Laserfiche WebLink
C7 ,- z <br /> Burnett County Office of Zoning Administrator 5-a � <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT - `" S\-)",3' <br /> To the Zoning Administrator: The undersigned hereby makes application for :1 �� <br /> a Permit for the work described and located as shown herein. The undersigned agrees that and J,f4 •�,, <br /> all work shall be done in accordance with the requirements of the County Zoning Ordinance, p <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- / 0 <br /> lations of the State of Wisconsin. , •,�,� :; <br /> 10htl s h%I1/a r - <br /> Owner or Agent (please print) Contractor or Surveyor <br /> Address Address c- <br /> Phone /_ Phone <br /> Plumber �!'j ren Well Driller e) 4 ;^'-• <br /> r <br /> .� ' -- mss r.�. I <br /> Address Address <br /> P. one Phone <br /> M <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities -, <br /> 1. Work (check one) Type of Construction No. Bathrooms . .2t. <br /> ,: a Dishwasher .r:�: <br /> New Building - ,;` •�• <br /> Addition Garbage Grinder <br /> Sanitary _. Size 2.467. ft. x •.4:c . ft. Autom. Laundry ' <br /> No. Bedrooms <br /> Alterations Height J ". Stories i.. Waste Disposal in) 'R <br /> Moving Area �- `� System I- <br /> i-' <br /> Wrecking Septic Tank Size • <br /> Mobile Home 5. Permits Required /-2_C' r Gallons • <br /> �' <br /> Privy Subdivision o' <br /> Absorption Field Site �' iii <br /> Well Sanitary �•• • Soil Type -S, C. a <br /> Subdivision Building <br /> Slope C` N <br /> Well Other (Specify) Pere. Rate r . <br /> 2. Classification P Y) Dry Well ter. <br /> Zoning Dist. Conditional Seepage Trench X, • tkJ <br /> Land Privy :41. - <br /> 3. Lot Size 6. Use (describe exactly, 1, Seepage Bed •. x. , h o \ <br /> Cli <br /> fam. home, motel, etc.) FOR COMMERCIAL USE <br /> .3:C.0. ft x rb:40. ft. i <br /> u Plans Submitted °' <br /> . .qQ t...C:�.. ?. sq. ft. Plans Approved 'd <br /> NOTE: A preliminary site inspection must be made and site approval granted on all struc- 2.,-- <br /> „ <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- <br /> posal systems, a copy of the percolation test m ust be attached to this application before a ''y <br /> permit will be issued. Do not purchase or ins tall a septic tank, do any plumbing or start any 0 <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of -%•--- co <br /> any of the information conveyed herewith is found to exist. Changes in plans or specifica- • T. <br /> tions shall not be made without approval of the Zoning Administrator. SEWER SYSTEM F <br /> SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. ” <br />