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...-. N <br /> Fig. A. //\ <br /> Location of proposed structures and <br /> 7 existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> A• tion and setback from all bodies of <br /> 1 water. If property is located at a <br /> Is - A(Q1/D highway intersection, show the inter- <br /> B lb" 7G L' secting highways and the setbacks <br /> ' <br /> -f required along them and at the in- <br /> _ ! ,;,I/f tersection, together with vision clear- <br /> ' ance triangles. <br /> cP NI <br /> PERMIT FEES <br /> `O /2ey►10 Je EXIST STEEL Land Use $ 1.00 <br /> TA NI: AND RE: p1.4 v Building 5.0 <br /> to/ WptJC►. Ti-NK IS,y 01,002- Sanitary 10.00 <br /> , le1? UEST: Well 5.00 <br /> �4 <br /> Septic Tank 1.00 <br /> Combination Building, Sanitary <br /> and Well 15.00 <br /> Conditional ./14 l0:o0 <br /> Zdalf.liee_ al---,-,46-1e 11-16T---rb <br /> Signature of Owner or Agent Date Zo4/1.,. 1,eid. . . <br /> drat <br /> ACTION Site approved (date) G�7 <br /> Permit Issued (date) �1.;I.!. Receipt Receipt No. 7 t 5 . Fee $./�-�'` <br /> Septic Tank Permit Issued (date) . 1.I.-.1 I—7.(e. . . No. ( 2-E.i. . . Fee $1.00 <br /> Conditional Permit Issued (date) No. Fee $ <br /> Certificate of Compliance Issued (date) . . <br /> Permit Denied (date) for the following reasons <br /> Work Started (date) . . . . Work pleted (date) <br /> INSPECTION Date Z t/*. . q 76. . . .. . Inspector . . . . . <br /> Remarks /� <br /> Q. . ... . . .4-0 <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 /> Copy of Decision to DNR (date) <br />