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- r <br /> Office of Zoning Administrator <br /> Burnett County 7410 County Road K,No. 102, Siren,W1 54872 3 C <br /> APPLICATION FOR LAND USE PERMITS = = <br /> OWNER TEIEPHDNE `L �f� <br /> �' N sin/>I ^ L / / 6/z-7177—�9y/ <br /> PROPERTYADDRESSI/SY S l e6"- �l6,L"2 <br /> tz <br /> LEGal DTscmPnoN//�,�-,T <br /> MAIUNG ADDREss E�J�PXGBCC IS�A/�IPr�-22.HrA� f 53�1/S ° <br /> TYPE OF PERMIT(S): <br /> ® Single Family Dwelling O Garage/Amesory Struo ure U Stairs U Commercial Building <br /> ❑Addition Cl Bunkhouse Cl Filling/Grading ❑Commercial Addition $ <br /> U Der( �❑.[59.692-(1/y))Gazeta ❑Camping Unit ❑Commerdal Act.Structure <br /> STRUCTIIRFJADDITION USE:T/UAJ ° 1 <br /> (Mom4CaLGHoie/ m—e <br /> ' Dln;Crnnrcial Ensness; Eedmom;Deck;etc.) <br /> BUIIDINGCONTRACTOR: 1110e 1&Z Deur/0~474 _ <br /> PLAT PUN---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. t s <br /> ""REOUIRED PLOT PLAN INFORMATION*— v <br /> U Brh'X 11'SHEET OF PAPER DISTANCE(IN PEETI TO: S <br /> O DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK is DRAINFIELD <br /> 4Dimenstons&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED <br /> U EXISTING BUILDINGS/STRUCTURES(Indu les deck,porde,etc.) 4CENTERLINE IF NOT SURVEYED w Y <br /> _4Dimensions&Heights _ ❑ ALL PROPERTY LINES <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK 5. UJ <br /> U ALL WETLAND AREAS <br /> NOTE: &cbily/sttv.Wre tration must be Staked for anste venflatim whm rietdM IIF_ �'n'(IIM t NWY GI <br /> THIS PERMIT I5 SUBJECT TO ALL CONDITIONS LISTED BELOW: D �v ,! 1'J D <br /> • Removal Or addng d trees and vegmum e,resotcti almg shaelire <br /> No sLUOures(inc lg reti ir.ng walls,etc.)are all udFss slxo6ouy -'`9JOV 14 2014 <br /> • No fithno,grading,or shore land alterations are allowed uNess spedgrally <br /> • Dmmmay must meet width lequrements within 60 days <br /> Amsny strucUreJgarage Permits allow for private rmdelOal storage only BURNETT COUNTY = x <br /> " used th be for human Notation or rental storage•' <br /> D l <br /> i etffire van this apglvtbn(housing any acempanTlrlg fUMuns)has IMn aomlmal by am AEalwgenl mY Imuw44 s,all <br /> par f it k true correct and complete. I a[krowlNge that r am lespm:iele fins the 4eGn and xarxy of all inrpmanpn range H Ia <br /> vara applan by (.Clueing anYmriot hsocq n in <br /> ell I raspier declare artf recognise than <br /> ma this 1-11 Hrlon prthar will pe <br /> varied upon pY the Wunry W aumN sol um m in mman nay wagger in our a permit 1 fuller aaxpt ad u"M o then maY the a <br /> sat ofge onany or BurnR[nlYln9 on vakitonruum lam pmridinp in qk aDpllo4we-I ryix Ou pemit mnnl' [L-:[tlu9cd - ----£-- — --- <br /> wish admiabori ll county m mantes Or other aWarlad Person to now,a[ws ta the apore-0esviped pmarahas at any reffidleMe <br /> nnw torthe vprpoae a inapemml. <br /> —aDDmoruL mNDrnONs-- � NOWYS_ `" a 3 a ._1 <br /> ��Ny PlN bl'wy usf b� « <br /> OS y ,�ysyjea.A MUsf GE CaIMPll al'I f" Wr/('i �e AIliM 6P,r a( ��'�MV uwesn <br /> OWNER'S SIGNATURE <br /> ZONING OFFICIAL �/ ZS 20/ - 9 - 3 c•^ n <br /> "TOWN/UIR)PERMITS MAYBE REQUIRED —THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE Of ISSUANCE - - <br /> You are responsible for mmPyng man stare all feeeral laws omcemio4 cnrstrumon n•.ar or on wetlands, lakes, and streans. - <br /> Weill that are not ass .bell won open ware,Can be diBkUlt to Nendly.Fall.to Curnely may result in mmo-M or moms tioo <br /> aFNni4aCtgn Ud[NMM <br /> dalg e law ptnC! pefNd6 or CDSIS. T9t more infomlatiMl Asir the 0.'P3r[menf W NLNraI Resources <br /> wetlands idenBfiCahon web Nge or cmuct a DepaRnent of Natural Resources SeNke Centel. <br />