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tom` <br /> Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator d - 0 0 <br /> APPLICATION FOR LAND USE PERMITS42 <br /> d 3. <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work 0 <br /> N <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other 3. o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. <br /> OWNER &i-ci C /���D��/ TELEPHONE 1 <br /> HOME ADDRESS 55,E �+C.. CO 5o9a v ` <br /> EMERGENCY/FIRE NUMBER /_1a) 907-17Y7 CAD NA E p,oyn�V ed <br /> LE6'ra.—Dcec wrioeL<sae_tar t(rnlc�ef� J ..✓]/ Y�//�� <br /> A0.c.K,56n 1 W r%511.p <br /> -' <br /> TYPE OF PERMIT(S):DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTURE i'� ADDITION o r <br /> N � <br /> O <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION a <br /> � o a (a <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> r <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. <br /> A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) T 3 v <br /> n o <br /> 1. All required dimensions or distances to be shown or drawn to scale. Ci <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate m —CMNorth (N). <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of (� <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. U r <br /> 4. Show the location of the well (W), septic tank (ST)and drainfield (DF), and all distances to buildings, 9J 3 <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. I C <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be r x <br /> signed and dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. N v J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. m <br /> CONDITIONS OF PERMIT: ° <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. �l <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Cl <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY D <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. �I <br /> 5. <br /> f <br /> 6. <br /> Q. mNmvtnD m <br /> M — $.� 2. am a y <br /> 7. m � y Zm o0o' ; <br /> e _ U). m <br /> m <br />