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Fig. A. Location of proposed structures and <br /> �L existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> .i in Fig. A. Include road setback, side <br /> and back yard dimension and lova. <br /> tion and setback from all bodies of <br /> I /aA/`/ water. H property is located at a <br /> highway intersection, show the inter. <br /> .,s' setting highways and the setbacks <br /> ' I required along them and at the in. <br /> II tersection, together with vision clear- <br /> $$ once triangles. <br /> we� III iY PERMIT FEES <br /> iZ <br /> a Lana Use ... ........ .......i 1.00 <br /> Building ... ........... .. ... 5.00 <br /> Sanitary ... . ..... 10.00 <br /> ` �✓A//y/// WWell ... .... .... ............ 5.00 <br /> Septic Tank .............. . .1.00 (/ <br /> Combination Building, Sanitary <br /> and Well ....... .... ..... . 15.001/ <br /> ° C ditional . <br /> naiLr0.00 <br /> ..!11� .. ... . .` 7'l. ?l ! .. .. .. lz,!ClU/1Z <br /> Sige.of ner or Agen� - � Date Zoning Administr or (� <br /> ACTION Site approved (date) . ... . . ... ... .... .. ....... <br /> Permit Issued (date) .. ...... .... . . ./a'.. Fee <br /> Septic Tank Permit issued (date) ... ....ji_"•.—. —.T:" .. . No. . I`IM/ Fee $1.00 <br /> Conditional Permit Issued (date) . .... .. No. . .... .... ... Fee $.... .... .... <br /> Certificate of Compliance Issued (date) . ... .. .. L. ....... .... .... ...... .....:......... <br /> Permit Denied (date) . .... .... .... .. .. . ... .... ..for the following reasons ... .... .... ...... .... .... .... . <br /> .. . ... ........ ........ .. .. .... .. .. . . .. . ... .. .. ........... .... .... .... .... .... .... .... . . .. ... . . ... .... . <br /> -Work Started (date) .. . .... .... .... .... . ... . Work Co pleted (date) . .... .... .... .... . <br /> INSPECTION Dale .. . . <br /> (0-.7.-..7.y....... . Inspector <br /> Remarks . ... .. --��9--•• A/� -- � .. y� <br /> .... ... ..... .... .... ... L ..... . ..4 .. ... W.�. ..!P..let!:tr.. ... <br /> ,.... ,a�...p.: ..ta..-,�...... <,. . .. : Ga .G..^w/.. ..;,$y.Z:,Tea 6, <br /> RECORD <br /> Application to Zoning Committee (date) . ..... ... ... . .... ... Notice published (date) ......... .......... <br /> Application to Board of Adjustment (date) . .. ....... ..... ... Notice published (date) . ........ ..... ..... <br /> Appealed to Board of Adjustment (date) . . . . ... .... . .. . ... . Notice published (date) ....... ............ <br /> Copy of Notice to DNR (date) . ..... ................ .. .... ... . .... . ... .... . . . . .... .... .... .... .... ... <br /> Appeal Heard (date) . ........... ... .. ........ ... Decision . .... .... .... ........ ........ ........ .... . <br /> .. . .. . ... ..... ..... ... ..... .... ... .... . ... . .... .... ... . ... ... . .... .... .... ...I .... .... .... ........ ..... <br /> Copy of Decision to ONE (date) . .... . ... . .... .... ....... . ... ... . .... .... .... .... ... . .... ... . . . .. .... . <br />