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07t e"" 7 <br /> Burnett Courtly 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator S m f q <br /> APPLICATION FOR — LAND USE — PERMITS <br /> d a <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and v <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the m m <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and 3 0 <br /> regulations of the State of Wisconsin. y m c <br /> OWNER Dahhepe Schu°tz TELEPHONE )612) 483-6175 a (w£ <br /> o ' <br /> m ' m <br /> m <br /> ADDRESS 1007 Robinhood Place, Shoaeview, MN 55126 — <br /> EMERGENCY/FIRE NUMBER ROADNAME Johlwon Lone <br /> i } <br /> LEGAL DESCRIPTION (seetaxieceipt) Lot 2, SW 114, SE 114, Section 14, T40N, R17U1, Town Q <br /> o4 Union I <br /> CONTRACTOR <br /> TYPE OF PERMIT(S). DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION _ <br /> n_ 0 <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> ° <br /> /1 <br /> r <br /> STRUCTURE/ADDITION USE: Sl7ni.tnhlj Onftl U�L�rI f)f,�b ' �Rt?`i j ,'..�i�I(;( o ° <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) �— z v /'M� <br /> o ° l I <br /> m <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 (N). <br /> r <br /> 2. Show the location of the well (W),septic tank (ST), and dreinfield (DF). � <br /> 3. Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building -1 04 <br /> measurement to the ordinary high water mark of lake,stream,or river. <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 4 <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. "ll a m <br /> 7I z `v <br /> PLOT PLAN offP' <br /> M V o <br /> C U <br /> m � <br /> SEE ATTACHED. ° <br /> 0 <br /> I{� <br /> o <br /> 0 <br /> m <br /> o <br /> D <br /> I T <br /> a M�r DaF <br /> a a b v= m <br /> CONDITIONS OF PERMIT: o F S ? <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. i rn M <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. r o: �O i O <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- J: o: i !: C <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- I '^m'^ T <br /> lion 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. $ <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have O m <br /> access to the above described premises at any reasonable time for the purpose of inspection., o <br /> SIGN HERE <br /> wade Wjlshokm <br /> `B <br /> (signature of owner or building contractor) I �Q <br /> 1'M1r\ tJ <br /> ZONING ADMINISTRATOR m W/ 1 <br /> are d. `nwa n <br /> TOWNSHIP PERMITS MAY BE REOUIRC� r. .o "n u u ^n $ N m <br /> 08888 :. bout <br />