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60 ( b J (p <br /> Burnett Coratty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator d _0o/ o <br /> APPLICATION FOR LAND USE PERMITS o <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work H <br /> described and located as shown herein. The undersigned agrees that all work shall be done inactor- --� <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. y m <br /> OWNER / , J n TELEPHONE GZ <br /> �� l/ <br /> HOME ADDRESS M <br /> EMERGENCY/FIRE NUMBER ROAD NAME 11'I I S CC Ji <br /> —� <br /> �,�- yA- cs rn � /� �- <br /> LEGAL DESCRIPTION(see tax receipt) V P Pc L <br /> CONTRACTOR <br /> apo <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTUREADDITION <br /> r _ <br /> m c <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION- <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin;drnmercial Business; Bedroom; Deck;etc.) <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) O 3 <br /> -n P m <br /> TZ <br /> 1. All required dimensions or distances to be shown or drawn to scale. oFL <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings (NB)and indicate m y: <br /> North (N). y <br /> 3. Show dimensions in feet of the following: (a) building(s) to all lot lines, (b) building(s)to centerline of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. r <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. C <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be <br /> signed and dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> N W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. � I�- <br /> CONDITIONS OF PERMIT: o <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY Z <br /> PERMITTED. D <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE 1 <br /> OHWM OF LAKES, PONDS, RIVER/ UNLESS SPECIFICALLY PERMITTED. r <br /> 6.5. C_� 1"b Lc A-+ leuvr 1 D F} �rort i✓ha.n y alo� rrr/aceine� <br /> v, <br /> 7. FL1� = m <br /> m � g —' am » � y <br /> N p t0 ; <br /> 6. £ � TIN: <br /> o [ is: = ;w <br />