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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator v 71 c o <br /> �- �~ APPLICATION FOR — LAND USE PERMITS 5 3 <br /> -- — <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and N <br /> located as shown herein.The undersigned agrees that all work shall be done in accordance with the requirements of the Bur- m c Oi <br /> nett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and regula- - a ,, d <br /> tions of the State of Wisconsin. v <br /> U \\10..,Thr /.OR,r/) 73/qt'iI.,C. <br /> CD <br /> OWNER(Please Print) Contractor or Surveyor or Agent o <br /> (-L 1z \, - `3 R 7 /, L?OX /6o5- Ft U) <br /> o <br /> Address Address I <br /> (r)P?\ IflSS1 O si /%•)-2--, — <br /> a/QW6/7/We/c , <br /> City, State,Zip Code U City,State, Zip Code S <br /> Telephone Telephone L L <br /> l a 3 (..c)i L/�j,d D L.A`t1 o <br /> Emergency/Fire No.and Road.Na(neT .✓ <br /> M ALLL o T Z _ /N r o ori dr / <br /> Legal Description(as indicated on tax statement) g• C <br /> Permit(s)Applied for: 0 s7 <br /> 0 <br /> New Building Sanitary Filling/Grading Camping Unit m r <br /> N <br /> Addition Privy Moving Subdivision o w <br /> Film/L.y c/tarn} z <br /> Structure Use: „ <br /> o <br /> (family home/cabin, garage, type of addition,etc.) <br /> V <br /> Directions for plot plan drawing: <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(SD,and drainfield(DF). R <br /> 3. Show the location of any lake or flowage-if within 1000 ft.and the location of any river or stream -if within 300 ft. J <br /> 4.Show dimensions in feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building to ordi- <br /> nary high water mark of lake, river or stream, if applicable. -_ J <br /> 5. If,separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and dated by <br /> the owner. o <br /> PLOT PLAN f Pf!J iAl fir. F C 1 7 WFA / cF <br /> _ _ - . _ ... _ - - c <br /> ��' • • <br /> a. <br /> f a <br /> a.s <br /> ,.s.. <br /> / § .z, <br /> ` ( I-P i 6 tL 7 a\ <br /> �`� • 1 0 <br /> nCD <br /> O <br /> f 3a,� ' / o <br /> c401tU II <br /> 1, ,., s'' o <br /> - .� a 1j -I <br /> o Z <br /> 30 <br /> ( /lc" <br /> k (kl - <br /> a w;ti 1a-17— <br /> r( /( y f O�� Lel o , <br /> ee C . i Dr.i ( d Ic <br /> h a(Je `turn arOu" ? ' <br /> ())1T-'' r 7(,o <br /> IC3U.Cf � \ IC� m N�CmDDi � <br /> (. } m a.< —o-maa37 <br /> , r,c , : -i i 177•t -. . L .- c a._fa Si .nc y o r 3 <br />