /> m <br /> TO THE ZONJNG ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and u c p <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirementof the $ <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and _ <br /> regulations of the State of Wisconsin. w m <br /> f° m <br /> r.I O <br /> OWNER \l/�� T' �G ry N TELEPHONE <br /> ADDRESS YV1�77 ✓ IV m ""R <br /> CO .R19. WEssrF-z, W( . 5`1$93 m � <br /> EMERGENCY/FIRE NUMBER ROAD NAME V� <br /> LEGAL DESCRIPTION (see tax receipt) <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> O <br /> SANITARY C PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 0 <br /> A <br /> oSTRUCTURElADDITION USE: (Home/Cabin;Commercial Bu ness;Bedroom;Deck;etc.) <br /> Z o <br /> o�` v <br /> IVwwh � <br /> UI } <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate Nort (N). <br /> 2. Show the location of the well (W),septic tank (ST),and drainfteld (DF). <br /> 3. Show dimensions In feet of the following:(a) building to all lot lines,(b)building to center line of road,(c) aullding <br /> measurement to the ordinary high water mark of lake,stream, or river. 0 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be sig ed and <br /> dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONS I E VERIFICATION BEFORE A PERMIT CAN BE LIED. 41 o m <br /> �_ Z o <br /> PLOT PLAN n ° n h <br /> In a R1 <br /> / R�t{EP a W <br /> 00 <br /> o <br /> 'I m <br /> n <br /> :o <br /> m <br /> I� <br /> o <br /> N <br /> III <br /> Z <br /> 64TT1? m m <br /> CONDITIONS OF PERMIT:1. Q Z .' <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. �, <br />