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C)7 1 <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Adminietrator m m o 0 <br /> APPLICATION FOR — LAND USE — PERMITS m <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 $ <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the lawvs and _ <br /> regulations of the State of Wisconsin. m° <br /> m <br /> m o <br /> OWNER SE� fl TELEPHONE � ' n £ <br /> o <br /> ADDRESS O 26 LX- RD, yrTNSUR WI. 5�183o m l (� <br /> EMERGENCY/FIRE NUMBER ROAD NAME �-U45rYI,-�n DRIVeV / ) <br /> LEGAL DESCRIPTION (see tax receipt) (n <br /> CONTRACTOR <br /> n <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITIONQA <br /> 1 p S <br /> o <br /> SANITARY X PRPRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION FA <br /> o <br /> STRUCTURE/ADDITION USE: S ,l-� - I /II o <br /> (Home/Cabin;Comm rcial Business;Bedroom;Deck;etc.) Z v <br /> 0 0 !— <br /> } <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 /> 2. Show the location of the well (W),septic tank (ST),and drainfield (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 <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 9 <br /> dated by the owner. OR <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE UED. 1I a N <br /> PLOT PLAN o a <br /> $U o <br /> C o <br /> �Gi�EA nai 9�'1 (n <br /> a oo <br /> � t L <br /> spa <br /> 0 <br /> w R� <br /> m <br /> o �- <br /> o <br /> w <br /> ^ I� <br /> Z <br /> D <br /> �i <br /> o ii� aaeggy <br /> o : � C1p g� <br /> CONDITIONS OF PERMIT: w: Z 'B m ; <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br />