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01) Ern 7 ZIP. <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator d T o 0 <br /> APPLICATION FOR - LAND USE - PERMITS w ' <br /> 0 <br /> TO THE'ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and T c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordan with the requirements of the <br /> Burnett County Land Use 9rdinipince,Sanitation Code,and with all other applica Coun din7ces and a laws andr lati sof th of isc sin. <br /> ln O <br /> le P int) V-A Cog1ractor or Sury o orAgent . o 7\tj <br /> I <br /> ess Address 9 <br /> City, State,Zip Code �y /' VCS Zip Code _ J <br /> Telephonet ( Telephone c <br /> Em Fie Mme <br /> Legal Description (as indicated on tax statement) `_,,, o <br /> �v 124 \ o <br /> Permit(s) Applied for: o <br /> Dwelling Addition -e� Filling/Grading Camping Unit o <br /> 2 0 <br /> Accessory Building Sanitary Privy Subdivision ° <br /> CD <br /> Garage <br /> Structure Use: <br /> 0 <br /> (family home/cabin, g)age, addition, etc.) <br /> 1A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: 0 <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and indicate North (N). X O <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). C 3 <br /> 3. Show the location of any lake or flowage-if within 1000 ft. and the location of any river or stream-if within P rn <br /> 300 ft. 41 Z Q <br /> � o a <br /> 4. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)building <br /> to lake, river or stream, if applicable. f11 <br /> 5. If,separate plans are submitted by an rchit t,engineer,b ilder,contractor,etc.,the plans must be signed and C , <br /> dated by the owner. iA <br /> M _ <br /> PLOT PLAN — W <br /> Cn <br /> (1 <br /> INS 0 <br /> 1 m <br /> T <br /> Z <br /> � � s <br /> mo c m m o a CD CL M9 <br /> < H o > > <br /> Z <br /> m Z4; . <br />