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BumetScounty 7410 co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator to O /o 0 <br /> APPLICATION FOR — LAND USE — PERMITS - <br /> s <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and Q a <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the o <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and <br /> regulations of the State of Wisconsin. u m 1' <br /> w <br /> c <br /> OWNER Gaeg Wittz TELEPHONE o <br /> m <br /> ADDRESS 4246 Royce Street NE Cotumbia Heights, MN 55421 >e, <br /> EMERGENCY/FIRE NUMBER ROAD NAME SpauKd<ng Road J <br /> LEGAL DESCRIPTION (see tax receipt) Ct. NW NE Section 3 red,, <br /> CONTRACTOR ^n <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> n L7 <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o � <br /> w � <br /> STRUCTURE/ADDITION USE: San2taAy Only o ° <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) Z <br /> o ° <br /> v <br /> m <br /> 3 <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 thefollowing:(a)building to all lot lines,(b)building to center line of road,(c)building fi <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. 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. o N <br /> PLOT PLAN A O 1 ( 1 <br /> CN ° I' <br /> ' <br /> 0 s <br /> � IZ <br /> I � <br /> 0 <br /> i <br /> 0 <br /> SEE ATTACHED <br /> 0 <br /> JIB <br /> o' <br /> O y <br /> C <br /> Z <br /> S <br /> , <br /> R <br /> = FFIj m <br /> m $� — a <br /> CONDITIONS OF PERMIT: = g _ .z c g, $, <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. Ze Q i 1 <br /> o ! Mi <br /> 2, REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. � rg� m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Wi IS <br /> L' O <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa. E N O'N i m <br /> tion contained in this application(Including any accompanying schedule)and I further declare that 1 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. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing In this ap- i i ' <br /> plication.I agree to permit county officials charged with administering county ordinances or other authorized person to have <br /> access to the above described promises at any reasonable time for the purpose of inspection. <br /> mTm <br /> 1 w <br /> SIGN HERE wade Ru zho.Pm <br /> (signature of owner or building contractor) <br /> ZONING ADMINISTRATOR ' g UOlinE <br /> N N NMMh Tt <br /> TOWNSHIP PERMITS MAY BE REQUIRE JUL D o IX {; IXiN'8 m <br /> �888�888',88 ai <br />