Laserfiche WebLink
C.— <br /> ty H z <br /> Burnett County Office of Zoning Administrator g' gN 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT M <br /> To the Zoning Administrator: The undersigned hereby makes application for <br /> a Permit for the work described and located as shown herein. The undersigned agrees that ,� , <br /> all work shall be done in accordance with the requirements of the County Zoning Ordinance, '9J ,�0 <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- <br /> lations of the State of Wisconsin. 9�. c, pleb <br /> ri <br /> .0r.71.1 r 4 r ►^I °' r" . .., .!rC1. . ... .5 .,. q <br /> Owner or Agent (please print) Contract r or Surveyor `144 4 <br /> Address S-S i /3 Address s <br /> Phon Phone <br /> ‘) ti <br /> lumber Well Driller a T <br /> Address Address <br /> IA v 4 - <br /> Phone Phone i <br /> DESCRIPTION 4. Building Details 7. Sanitary <br /> y Facilities 1 <br /> 1. Work (check one) Type of Construction No. Bathrooms <br /> New Building ••./••:7:..?.01'1t.:4 Dishwasher <br /> .... .0 <br /> Addition Garbage Grinder <br /> Sanitary Size . ft. x 0 ft. Autom. Laundry . L , <br /> Alterations Height ... . Stories . ... WasteeDisposal <br /> Bedrooms <br /> MovingWaste <br /> Area System <br /> Wrecking Septic Tank Size <br /> Mobile Home 5. Permits Required '7 .,. •0Gallons <br /> WellPrivy Subdivision �,� Absorption Field Site ,, 1 ' <br /> Sanitary Soil Type S`"- ' S R <br /> Subdivision Building ••• Slope g; 6 <br /> Well 1 5 C <br /> Other (Specify) Perc. Rate �. <br /> 2. Classification P y) Dry Well W i <br /> Zoning Dist. Land <br /> dditional Seepage Trench Cr) 1 <br /> Privy I <br /> 3. Lot Size 6. Us 'be exactly, 1- Seepage Bed / ) X'.1 H P <br /> i '7 S X `c X am. om 'Motel, etc.) FOR COMMERCIAL USE U� <br /> ft. x ft. Plans Submitted <br /> r <br /> sq. ft. Plans Approved 'd e <br /> t <br /> ,r., , <br /> NOTE: A preliminary site inspection must be made and site approval granted on all struc- n <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- �- d <br /> posal systems, a copy of the percolation test must be attached to this application before a P permit will be issued. Do not purchase or install a septic tank, do any plumbing or start any ea <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of CD <br /> any of the information conveyed herewith is found to exist. Changes in plans or specifica- <br /> tions shall not be made without approval of the Zoning Administrator. SEWER SYSTEM t <br /> SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br />