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GIIIG Vy/�IrC IYy�tlllY flYY{�Ytl111C ��_ �SI�� <br /> Legal DescC^riiption 1((as Indicated on tax statement) a <br /> Perrnit(s)Applied for: E 0V <br /> N <br /> n r <br /> Dwelling Addition � Filling/Grading Camping Unit o °— <br /> v 1 <br /> Z o <br /> Accessory Building Sanitary Privy Subdivision ° m <br /> Garage <br /> Structure Use: CA&I iJ <br /> (family home/cabin,garage, addition, etc.) <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 0 IN <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 dralnfleld (DF). on 3 '1 <br /> 3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building 11 z <br /> n o v <br /> measurement to the ordinary high water mark of lake,stream,or river. o Z a I <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and �� N IZ <br /> dated by the owner. ffl Q o <br /> C <br /> 4 <br /> PLOT PLAN � m <br /> ArCZ <br /> as Ro l <br /> 3 <br /> J <br /> 0 <br /> o <br /> �� tiEetc ! (24) m t <br /> '75 <br /> SF.wiIElL � _ <br /> I w <br /> CI�V.�I`��� JI'.• D <br /> i - 0. V (/fir DDp m <br /> / m E � <br /> r <.HCo � � 3 <br /> � <br /> " <br /> (.l %>,. iJ z e/ O <br /> rr <br /> 00C <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 8 m <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication. I agree to permit county officials charged with administering county ordinances or other authorized person to have n o <br /> access to the above described premises at any reasonable time for the purpose of inspection. m 3 8 <br /> A D A w <br /> m : o <br /> SIGN HERE � ' u <br /> i u e of i- conC�'caner or b <br /> ZONING ADMINISTR � fe(l M G i o <br /> n <br /> ` g <br /> TOWNSHIP PERMI / MAY BE REQUIREDSM srX <br /> 2d N)v' o o R <br /> j`� 8888888 ( <br />