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Burnett County 7410 Co. Rd. K, No. 102, Siren, WI 54872 Office of Zoning Administrator U) m o 0 <br /> APPLICATION FOR - LAND USE - PERMITS <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for thew descri,�,1p,,�,and 9 c c <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requiremem8 of the <br /> Burnett County Land Use Ordinance,Sanitation Code, and with all other applicable County Ordinances and the Is s and <br /> regulations of the State of Wisconsin. m <br /> fO m <br /> £OWNER Tlf_, 1I� �IntQEQ/ TELEPHONE m <br /> ADDRESS 3 RD. R I, r�Q�O <br /> EMERGENCY/FIRE NUMBER `J ROAD NAME 1 ^fir <br /> W <br /> LEGAL DESCRIPTION (see tax receipt) � <br /> CONTRACTOR <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION_� O <br /> m0 <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION o ° <br /> 0 <br /> a STRUCTURE/ADDITION USE: ° o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) z o <br /> 0C` `` <br /> sb c <br /> a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) (i <br /> 1. Show the location and size of all existing buildings (EB) and all new buildings (NB) and indicate North (N). <br /> 2. Show the location of the well (W),septic tank (ST),and drainfield (DF). a <br /> 3. Show dimensions in feet of the following:(a) building to all lot lines,(b)building to center line of road,(c)I uilding <br /> measurement to the ordinary high water mark of lake,stream,or river. C <br /> 4. If separate plans are submitted by an architect,engineer,builder,contractor,etc.,the plans must be algi ed and 9 <br /> dated by the owner. C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISWED.. an 7I a m <br /> z `c <br /> PLOT PLAN ? S <br /> C O 0 <br /> to <br /> K�T(RcHCD In <br /> i <br /> I � <br /> o' <br /> IQ ) <br /> m <br /> 4 � <br /> N_ <br /> n <br /> i <br /> f <br /> In <br /> . M <br /> CONDITIONS OF PERMIT: < m' Z � g� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. o f 5 p ;IQ ; -q <br />