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Burnett County 7410 County Road K,No. 102, Shen,WI 54872 OR10 of Zontnp Adndnkuuw a <br /> APPUCe^A'TION FOR LANE) USE PERMITS <br /> OWNER I�p <br /> TELEPHONE <br /> MAILING ADDRESS (s+ dx' <br /> aERG Lyx �� �y 49SSyR30 <br /> PROPERTY ADDRESS n �, <br /> LEGAL DESCRIPTION 1 <br /> o <br /> 71'PE OF P®IlBI'(S): SINGLE-FAMILY DWELLING ADDITION ❑ DECK❑ GARAGFJACG7=S5tlRY STRUCTURE 6- <br /> BUNKHOUSE O 59.692(1V)GAZE80 0 STAIRS❑ FILLING/GRADING D CAMPING UNIT o I N <br /> COMMERCIAL BUILDING D COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE p A <br /> STRUCTURE/ADDITION USE: UO iT,xAl(a <br /> (Han1 'n; C'*"wnercTal Business;Bedroom; Deck;etc.) ry I o <br /> y, \ <br /> BUILDING CONTRACTOR: A) <br /> A PLOT PLAN MUSE<!FCAR-{. FT-IA U�' me <br /> WILL BE RETURNED. PROVlOED Olf IV)8 yi X115MBiOF PAPBt. ANY INOOMpLEiE OR'DJAGIB1E PLOT PLANS _6 <br /> DIRECTIONS FOR PLAT PLAN DRAWING: (ARIAL OR Top ®Y�F <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO g AWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> ANDIN INDICATE <br /> NORTH <br /> (N (MR),INCLUDING DECKS,PORCHES AND OTHER 57RUCTURES, , <br /> AND INDICATE NORTH(N), p <br /> 3. SHOW DIMENSIONS IN FEET'OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S) n' Z <br /> TO CENTOF ERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY NIGH WATER MARK <br /> S. <br /> 4. SHOW THE LOCATION OF THE WSTREAM OR ELL(W),SEPTIC TANK(ST)AND R AND WETLAND AREAS,AND(D)LOT DRAINFIELD(OF)i AND ALL DISTANCES b <br /> TO BUILDINGS,ROADS,LAKE,LOT LINES. _5Ft <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, E <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. TC.,THE <br /> O <br /> NOTE: NEEDED. RE LOCATIONS MUST LTE STAKED SO AN OMBTIE VBUFICATION MY BE DOME WHEN UI y G1 <br /> THS.PERMIT IS SUBIECT TO ALL CONDI73ONB LwfED BELOW: rT ry� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Y I I^ C) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. U :I 2 C <br /> 3. NO GRADING OR SHOREUWD ALTERATIONS ARE ALLOWED UNLESS SPECIgCAORLLY PERMITTED. -� " z <br /> 4, NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER ( 1 <br /> SETBACK AREA, vv <br /> 5. ACCESSORY SED FORR HUMAN <br /> HA PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGWSTORAGE ONLY.NOT TO BE USED FOR HUMAN HABITCA <br /> ATION. <br /> F' (flus+ �(0041 w *)jv e reG ire✓ tvts of gfLe s I rltd ct nd recorded f <br /> 7, 3hcweiagd iuwen�-we PrU�travr� Cpv2ncr�'i+. _ r <br /> LR0 R eStl O 3S <br /> 3 deda�e ONt UrN epplkalNe(Ndudeq any eoaampwryhp tae)hoe been alo�Nad 1 <br /> and bdwRbCUR.•arI ad hYrUandb al beets <br /> ,=and <br /> aMS m= f a"- (Indt�Mb gp )end I fi.Thr�aedof sits, a�t LMt I nrawims u at tlrs 19 �WEE m a <br /> alroimdan I am pool ft wm a raw <br /> further accept eq(kb1YIY Bat mqr a a Iaadt of Ito moo/Burnett womman In deaemdnap whwas to Nene a permlt I Z r Ti E A <br /> tiss <br /> B�oI ammn:de ° y�A16W' � 00oft kftTnmft w auden pm povMft mjnam ae Toa <br /> M <br /> OWNER'S SIGNATU &/,Z� 1 o <br /> ZONING ADMINISTRATOR �J I m �L�Y '1 (� �) y <br /> F'. <br /> Bait: e <br /> TOWNSHIP PERMITS MAY BE <br /> THIS PERMIT SHAEXPIRE ONE YEAR FROM DA <br /> M TE OF G` n <br /> Pe(in�+ afld fi`g is <br /> Dona $'�13-1 k 0'c'e c � L✓a�1�1 r� <br />