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oft emp, <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator iv m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS 3' ' <br /> 0 <br /> TO THE ZONING ADMINIS TOR:The undersigned hereby makes application for a Permit for the work described and 0 <br /> located as shown herein. Tt e undersigned agrees that all work shall be done in accordance with the requirements of the mc <br /> Burnett County Land Use Ot dinance,Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of W sconsin. w m <br /> c <br /> m O <br /> OWNER George and ChtA WeidendoA4 TELEPHONE '612) 689-3369 (�j A <br /> m <br /> ADDRESS 31270Jaclzh n Road NE CambA-idge, MN 55008 <br /> EMERGENCY/FIRE NUMBER 28874 ROAD NAME YWOW RcVeh. Road <br /> f�— <br /> LEGAL DESCRIPTION (seetso receipt) Lot 8, RcveA Oaks Subdivision, Section 7 T40N R16W <br /> CONTRACTOR Town o4 Oah2and <br /> TYPE OF PERMIT(S): DWELL NG/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> n 0 <br /> SANITARY x PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISIO o ° <br /> STRUCTURE/ADDITION USE: San<-taA Ont w'^ t`-'1 C�fml 1 �-1t�C a <br /> (Home/Cabin;Commercial Business;Bedroo I, Deck;etc.) Z p <br /> 0 0 <br /> 3 <br /> DIRECTIONS FOR PLOT F LAN 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). `yah <br /> 2. Show the location oft the well (W), septic tank (ST),and drainfield (DF). <br /> 3. Show dimensions in fee of the following:(a)building to all lot lines,(b)building to center line of road,(c)building <br /> measurement to the orc inary high water mark of lake,stream, or river. <br /> 4. If separate plans are su 3mitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. in 3 N <br /> c <br /> _ Z c <br /> PLOT PLAN 0 <br /> fA o <br /> C I <br /> a '�j: <br /> fn (n <br /> _O <br /> SEE ATTACHED <br /> 8 y <br /> o <br /> l7 y <br /> N <br /> Z <br /> A � c>?d 900 �m I <br /> a e3.: c gel <br /> CONDITIONS OF PERMF': <_ m : `z S 8 ° 0 <br /> 1. DRIVEWAY MUST ME DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. p f O �'� � ' <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. p al r^ <br /> i N t i 6 2 pyo? <br /> 3. NO GRADING OR SH RELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 8 n o:- <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- m ! i <br /> edge and belief it is true,c rrect and complete.I acknowledge that I am responsible for the detail and accuracy of all informa- <br /> tion contained in this apps cation(including any accompanying schedule)and I further declare that I recognize that this infor- B <br /> mation I am providing wil be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I b(8 <br /> further accept all liability N ehich may be a result of the County of Burnett relying on this information I am providing in this ap- <br /> plication. I agree to permit county officials charged with administering county ordinances or other authorized person to have O N p <br /> access to the above desci abed premises at any reasonable time for the purpose of inspection. r ' 3 'oo 9- i <br /> � mMwo <br /> SIGN MERE Wac e Ru ,s /91.9ho2m - <br /> r— <br /> (signature'of owner or building contractor) (d <br /> ? !�!f <br /> ZONING ADMINISTRATO <br /> TOWNSHIP PERMITS MAY BE REQUIRED MAY - 911 o N N N <br /> 000 0111 <br />