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Burrett County.7410 Co. Rd. K, No. 102, Sinn, WI 54872 Office of Zoning Administrator 5/` ; E <br /> APPLICATION FOR — LAND USE — PERMITS s = 0 <br /> TO THE ZONING ADMINISTRATOR:The undersigned hereby makes application for a Permit for the work described and 9 m <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the <br /> Burnett County Land Use Ordinance,Sanitation Code,and with all other applicable County Ordinances and the laws and o <br /> regulations of the State of Wisconsin. w m `� <br /> w o <br /> c O <br /> OWNER / TELEPHONE C` o <br /> zsk, r &0 �` <br /> z <br /> ADDRESS <br /> f v <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> i <br /> I <br /> J <br /> LEGAL DESCRIPTION (see tax receipt) L_ ?r" <br /> Hare I <br /> S <br /> CONTRACTOR <br /> TYPE OF PERMIT(S) DWELLING UILDING GARAGE/ACCESSORY STRUCTURE ADDITION m <br /> ' fSU C�VIInSIION <br /> SAY 0ws <�.LCAMPING U <br /> STRUCTUREADDITION USE: <br /> �- <br /> �I <br /> (Home/Cabin;Comm rcial Business; Be oom(Deck;etc.) o 0 o <br /> � <br /> 3 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) � <br /> 1. Show the location and size of all existing buildings (ES) and all new buildings (NB) and Indicate North (N). ^ <br /> 2. Show the location of the well (W),septic tank(ST),and drainf laid (DF). S1 <br /> 3. Show dimensions In feet of the following:(a)building to all lot lines,(b)building to center line of road,(c)building O <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 <br /> dated by the owner. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE ISSUED. <br /> o g <br /> PLOT PLAN `- I <br /> C <br /> a <br /> � I <br /> 0 <br /> s� I� <br /> 0 <br /> o I� <br /> Z <br /> Ir <br /> CONDITIONS OF PERMIT: g <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ? <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 1 declare foal rola application(Including any accompanying schedule)has been examined by me and to the best of my knowl- <br /> edge and belief It is true,correct and complete.I acknowledge that I am responsible for the detail and accuracy of all inlorma- <br /> tion contained In this application(including any accompanying schedule)and 1 further declare that I recognize that this Infor• psi lS <br /> merlon 1 am Providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. 1 �f $ $ t <br /> further accept all liability which maybe a result of the County of Burnett relying on this information I am providing In this ap- ; <br /> y other authorized Person to have <br /> P ng Y _- T i i aZl3i <br /> plication.I agree to permit count officials charged with administering county ordinances or <br /> accost to the aloe described promises at an reasonable time for the purpose of inspection. ' <br /> eo • I���i1��/��99G/ " <br /> SIGN HER <br /> (signature of wrier r bui Ings t 0 Noy r(4alC 1994 <br /> 1 u <br /> ZONING ADMINISTRATOR '" N <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> _-- 888881$8 <br />