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• 410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator ( -0 -- 0 <br /> APPLICATION FOR — LAND USE — PERMITS <br /> o <br /> ,G ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and (A <br /> ;own herein. The undersigned agrees that all work shall be done in accordance with the requirements of the (1) C <br /> ,nty Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the laws and _ C—) <br /> ,,s of the State of Wisconsin. y <br /> C <br /> ID O <br /> Whis-oering Pines Unite(' Methoc'ist CampTELEPHONE 71 _112;_ging <br /> '40DRESS 11050 Wriisperin, Pines Road, Frederic, WI 54827 <br /> l <br /> EMERGENCY/FIRE NUMBER 11 050 ROAD NAME Vriisperiri 7 'lrieS Raod <br /> LEGAL DESCRIPTION (see tax receipt) T37N R186d Sec. 11 SE 114 SI: 1141 Gov. Lot #.`.i <br /> CONTRACTOR Eure':a MovinJ Company- Kirin, eXcavation aril foundation wor', only <br /> TYPE OF PERMIT(S): DWELLING/BUILDING - GARAGE/ACCESSORY STRUCTURE ADDITION p <br /> 0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o 0 <br /> STRUCTURE/ADDITION USE: For use by individual families oily or staff housir!g o <br /> {=CdrPi'eltitt16A4ff • �edr Deck;etc.) Z <br /> 0 0 <br /> v <br /> co <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), o <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. C <br /> 4. If separate plans are submitted 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 ONSrrE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 7I a N <br /> Z v <br /> o a <br /> PLOT PLAN This cabin has been donated to the camp, a t.z.ro ?oedroom one 'oath n I n <br /> rith living room and kitchen measuring a total of 241x ?31 . We :rant to have M o v 1 <br /> �'oout a 4' craTd- space, the trell to be done by Danwel.l Inc. and the sewage to C ! <br /> m done by Wade Rufsholm, Wade and inspector has already too'; per', test in that <br /> area and had advi&.ed us of the location the seTrage will have to be in as indicate <br /> )e1017. Eure',a Moving Company will he transporting the cabin from Deer La',e near DO <br /> 3t. Crow to VPiisperir.r Pines. { �, <br /> NJ L <br /> (t <br /> o <br /> a , g '\ _ o` Y "^ ..•"""*,'+, PJo, t'. y k t{1 P4 <br /> .r( ,-1,�.C. `r.l ,�'��'_..^_'+� '-� •.� `i ,s d ° �TF��' f,,{ li �C1 <br /> Aseta;& a r• � r^'1 „S 3� ry 'u,;'�,� <br /> to <br /> �; t�1 {(��'7i9i°' 1 `?7Rq ` '• .� ° .£.r Oil <br /> ip i:i?� -Y'e^�' ®�` k {t,b},.�,.t ` Q. <br /> % Ili 1''04 <br /> sc, <br /> I l f I F tq fill1f F{ <br /> 7 11 <br /> a , I evre,r AA"Al"necrir.uo <br /> (ncla�t� rDDO -D <br /> SQtG7` 6� o c 0 0 C) <br /> CONDITIONS OF PERMIT: <br /> o <br /> Q� <br /> ��Q w a o .0.1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. 0 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. v�i c A rrl <br /> c : a c jo <br /> C <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- c E o o . <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informa <br /> tion contained in this application(including any accompanying schedule)and I further declare that 1 recognize that this infor- " m <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I 8 8 <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 h <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 p e at ny reasonable time for the purpose of Inspection. i o g <br /> m O A <br /> SIGN HERE C1114 1 nil F�a� M 8 <br /> _ __- <br /> (signature of owner uil i contr (d ) . $ <br /> Fr <br /> f ZONING ADMINISTRATOR _ at. 8 <br /> �i�iw�'iHj' m <br /> TOWN IP PERMITS MAYBE REOUIREO i OCT 3 1992 8 �' o o "' <br /> i 8888888ca <br /> iinaland one co, <br />