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- - - <br /> ID CV '- Z <br /> Burnett County Office of Zoning Administrator m g <br /> o <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT \�` <br /> To the Zoning Administrator: The undersigned hereby makes application for �1 <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, ^ ' <br /> c---i <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- <br /> lations of the State of Wisconsin. K (J 2) <br /> Robert A. Beaman „r c 74 <br /> Orino �pp�� nt lea riot) Contractor or Surveyor yJ '� b <br /> ��F5teh S( loopQ �. s <br /> Hugo, MN. 55038 1 o, rF <br /> Address Address V' a a) <br /> 612-429-1933 0 <br /> w a <br /> Phone Phone 0 <br /> o <br /> G 0 <br /> Plumber Well Driller a) <br /> o ,-,- <br /> Address Address .-)- <br /> o <br /> Phone Phone °►'I <br /> ig <br /> a <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities <br /> 1. Work (check one) Type of Construction No. Bathrooms :Q g4 <br /> New Buildings a J Dishwasher �+ \ <br /> Addition Garbage Grinder A <br /> SanitarySize 6 ft. x 12 ft. Autom. Laundry :et <br /> g+ No. Bedrooms ""k <br /> • <br /> Alterations Height Stories . ... Waste Disposal <br /> Moving Area System <br /> Wrecking Septic Tank Size <br /> Mobile Home x 5. Permits Required Gallons <br /> Privy Subdivision aifl g' <br /> Well Sanitary <br /> � // Absorption Field Site <br /> .Y.. . <br /> Subdivision Building Slope Soil I� 0. ° t <br /> Well Other (Specify) Pere. Rate o • <br /> _ <br /> 2. Classification C.Q +� p y) Dry Well C <br /> Zoning Dist. 'Is.1Y Conditional Seepage Trench <br /> Land Privy / i <br /> 3. Lot Size 6. Use (describe exactly, 1- Seepage Bed o • <br /> 36°' 0"-`-"'"`'n-"' fam. home, motel, etc.) <br /> 38 0' '7"`�f ``x i°c ft. FOR COMMERCIAL USE Og <br /> summer vacation home Plans Submitted 61 r �` <br /> sq. ft. Plans Approved 'b <br /> NIx <br /> DI CA <br /> NOTE: A preliminary site inspection must be made and site approval granted on all struc- <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- �`sd \ <br /> posal systems, a copy of the percolation test must be attached to this application before a <br /> permit will be issued. Do not purchase or ins tall a septic tank, do any plumbing or start anyaa <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of o <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 .�' <br /> SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. ••t <br />