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erg Gam/ <br /> Kett County 7410 Co. Rd.K, No. 102, Siren,W154872 Office of Zoning Administrator 0 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work y <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- ( a <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 _ <br /> o v O <br /> OWNER TELEPHONE CT <br /> HOME ADDRESS r Q; <br /> EMERGENCY/FIRE NUMBER Lin ROAD NAME -7n <br /> LEGAL DESCRIPTION(see tax receipt) ,: j anet _k lnr3rr1 Dal r 7�i�i l� �� <br /> CONTRACTOR <br /> � o � <br /> TYPE OF PERMIT(S):DWELLING/BUILDING—GARAGE/ACCESSORY STRUCTUR .-ADDITION— <br /> SANITARY—PRIVY FILLING/GRADING CAMPING UNIT_X_SUBDIVISION Z <br /> 0 00 <br /> cn <br /> STRUCTURE/ADDITION USE: i '� CIC4 <br /> (Home/Cabin; Commercial Business; Bedroo ; Deck;etc.) <br /> o <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> O <br /> ix <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) <br /> O 3 <br /> m p co <br /> 1. All required dimensions or distances to be shown or drawn to scale. oo Cr <br /> n <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 I <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. Z <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. <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. ` Cn <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> N <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: v <br /> y <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. OQ <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ? <br /> PERMITTED. f 70 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. <br /> r � <br /> r <br /> r/)a sD gDa -V <br /> 7. —a� am `�'fD M <br /> m m< — C y 6 ? <br />