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1995/05/31 - SANITARY - SAN - Other
Burnett-County
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TOWN OF LAFOLLETTE
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10176
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1995/05/31 - SANITARY - SAN - Other
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Last modified
3/5/2020 11:09:20 PM
Creation date
9/28/2017 8:25:50 PM
Metadata
Fields
Template:
Property Files v2
Document Date
8/21/2007
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
10176
Pin Number
07-014-2-38-15-35-5 05-004-016000
Legacy Pin
014223501900
Municipality
TOWN OF LAFOLLETTE
Owner Name
GREENE FAMILY TRUST
Property Address
22898 JOHNSON RD
City
FREDERIC
State
WI
Zip
54837
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INCIDYA <br /> / <br /> Bunion County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator N o -'40 <br /> APPLICATION FOR — LAND USE — PERMITS . <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby by makes application for a Permit for the work0 <br /> desci ibed and v <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requireme s of the o <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the aws and $ <br /> regulations of the Stale of Wisconsin. <br /> OWNER Diane Sjobeck TELEPHONE 612-653-2594 o m E <br /> o <br /> m <br /> ADDRESS 3510 Widgeon Way Eagan MN 55123 J <br /> EMERGENCY/FIRE NUMBER 2P898 ROAD NAME Johnson Rd v <br /> LEGAL DESCRIPTION (seetaxreceipt) GL 4 S35 T38N R15W y/J i <br /> CONTRACTOR Daniels Plumbing & Heating Inc <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION �� p <br /> SANITARY_ XPRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> o = / <br /> '^ r <br /> STRUCTURE/ADDITION USE: Fxiqtinq I hdrm rabin <br /> (Home/Cabin;Commercial Business; Bedroom;Deck;etc.) m <br /> Z o' <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). ✓n <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). <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. ¢ <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be signed and 9 <br /> dated by the owner. 0 0 <br /> NOTE: BUILDING/S-MUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 13SUED. 11 M to <br /> PLOT PLAN o 'n <br /> � G <br /> � N <br /> C <br /> L <br /> See Attached fA <br /> fA r\ s <br /> 0 <br /> n <br /> 0 <br /> � J <br /> N <br /> n t. � <br /> O y <br /> w <br /> ICIO <br /> JZ <br /> I <br /> f <br /> A m <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. = m Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ M <br /> B. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. i <br /> 0 <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowl- 0 : <br /> edge and belief it is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all informs- i N •+: m <br /> tion contained in this application(including any accompanying schedule)and I further declare that I recognize that thia infor- �'l 8 <br /> mation I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue permit. I <br /> further accept all liability which may be a result of the County of Burnett relying on this information I am providing In this <br /> plication.1 agree to permit county officials charged with administering county ordinances or other authorized person to have ' <br /> access to the above described promises at any reasonable time for the purpose of inspection. <br /> In <br /> SIGN HERE '^/� <br /> (signature of owner or build) c nir t d <br /> ZONING ADMINISTRATOR E $ i <br /> TOWNSHIP PERMITS MAY BE REQUIRED j R; N g m <br /> rn <br /> $ $ 8 8888 to <br /> L._.__---- -- <br />
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