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L/Rurnett County Office of Zoning Administrator ( �
<br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT ° ° °
<br /> 3
<br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application fora 0 °7
<br /> Permit for the work described and located as shown herein. The undersigned agrees that all
<br /> work shall be done in accordance with the requirements of the County Zoning Ordinance, (�
<br /> Sanitation Code, and with all other applicable County Ordinances and the laws and re gu- t
<br /> lations of the State of Wisconsin. a
<br /> 7� — 3 `V+ O
<br /> Owner or Agent (please print) Contracto»� er . . . . . . . . . . . . . . . . 1
<br /> Sox . 37. .!N1 ,Ff CSN
<br /> a :
<br /> Address
<br /> Address — : \•
<br /> 5 ? . . . . . . . . . . . Phone
<br /> Well Driller
<br /> Address Address
<br /> n G)
<br /> ,244- 5509 V �.
<br /> '�
<br /> Phone .P. .one. . . . . . . .
<br /> . . . . . . . . . . . . . . . . . . . . . . . . . m r
<br /> h
<br /> o
<br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities: °
<br /> Type of Construction No. Bathrooms • • • • • Z Z o
<br /> 1. Work w!'�l'1 I 'II�YI�. . . . No. Bedrooms �. . ° o m
<br /> New Building Size , ./eft. x . , .� ft. Septic Tank Size Gals. 7�Q
<br /> . . .
<br /> Addition . , Height . .i? . Stories . ,/. . . . S7ztML
<br /> Sanitary , Area . . . . . . . ././.� �. . . . . 7a.Absorption FieldSite: � \\`T '
<br /> Filling Soil Type
<br /> Moving 5. Permits Required Slope . . . . . . . . . .oe--447 , , i
<br /> Grading . . . . . . Subdivision . , , , , , Perc. Rate
<br /> Mobile Homem -
<br /> • . . . . , Sanitary , ,T,'• Dry Well . . , , , , T T
<br /> Privy . . . . . . Building , , Seepage Trench
<br /> Well Well Privy 46
<br /> Subdivision . . . . . . Other (Specify) . . , , , , Seepage Bed
<br /> Conditional
<br /> 2. Classification Land Use . . . .
<br /> Zoning Dist. , , , . , , a
<br /> �• o
<br /> 6. Use (describe exactly, 1 •fam
<br /> 3. Lot Size home, motel,etc.) FRf t;OMMERCIAL USE
<br /> SQ. , ft. x . ./�it�Q, ft. 2P Z) hzo•,rlE Plans Submitted . . . . . .
<br /> . . . . . . . . . . . . . . . . . sq. ft. t� PAs Approved
<br /> ��
<br />--------------------s- --- ,,11!,
<br /> EJzt 71N6 6.rG�� Fig. A. -� � � t�' --------------
<br /> 5 SY�Lz7. P� N��� ocation of proposed structures and :l
<br /> r pX existing structures, well, sewage sys- tv o
<br /> t lSTl�trb 8.[D6. � tem s, roads, etc., should be sketched
<br /> in Fig. A. Include road setback, side s
<br /> ao; p�y.� and back yard dimension and location v'
<br /> A/C9�us+0 M and setback from all bodies of water. ?„,1
<br /> /O� �g� 4DA�7%A.) If property is located at a highway in-
<br /> �— tersection; show the intersecting high-
<br /> ' ,.., ;
<br /> /p ways and the setbacks required along
<br /> S � them and at the intersection. :-„(,`, �Jl:
<br /> �^^ 74Z)
<br /> � � ��• PERMIT FEES :!j t. ;
<br /> �L Subdivision..... $25.00 + $2.00 per lot. I
<br /> La
<br /> Land Use -
<br /> � • ................................. $10.00 � • �
<br /> Building................................... 10.00
<br /> San itary20.00
<br /> ..
<br /> Well
<br /> 10.00
<br /> Septic Tank ..... 10.00 r•`
<br /> Privy ....................................... 5.00
<br /> it
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