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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator m a o 0 <br /> "APPLICATION FOR — LAND USE — PERMITS . E <br /> " m = <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and a '- <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m c <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. <br /> OWNER Michael & Marilynn Vall TELEPHONE 1-612-433-2719 CZLC £ <br /> O = <br /> ADDRESS 1410 Quant Ave . N. , Marine on St . Croix, Minnesota 55047 <br /> West Yellow <br /> EMERGENCY/FIRE NUMBER ROAD NAME River Road Lot 19 ) <br /> History 439/647 489/484 S T40 R16W ACRES 1 . 4 0 W <br /> LEGAL DESCRIPTION (see tax receipt) 1 CL# 40. 16 . 155 . 02900 RIVER OAKS Lot 19 & 1/43 <br /> INT IN OUTLOTS 1 & 2 <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE X ADDITION 10 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o o <br /> c » <br /> m 0 <br /> STRUCTURE/ADDITION USE: Garage o 0 <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Z o <br /> o � <br /> m <br /> 3 <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 (I). <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). 17 <br /> 3. Show dimensions In feet of thefollowing:(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. C <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 'A <br /> dated by the owner. O o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I v y <br /> 1I Z `a <br /> PLOT PLAN SLE /{ r7-A C H ch p n <br /> M pC3� 0 <br /> C I <br /> In <br /> I - <br /> 0 <br /> N <br /> O y <br /> N <br /> V Z <br /> rr G <br /> O c T ro m G <br /> CONDITIONS OF PERMIT: < Z m o .0 m ; <br /> t. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o E r� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. y <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 5j inn i p g : m <br /> g` Re : c <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 6 a <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa. i? m <br /> � <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that this infor- f„: G <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability which may beAjesult or County of Burnett relying on this information 1 am providing in this ap- <br /> plication.I agree to permit count>-offidial char ith administe ounty, rdinances orother authorized person to have <br /> access to the above described a Iles t n le e r th " se s on. <br /> SIGN HERE a ' <br /> (s�u f owner oIding contractor) Ili:..- I` <br /> 8 a <br /> $ : : <br /> y� �: E <br /> ZONING ADMINISTRATO i <br /> MAR ? 4itt��«» m <br /> TOWN-SHIP PERMITS MAY BE REQUIRED $ 8 8 8 8 8 8 8 m <br />