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Burnett County Office of Zoning Administrator d 0 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT 3 <br /> TO THE ZONING ADMINISTRATOR'. The undersigned hereby makes application for a Permit for the work described and located as o iJ <br /> shown herein. The undersigned agrees that all work shall become in accordance with the requirements of the Burnett County Land Use <br /> Ordinance, Sanitation Code, and ith all other applicable Count Ordinances and the laws and regulations of the State of Wisconsin. — a �J <br /> y PP 3 <br /> ............. N o <br /> . _ <br /> 0 NER (please pn 1 CONTRACTOR or SURVEYOR or AGENT m <br /> goo....... ....... . s. ...J....................................... ................................................................................ ........... �lb �. <br /> AD S ADDRESS m : <br /> RES <br /> s`tGi� Ste.✓ .....................................jy/✓ :Cb <br /> ADDRESS �.... ................................................................................ ........... <br /> ADDRESS <br /> ........ <br /> 7/�/ <br /> PHONE. .................................................._........................... PHONE <br /> PLUMBER WELL DRILLER Ey. <br /> ........................................................................................... ................................................................................ ........... — <br /> ADDRESS ADDRESS <br /> . . .................................................................... ... . . ........................................................................ ........... a <br /> PHONE PHONE Z <br /> DESCRIPTIONr <br /> 4. Sanitary Facilities: ° o <br /> 1. Work: 2. New Building Details No. Bathrooms <br /> New Building ..,...,,,, Type of Construf�,pn: No. Bedrooms .......... <br /> Addition �, ..,/ �.. /A Septic Tank Size Gals. .......... <br /> .. ... ...................... p <br /> Sanitary Size ft, x .............. ft. ••• • <br /> .......... .............. <br /> Filling/Grading „ ,,,,,,,, Height............. Stories ............... 4a. Absorption Field Site: <br /> Moving Soil Type ........... <br /> .......... .................................4......... r <br /> Mobile Home .......... Slope ....................... 0 <br /> ....... ........... i <br /> Privy .•...,,,,, 3. Use (describe exactly, 1 -family Perc. Rate ....................... ........... <br /> well •.....,,,, home, garage, motel, etc.) Dry Well .......... <br /> Subdivisiony ....{[��//N•• ,p7 Seepage Trench .......... , <br /> Camping Unit ......,,,. / Privy .......... I <br /> .................................................... <br /> Seepage Bed .......... <br /> Local inn of proposed structures and existing structures well, sewage systems, roads etc., should be sketched In Fig A. rick de. road <br /> setback, side and back yard dimension and location and setback from all bodies of water. It property is located at a highway Inter- a <br /> section, show the intersecting highways and the setbacks required along them and at the intersection. CLEARLY LABEL EX STING (h <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS. v1 H <br /> __---____ v 1 o <br /> 5. Lot Size: Fig. A. 6. Location: <br /> ................ ft. x .............. ft. — ............................... sq.ft. .................................................................. ............ <br /> J`” P <br /> 0 <br /> N o <br /> o > <br /> O <br /> 0 <br /> s <br /> 1 E <br /> T <br /> Z Z <br /> qtr <br /> / V ' <br /> X M , a �E <br /> Z oo' � — rt <br /> C _O n <br /> / r0.e�•� 9�9�OY vJ <br /> / � R <br />