Laserfiche WebLink
Burnett County Office of Zoning Administrator 0 o/ 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT 3 <br /> rw 0 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and opi ted as m ;� <br /> shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the Burnett County Land Use m OC <br /> Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and regulations of the State of Wisconsin. a <br /> r <br /> ............................ ........................................................................ <br /> . . . ...... . . . . <br /> OWNER (please print) CONTRACTOR or SURVEYOR or AGENT o' <br /> .... ....... ..r.K......5 .7....................... .................................................................................. ......... a SJ <br /> ADDRESS ADDRESS <br /> ADDRESS ADDRESS :� <br /> ip <br /> ..................................................,3314 3 4J [� <br /> ......................................... <br /> PHONE PHONE <br /> l.VL.. 1 Y Lr................................ <br /> l�.........4........�... .................................................................................. ......... <br /> PLUMBER WELL DRILLER ' <br /> ........... Y ,9 .............. ..................................... o <br /> ADDRESS ADDRESS <br /> m 0 <br /> /.5. ........................................................................ =. €C7J <br /> . . ......................................................................... ......... o :o <br /> PHONE PHONE Z N ;� <br /> DESCRIPTION 4. Sanitary Facilities: / ° <br /> 1. Work: 2. New Building Details No. Bathrooms (�S� o : <br /> New Building Type of Construction: No. Bedrooms . o <br /> Addition Septic Tank Size Gals. <br /> Sanitary <br /> ...... ............................................. <br /> . <br /> v .J�..... Size .............. ft. x .............. ft. ........ <br /> Fiilingl Grading ,,,,,,,,,, Height............. Stories ............... 4a. Absorption Field Site: .V` <br /> Type ...... ' ' <br /> Moving .......... Area ........................................... Soil Y.. �� .� '0 <br /> Mobile Home $IOPe ............. „ <br /> Privy .......... 3. Use (describe exactly, 1 -family Perc. Rate ...... <br /> Well .......... home, garage, motel etc Dry Well .......... �./� <br /> Subdivision ,d F �-•. Seepage Trench <br /> W v i <br /> y <br /> —Camping Unit —.......... V$.C.ITt.�..�1.G.fh..�.................T Privy ...... <br /> Seepage Bed ..,x... ::11i <br /> ---- ------------------------------------------------ --- bl <br /> Location of proposed structures and existing structures, well, sewage systems, roads, etc., should be sketched in Fig. A. induce road Q <br /> Q <br /> setback, side and back yard dimension and location and setback from all bodies of water_ If property Is located at a hlghwa Inter- "4-- � a <br /> section, show the intersecting highways and the setbacks required along them and at the Intersection. CLEARLY LABEL EXI TING 11,1 LV <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS. rN' <br /> ---------------__------------------ ------ --- V <br /> 5. �t SS'Ize: /Acy es Fig. A. 6. Location: :R <br /> Ci...r............ .4,x .............. ft. — ............................... sq. ft. .................................................................... ......... a1 <br /> V <br /> N <br /> IN o, <br /> o <br /> elJ <br /> s `c <br /> v r Sy o <br /> jrl exCzfc <br /> M to r 9 y ry 2 <br /> Z <br /> �� a oF. � •c m' am <br /> 0 zi <br /> 0zi n S <br /> 0 a ° 3 <br /> 0 <br />