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CN <br /> Bunten Count# 7410 Co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator V) v z <br /> APPLICATION FOR — LAND USE — PERMITS E <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v <br /> located as shown herein' The undersigned agrees that all work shall be done in accordance with the requileirrents of the $ <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and he laws and --C <br /> regulations of the Stale of Wisconsin, = r ! <br /> m m /fUe/ <br /> ELEPHONE =mw <br /> c <br /> m <br /> ,v <br /> E YO H Jn rre5G,k 7 -< � <br /> ADDRESS Q k <br /> EMERGENCY/FIRE NUMBER i1 ROAD NAME s� <br /> LEGAL DESCRIPTION (see tax receipt) 42 C , .r f4 I 1 / e� <br /> rV <br /> CONTRACTOR/f S QQ Y'S L'D K. -�i"U G <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION ' 1 <br /> 0 <br /> SANITARY PRIVY FILING/GRADING CAMPING UNIT SUBDIVISION o <br /> o <br /> STRUCTURE/ADDITION USE: o a <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) m <br /> Z o <br /> 0 c <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 N rth (N). <br /> 2. Show the location of the well (N),septic tank (ST),and drainfield (DF). <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road, c)building g <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 signed and M <br /> dated by the owner. O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN B ISSUED. on o <br /> N <br /> PLOT PLAN 11 Z o <br /> a n <br /> / <br /> w � <br /> I � <br /> G <br /> zr <br /> s � i <br /> 0 0 <br /> aNR <br /> 0 <br /> R.aF 4: t B t. RVV <br /> o ,4� crah<ry m — <br /> v <br /> ark >ax � E13 <br /> a <br /> Na a a, �' z <br /> aso o <br /> 0 <br /> fra�sr� y <br /> CONDITIONS OF PERMIT: m 33 <br /> m <br /> i Q88 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Z m o': >>TJ.z i <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. iris G) T <br /> i 0 <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the beat ol my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of II informs- R•! " i N m`^ i T <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- $ B rn <br /> motion I am Providing will be relied upon by the County of Bumett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providin 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 promises at an reasonable time for the u <br /> p Y purpose of inspection. <br /> m <br /> N b <br /> SIGN MERE - IA,04tZtLi�� <br /> (signal roof owner building1 co roc oq �' `-=' id■ta 'xx^ <br /> E ; <br /> ZONING ADMINISTRATOR L IF <br /> ( I g <br /> � V'NNN NNNN+ T <br /> TOWNSHIP PERMITS MAY BE REQUIRED o �' � � N g m <br /> 3$ 88 8888 M <br /> lt��C sem s-�-�_— � ., <br />