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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54072 office of Zoning Administrator 5 I a 0 ; <br /> APPLICATION FOR - LAND USE - PERMITS <br /> m <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requiremer> of th <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the Iwse c <br /> and __ <br /> regulations of the State of Wisconsin. <br /> w <br /> O <br /> OWNER TELEPHONE <br /> ,�A S <br /> r n �A2LEn,E � T2EaGUE 'IIS-S66-7374 � o A <br /> ADDRESS Zqjq3 -rowEfzfzAX IIM30 <br /> g ( QJ <br /> EMERGENCY/FIRE NUMBER8 9 ROAD NAME T U1 E2 CoA 0 <br /> I <br /> LEGAL DESCRIPTION (see tax receipt) uW N1W 14-R4o - t of <br /> CONTRACTOR Se <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> n L7 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> 11 <br /> STRUCTURE/ADDITION USE: 'O QPAW IiviaA Rnom hjNijfi ROO,41 AAA &Svl4 <br /> (Home/Cabin;dommercial Business;Bedroom; Deck;etc.) z a <br /> a v <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 Nort (N). I r <br /> 2. Show the location of the well (W),septic tank (ST),and drainfleld (DF). o <br /> 3. Show dimensions in feet of the following:(a)building to all lot linea,(b)building to center line of road,(c�building <br /> measurement to the ordinary high water mark of lake,stream,or river. 0 <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be slued and <br /> dated by the owner. o <br /> NOTE: BUILDINC/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 3SUED. o N <br /> 1A z c <br /> I o n <br /> PLOT PLAN <br /> 150 10 TOWEK Rd 5/�1nn <br /> Cfe- fC�`'�-- 111 <br /> C <br /> dpB � <br /> lfo' 05. mchear ao-s3aatfsoC <br /> o <br /> o �L <br /> f VON 90p <br /> ooEB z S6R <br /> 14 'x� m <br /> c � � o <br /> tic% r <br /> ®_well <br /> z <br /> n <br /> Ne <br /> T <br /> 0 14 x zVe" <br /> f <br /> pF <br /> g m <br /> CO IONS OF PERMIT: o ',� 0 g <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br />