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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator cn Mo <br /> APPLICATION FOR — LAND USE — PERMITS3. <br /> d o <br /> TO THE ZONINd ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work descr bed and w <br /> located a.,shown herein. The undersigned agrees that all work shall be done in accordance with the requireme its of the m <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. m m <br /> C m <br /> VOYAGER VILLAGE POA DANIELS PLUMBING & HEATING INC u f <br /> OWNER (Please Print) Contractor or Surveyor or Agent m° <br /> 28851 KILKARE RD PO BOX �16 <br /> Address Address <br /> DANRTTRY wTIry Ain CTRFAT j,,)I G1 872 0 <br /> City,State,Zip Code City,State,Zip Cade <br /> Te ep one e p n 9933 <br /> Emergency/Fire No. and Road Name 28851 Kllkare Rd t <br /> <) L <br /> Legal Description (as Indicated on tax statement) f° - <br /> SWySWi+ S7 T40N R14W m» o <br /> Permit(s) Applied for: Lot 60 Meadow Green Addition to VV ° <br /> '^ r <br /> Dwelling Addition Filling/Grading Camping Unit ° g <br /> v <br /> Z o <br /> Accessory Building Sanitary x Privy Subdivision -07 <br /> Garage ^ <br /> Club house �1J' <br /> Structure Use: C o <br /> (family home/cabin, garage,addition, etc.) v <br /> 1A <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 North (N). O o <br /> 2. Show the location of the well (V ),septic tank (ST), and drainfield (DF). <br /> 3. Show dimensions infest of thefollowing:(a)building to all lot lines, (b)buildingto center line of road,(c)building Z c <br /> measurement to the ordinary high water mark of take,stream, or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and m p a <br /> dated by the owner. C oo <br /> i <br /> PLOT PLAN m N <br /> s <br /> co <br /> n <br /> SEE STATE APPROVED PLAN IT o <br /> N H <br /> _ <br /> ig9P <br /> of � ? <br /> ocTmm o aF 9 <br /> �✓1.�1 PIG ���vy m. M <br /> < w o 0 mo ; <br /> cN: m <br /> 3 g i E q\ i E y <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best f my knowl- o m <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy o all informs- « m« O <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- m N <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issu a permit. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information 1 am providing in this ap- <br /> plication.1 agree to permit county officials charged with administering county ordinances or other authorized person to have 0 rn o <br /> access to the above described premises at any reasonable time for the purpose of inspection. <br /> m i 3 n <br /> � x : <br /> m R A N <br /> SIGN HERE <br /> 10/24/94 4 8 ; <br /> (signature of owner or titlding co ra to (date) <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIREDo .o 9 m <br /> 888. 8888vmi <br /> G <br />