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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administratoro' c c <br /> APPLICATION FOR — LAND USE — PERMITS 9 �. ` <br /> TO- THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q w <br /> 's -j <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the $ O <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 <br /> w m <br /> C <br /> O <br /> OWNER RichaAd and Judy Rheautt TELEPHONE 17151689-2770 0 W <br /> m_ <br /> ADDRESS 1141 CaAtton DAive AAden H-rtts, MN 55112 0 <br /> EMERGENCY/FIRE NUMBER 10761 ROAD NAME I?Ao mtown Road f <br /> i <br /> LEGAL DESCRIPTION (seetarreceipt) Lot 5, CSM Vol. 12, Pg. 99, Section 25, T38N, R18w, <br /> Own. o6 WoodtveA <br /> CONTRACTOR k' <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGEJACCESSORY STRUCTURE ADDITION p L <br /> n <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION O <br /> o <br /> '^ r <br /> STRUCTURE/ADDITION USE: SanctaAN Ont y o o ry <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) Z v r- <br /> 0 <br /> 'm <br /> = F <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). <br /> 2. Show the location of the well (W),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 <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. 2 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 11 3 m <br /> PLOT PLAN Z c <br /> o n <br /> o <br /> C <br /> SEE ATTACHED P <br /> N I(�T <br /> G 1 <br /> d <br /> O � <br /> w <br /> � ICQ <br /> Z <br /> 1v I� <br /> MU m <br /> o Z: 8- 9 <br /> CONDITIONS OF PERMIT: c, Z 8 ; <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. p •i �`z : '1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. i D7 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. IN' �' p <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> i ` <br /> edge and belief It is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- ON. . }}+�m , In <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- -C.i i Ef 75 E O <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I O E . <br /> further accept all liability which may be a result of the County of Burnett relying on this information I on providing in this ap- i E ' <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. m € <br /> SIGN HERE wade RuohokJn r.' ",✓, I•? j N <br /> (signature of owner or building contractor) idat4"-- <br /> \ ' <br /> ZONING ADMINISTRATOR —% I I l7`' <br /> Q: N. N <br /> TOWNSHIP PERMITS MAY BE REQUIREML�—= Po i' 15 ' U 1,+'I)4 m <br /> 888888,$8 fn <br />