Laserfiche WebLink
fig' A. Location of proposed structures and <br /> existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> water. If property is located at a <br /> highway intersection, show the inter- <br /> secting highways and the setbacks <br /> required along them and at the in- <br /> tersection, together with vision clear- <br /> ance triangles. <br /> PERMIT FEES <br /> g5 Land Use . . . .... ... . . . .. .. .$ 1.00 <br /> Building . . . . . . . . . . . • . . . .• . . 5.00 <br /> / Sanitary . 10.00 <br /> Well ... .. . . . . .. .. .. .. . ... . . 5.00 <br /> Septic Tank . .. .. .. .. .. .. .. . 1.00 <br /> Combination Building, Sanitary <br /> and Well . . . . . .. .. .. ... . .. 15.00 <br /> gd <br /> i ature of Owner or Agent Date Zonist or <br /> ACTION Site approved (date) C . . ..... .. .. . <br /> Permit Issued (date) . . . . . . .. . . . . ✓ ipt No. �. ee $.� :. . . . <br /> Rece <br /> Septic Tank Permit Issued (date) . .. . . :� .�.`. .�. . . No. �l�Fee $1.00 <br /> Conditional Permit Issued (date) . . . . . . . . . . . . . . . . . . . . . . . . No. . . . . . . . . . .. . Fee $. . . . . . . . . .. . <br /> Certificate of Compliance Issued (date) . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . .. . . . . . . .. .. . <br /> Permit Denied (date) . . . . . . . . . . . .. . . . . . . . . . . . . . for the following reasons . . . . . . . . . .. .. . . .. .. .. .. ... . . .. <br /> .. . . . . . ... .. .. .. . . . . . . .. .. .. .. . . . . . . . . . . . . . . . . . . . . ... .. .. .. ... . . . .. . . . . .. .. . . . . . . . . .. . . .. . . .. . . . . . . . . . <br /> Work Started (date) . . . . . . . . . . . . . . . .. .. . . . . . Work ompleted (date).t. . .,.... ....... .. .. .. .. . <br /> INSPECTION Date sK.7. . f l. .T4 In Spector ..... .. .. . <br /> Remarks .. . . . . . . . . . . . . . . . .. . . . . .. .. . . . . .. .. .. ... . .. .. .. .. . . . <br /> . . . . . . . . .. . . . . . . . . . . . . .. .. .. . . . . . . . . . .. . . . . . .. . . . ... . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. .. . . . .... . . . .. . . .. . <br /> . . . . . . . . . . .. . . . . . . . . . . .. . . .. .. . . . . . . . . . . . . .. .. .. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. .. .. .. . .. ... . <br /> RECORD <br /> Application to Zoning Committee (date) . . . . . . . .. . . . . . . . . . . . Notice published (date) . .. .. .. .. . . ... .... . <br /> Application to Board of Adjustment (date) . . . . . .. .. . . .. . . . . . Notice published (date) . .. .. .. ..... .. ..... <br /> Appealed to Board of Adjustment (date) . . . . . .. . . . . . . . . . . . . Notice published (date) . .. .. . . .... . . ...... <br /> Copy of Notice to DNR (date) . . . . . . . . . .. .. . . .. .... . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. .. . . . . . . . . . <br /> Appeal Heard (date) . . . . . . . . . . . . . .. .. . . .. . . .. .. . Decision . . . . . . . . . . . .. . . . . . . .. . . . . .. .. .. ... . . ..... . <br /> .. . . .. .. . . . . . . . . .. .. . . .. . . . . .. .. .. .. .. . . . . . . . . .. . . .. . . . . . .. . . . . . . . . .. .. .. .. . . . . . . . . . . . . .. .. .. . . ....... <br /> Copy of Decision to DNR (date) . . . . . . . . . . . . . . . . . ..... . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . <br />