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Burnett County 7440 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administratoriu ; 0 0 <br /> APPLICATION FOR LAND USE PERMITS d 3. <br /> e s <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work m <br /> described and located as shown herein. The undersigned agrees that all work shall be done in actor- � C <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other 2 o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. H w <br /> OWNER / '' � 3 <br /> A� W TELEPHONE 'S 6S 6' 3//6 <br /> u n b <br /> HOME ADDRESS AIT <br /> w w�l <br /> EMERGENCY/FIRE NUMBER !30,21-7 ROAD NAME 14(,uy 3 (t S -7-7 --� <br /> LEGAL DESCRIPTION(see tax receipt) S ajV <br /> CONTRACTOR <br /> 0 <br /> TYPE OF PERMIT(S):DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE-ADDITION- <br /> 0 <br /> TRUCTURE ADDITION0 <br /> SANITARY PRIVYFILLING/GRADING CAMPING UNIT SUBDIVISION v <br /> Z 23 <br /> STRUCTURE/ADDITION USE: r?i.Vk� <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> ' o <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) 0 3 <br /> T P ur <br /> 1. All required dimensions or distances to be shown or drawn to scale. o <br /> 2. Show the location and size of all existing buildings (EB) and all new buildings(NB) and indicate m 2: <br /> North (N). w 0 <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of m <br /> road, (c) building(s) measurement to the ordinary high water mark(OHWM) of lake, stream or river. J'} In <br /> 4. Show the location of the well (W), septic tank(ST) and drainfield (DF), and all distances to buildings, JJ ` <br /> roads, lake, lot lines. <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, etc., the plans must be O <br /> signed and dated by the owner. �j c <br /> I $ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. 0 <br /> N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: o <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. /� z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY z <br /> PERMITTED. D <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. }� <br /> 5. S-rAft Y/lliv 6,VV6 F/ Pe aufd )A�, 5A-,u,01) Pbl 5�1t <br /> 6. 5*6,4 )0/4, of fro l <br /> 7. <br /> f m <br /> (1N O kQ : : <br /> 6. Zj£ y : 0 <br /> 0 v is c� <br />