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Burnett County 7410 Co. Rd. K, No. 102, Sinn, WI 6072 Office of Zoning Administrator � m o' o <br /> APPLICATION FOR — LAND USE — PERMITS <br /> m o <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work descri and c <br /> located as shown herein. The undersigned egress that all work shall be done in accordance with the requiremei of the <br /> Burnett County Lard Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the I ws and <br /> regulations of the State of Wisconsin. ° <br /> m <br /> � C m <br /> OWNER AT 1--V A-SIcr< TELEPHONE <br /> ADDRESS "/ /3 44otipS�wj rl L. 1 �r�'/t! Awl SV d 9.5i IF m <br /> EMERGENCY/FIRE NUMBER }9-?3 ROAD NAME T4vO , PSOA/ <br /> LEGAL DESCRIPTION (see t"receipt) 1l', LOT 3 G 3 M V p. +► fit, <br /> CONTRACTOR �, C.®T 1 <br /> TA-T bf1-SC_FJ� I <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> L (� <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION —� <br /> o` <br /> 0 <br /> STRUCTURE/ADDITION USE: o —RC�1 <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) z <br /> 0 0 <br /> 0 <br /> m <br /> 3 <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 Nort (N). <br /> 2. Show the location of the well (W),septic tank(ST),and drainfield (DF). g <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. e <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. 1I a N <br /> �_ Z a <br /> PLOT PLAN o a <br /> M o <br /> Rb C <br /> �Sr ag JA I y <br /> a n <br /> EP o <br /> I_ <br /> z <br /> Iv <br /> S g� R.aN n,m <br /> a <br /> CONDITIONS OF PERMIT: ^ z' z ffi 9 8 S 9 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br />