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N <br /> Fig. A. Lcc ton of pr000se5d <br /> sir•ecra anC, c..- sting <br /> A ' strt:n res, uel?., ;age <br /> systems, roads, ;:',, <br /> shc__a 1 be sketched in <br /> Fr;, A. Include rood <br /> setback, side anCi back <br /> yard 1imensicn and loca- <br /> tion and setback from <br /> all boc1.<s of. r*ate:'. <br /> 12 p:;G; 'oty is located <br /> Al(* at a i 'i..ate' ir'- <br /> tic lq r..hcu the 77.rtE.r <br /> �J� sec'h;j_ia�, ii F`.:T!: :..y3 a r.d <br /> ✓`-I �n tile; EJebaci:s reC'' :ia ed <br /> fir n , long them and _,t the <br /> �� �r� intercccti.on, teg Cher <br /> 3�� ::ith vision clearance <br /> �S triangles. <br /> _ _ P RLiIT FENS <br /> ZSG 5 , Land Use __-- <br /> $ 1.00 <br /> Building 5.00 <br /> T Sanitary 10.00 <br /> • 'Jell if?9 kJ Septic 'Link 1.00 <br /> Combination D1dJ . , <br /> -_ Sanitary & Jell 15.00 <br /> Condition-1 10 r <br /> J <br /> /d/9/7/ , <br /> Signature of Owner or Agent Date Zoning administrator <br /> ACTION Site approved (date) <br /> Permit Issued (cite) Ly / 7/ Receipt No...... Fee $ // - <br /> Septic Tank Permit Issues?(date)/a 300zpt No. 7 71Fee $ 1.00 <br /> Conditional Permit Issued(date)_, Receipt No._ Fee $ <br /> Certificate of Compliance Issued dote) <br /> Permit Denied. (date) for the follojn reasons <br /> Work Started (date) 1Jo Completed ks�ate) <br /> INSPECTION Date / I q 7/ Ins ector G� - � "64.l.s e? , <br /> RECORD <br /> Application to Zoning Committee(date) Notice published(date) <br /> Application to Board of Adjustment(date) Notice pubiishe,i(date) <br /> Appealed to Board of Adjustment(date) Notice published(date) '_� <br /> Copy of Notice to Division of Resource Development(date) <br /> Copy of Notice to DRD Regional Office(date) <br /> Appeal Heard(date) Decision <br /> Copy of Decision to Division of Resource Development(date) <br />