Laserfiche WebLink
Burnton County Office of Zoning Administrator o -i z <br /> m 0 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT 3 A <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a' <br /> Permit for the work described and located as shown herein.The undersigned agrees that all <br /> work shall be done in accordance with the requirements of the County Zoning Ordinance. <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- <br /> lations of the State of Wisconsin. 3 aA p <br /> Robert.Wngaer, . _ - ' 1 m <br /> .... .. . . .... veyor . . ..... . . ... ..... . . <br /> Owner or Agent Ipiease print) Con-tractor or Surveyor <br /> c r� <br /> 13009 Opto:. Ave. S. <br /> Address •• <br /> . .... . . ... ..... .. ... ... . <br /> Address -•l e, a <br /> Buraville, FLS 55337 <br /> Phone. . ... .... .. ... ...... ... ........ Phone.... ... ....... . .. . .......... .. . m �� <br /> Do ald D diels <br /> Plumber. ......... ... ..... . ... . ..... .. Weil Driller.... .. . .... . .. . . . .... .. <br /> -44 <br /> Sire.i, Wl 54072 <br /> . . . . . .... . .... . .. . . .. . . . . .... . . � :H _. <br /> Addre ...... ..... ... . . .... .. <br /> S's Addr..e�. .... � � c :�&s <br /> 715-463-2333 or 349-5364 `• <br /> . .. . .. ......... .. .... ... .... .... ... .. . ..... .. <br /> Phone Phone <br /> 1 n o <br /> m p <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities' s Type of Construction No.Bathrooms a z o <br /> 1. Work ... No.Bedrooms <br /> 11 yy ''// ..3... <br /> New Building •.x.•. Size .4.p ft.x..`..� it. Septic Tank Size Gals. '1060- <br /> Addition ...... Height ..... Stories...... ...... S :•� (�t� <br /> Sanitary .,X... <br /> Area 7a.Abwrption Field Site: <br /> Filling Soil Type .................. <br /> ................... <br /> Moving ...... 5. Permits Required Slope •.... - .. .. .- <br /> Grading ... Subdivision ...... Perc.Rate ....3...3..3..... \ = <br /> Mobile Home .... Sanitary ..Y.:.• Dry Well ...... L� �'� <br /> Privy ...... Building „x„- Seepage Trench ...... sixi `�t <br /> Well .x.... Well ..x.,• Privy ...... <br /> Subdivision ...... Other ISpecifyl ...... Seepage Bed <br /> Conditional ...... 10 :� us N <br /> 2. Classification D lard Use ...... ° a <br /> Zoning Dist. //.!:7 <br /> R• & Use(describe exactly,1-tem. <br /> 3. Lot Size home,motel,etc.) FOR COMMERCIAL USE m <br /> ....kQQ..ft.x .1iQ0.... ft. Si.rgle family Plans Submitted <br /> .................. sq.ft. cabs? Plans Approved ...... <br /> ---------------------------------------T ----- <br /> F,g.A. Location of proposed structures and <br /> existing structures, well, sewage sys- � <br /> terns, roads, e1c., should be sketched - s <br /> in Fig. A. Include road setback, side <br /> and back yard dimension and location o <br /> and setback from all bodies of water. _r. <br /> If property is located at a highway in- :rw� <br /> terseetion, show the intersecting high- v` <br /> ways and the setbacks required along <br /> them and at the intersection. <br /> 9 <br /> PERMIT FEES <br /> Subdivision.....$25.00+$2.00 per lot. m <br /> Land Use..................... .......--$10.00 <br /> wilding......... <br /> !r :s7�F'�o... -1.g9& <br /> San iter ....�Iw- --- •36- <br /> W e l 10.00 <br /> Privy ....................................... 5.06 <br /> vas oa <br /> 9.�-.�...;wn-..... ................... ...........`................ ��., °. '..... instra.......................... <br /> Sr natureppot Owner or A ent Date�/� �gZonin Administrator <br /> Inspection Data.B.....IZ:7, `....................... Inspector ...C,(. l!sF!w'!r..5 �......... <br /> .................... <br /> Remarks -Q� �. .:................................................................................................ ................ <br /> .........................................................-..........-....................................................--........................................................---........ <br /> .......1.--------------.......................................................................................I............................_.....-.....................................-.... <br /> NOTE: A preliminary site inspection must be made and site approval granted on all structures involving sanitary facilities <br /> before construction can begin. In the case of sewerage disposal systems,a copy of the percolation test must be attached to <br /> this application before a permit will be issued.Do not purchase or install a septic tank,do any plumbing or start any build. <br /> ing until a permit has been issued.A permit may be revoked if misrepresentation of any of the information conveyed here- <br /> with is found to exist. Changes in plans or specifications shall not be made without approval of the Zoning Administrator, <br /> SEWER SYSTEM SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br /> ion. _ <br />