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Burnett County 7410 Co. Rd. K, No. 102, SinnAdministrator <br /> � WI 54872 <br /> Office of Zoning U) y Z <br /> APPLICATION FOR - LAND USE - PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes <br /> located as shown herein. The undo application for a Permit for the work •2 g <br /> Burnett County ^�agrees that all work shell be done in accordance with the requirements of the o c DC <br /> Land Use Ordinance,Sanitation Code and with all other applicable County Ordinances and he laws and w <br /> regulations of the State of Wisconsin. � $ <br /> OWNER Duane Hazelton $ m <br /> TELEPHONE (715)866-8857 OJ� <br /> ADDRESS P.O. Boa 218 Danbury, <br /> WI 54830 <br /> a <br /> EMERGENCY/FIRE NUMBER <br /> ROAD NAME First Street <br /> LEGAL DESCRIPTION (see tax receipt) <br /> Lot 6 S 7 Block ➢., Original Townsite of Danbury, n <br /> CONTRACTOR u <br /> TYPE OF PERMIT(S): DWELLING/BUILDING <br /> ACCESSORY STRUCTURE ADDITION <br /> SANITARY a GARAGE/ <br /> ACCESSORY <br /> FILLING/GRADING CAMPING UNIT SUBDIVISION mo <br /> n <br /> STRUCTURF-/ADDITION USE: Sanitary Only <br /> 0 <br /> '^ r <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Z } <br /> o T <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or tap view) m <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and Indicate North (N). ✓ 3 <br /> 2. Show the IOCrlon Of the well <br /> 3. Show dimensions in feet of the followiictank (ST),anddrainfied (DF). ( ) <br /> measurement to the g:(a)building to all lot lines,(b)building to center line of road, building Ol <br /> r mark of lake,stream, of river. <br /> 4. ff separate a ans owner. sublmitted by watan architect engineer,builder,contractor,etc.,the plans must be signed and <br /> dated by the owner. .,•- <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT- CAN BE LSSUED. 0 0 <br /> PLOT PLAN 71 o u <br /> z <br /> o $ <br /> M _ I <br /> w <br /> C � � <br /> i <br /> Q <br /> SEE ATTACHED <br /> O I� <br /> o' > <br /> v <br /> .. ly <br /> Z <br /> S <br /> I <br /> / <br /> � f <br /> NDITIONS OF PERMIT:ORfurn <br /> IVEWAY MUST MEET WIDTH REQUIREMNTS WITHIN 60 DAYS OF PERMIT <br /> t. REMOVA OFI TREES AND VEGETATION ES RESTRICTED ALONG SHORELINE. <br /> a ' : ? 8 g°� -C <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. . <br /> i AT <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of m knowl- O <br /> edge and belief it is true,correct and complete.I acknowledge that I am res - C <br /> contained in this application(including any accompans nying I responsible for the detail andaccuracyc of all informs- <br /> tion <br /> motion I am providing will be relied u W^y�^ schedule and I further declare that I reco nize that this i - m <br /> further accept all liability which may be a resultofthe C4 it <br /> ofof rfl it tiettrelying sion this information miningethe to issue a Permit. I ` - <br /> plication.Iagree to permit county officials charged with administering count ordinances or other authorized <br /> In his a e V ' i gig <br /> access to the above described Premises at an g y Darvon o have ' <br /> y reasonable time for the purpose Of inspection. fps <br /> n <br /> Wade Rufsholm m w <br /> SIGN HERE � <br /> 6/1/95 « <br /> (signatureof own but Ing n t (date) ' <br /> ZONING ADMINISTRATOR <br /> TOWNSNI PERMITS MAY BE REQUIRED <br /> B� iS �d m <br />