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'9..,,) <br /> Burnett County Office of Zoning Administrator <br /> CCIlf-o <br /> CD CD H Z <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT NCD <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a ,+ o <br /> Permit for the work described and located as shown herein. The undersigned agrees that all d y <br /> work shall be done in accordance with the requirements of the County Zoning Ordinance, CD 1... i, <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- -o <br /> lations of the State of Wisconsin. CD a <br /> w <br /> William homey r+ m `\ <br /> Owner or Agent (please print) Contractor or Surveyor y v `-D <br /> Rt. 2 Webster, WI 54892 a y <br /> Address Address a . <br /> Phone Phone V �\ <br /> Donald Daniels Donald Daniels <br /> X 1 <br /> Plumber Well Driller <br /> Siren, WI 54872 <br /> :+ o <br /> Address Address ' 0 c) <br /> 349-5364 or 463 - 2333 ,- .� <br /> Phone Phone CD y r <br /> C) r. 0 <br /> CD 0 \ <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities -o" -ov <br /> Type of Construction No. Bathrooms . . . . . Zo <br /> 1. Work Pre fab Dishwasher . .x. . . ° ° CD <br /> o <br /> x <br /> New Building Size ft. x ft. Garbage Grinder . .x. . . ` .<74 1 <br /> Addition Height Stories Autom. Laundry <br /> Sanitary x Area No. Bedrooms ~ 1, <br /> Alterations Waste Disposal System 2 .`\ o \ <br /> Moving 5. Permits Required Septic Tank Size Gals. 990 <br /> j ', 1 0 <br /> Wrecking Subdivision Absorption Field Site ) m T <br /> Mobile Home Sanitary . .xSoil Type n .a CD CD <br /> Privy Building . .X. . . Slope 2% C.1� c� <br /> Well . . . Well . . . Perc. Rate 4 4 <br /> uJ 4fl r <br /> Subdivision Other (Specify) Dry Well o ': <br /> Conditional Seepage Trench + Nigh. c CD <br /> 2. Classification Land Privy Rcr r) <br /> % /) <br /> Zoning Dist. Seepage Bed CD <br /> �� ° o <br /> 18x35 <br /> 6. Use (describe exactly, 1 -fam. H' <br /> 3. Lot Size home, motel,etc.) FOR COMMERCIAL USE J ° v <br /> � " <br /> ft. x ft. single famiely Plans Submitted8 : ,. <br /> - <br /> . . 11...9 .acres . . . . sq. ft. Plans Approved <br /> „/ • <br /> Fig. A. Location of proposed structures and Il, <br /> , i <br /> existing structures, well, sewage sys- '1 I ' g <br /> tems, roads, etc., should be sketched it c <br /> } in Fig. A. Include road setback, side Ig <br /> P1---'6 <br /> /0and backyard dimension and location a" <br /> and setback from all bodies of water. <br /> If property is located at a highway in- Uv <br /> tersection, show the intersecting high- I�lb `. IIi <br /> �� ways and the setbacks required along i :} <br /> them and at the intersection. 11 <br /> ,...5 <br /> 11 DJ <br /> PERMIT FEES -1 ' °' <br /> i�11 <n <br /> Subdivision $15.00 Iiiti SIC' <br /> Land Use 1.00 bit 1114 \ <br /> Building 5.00 11 • <br /> Sanitary 10.00 <br /> Well 5.00 <br /> Septic Tank 1.00 <br /> Combination Building, Sanitary <br /> and Well 15.00 <br /> _ <br />