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d y z <br /> Burnett County Office of Zoning Administrator <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT <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, p <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- <br /> lations f the State of Wisconsin. <br /> ro <br /> �. :5. . .. .. . . �.:tl1.�. . .. ..� . . . .... .. . <br /> Owner or Agent (please print) Contrac or or Surveyor ; <br /> 6.9..h. .�?.yfi .0 .. . . . .... .. ...... .... .. .. .. .. .. ....... ....... Q <br /> Address Address <br /> Phone ... .......... .. ... . .. . .. .... . . .. . . Phone ;� Q <br /> . .. ... . . . . . . . . . . . ... . . . . . . . .. . . . <br /> W 5. <br /> Plum r ell Drille.r. <br /> -. .. .. .. .. .. .. .. .. . . .. . . . . . . .. . . . . .. .. . . . . . . . . . .. . . . . . s <br /> Address Address � .Y '� <br /> Phone Phone �\ <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities <br /> 1. Work (check one) Type of Construction No. Bathrooms . . <br /> Dishwasher . .. . . . <br /> New Building <br /> .. . ..... .. ... .. . .. ... Garbage Grinder . .. . . . � . <br /> Addition Size . . .. . ft. Autom. Laundry . .. . .. <br /> . . . . . . ft. x ry <br /> Sanitary No. Bedrooms <br /> Alterations ...... Height . .. . Storigs . .. <br /> Moving , ,,,,, // .4 ! Waste Disposal c , <br /> Area �!/QQ.. .. . . . .7 System - <br /> Wrecking Septic Tank Size <br /> Privy <br /> le Home 5. Permits Required n Gallons �` <br /> . .. .. . Subdivision <br /> Absorption Field Site :v1 <br /> Well • •••• • Sanitary <br /> Soil Type <br /> Subdivision . .' . .`..!?.. ... c <br /> • •• •• • Building Slope . . . . . . . . . . . . .. . e � <br /> SeeWell :� <br /> 2. Classification Other (Specify) c � <br /> a a Trench <br /> Dry . .. . . .. .. . . . <br /> Zoning Dist. ...... Conditional . .. . . . p g <br /> Land . . . . . . Privy . .. . . . <br /> 3. Lot Size 6. exactly, 1- Seepage Bed . .. .. . c <br /> famhome,p'otel, etc.) FOR COMMERCIAL USE :7 <br /> Plans Submitted . .. .. . <br /> �q. ft. Plans Approved . . . . . . <br /> preliminary p pp granted on all struc- <br /> NOTE: A relimina site inspection must be made and site approval <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- <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 install a septic tank, do any plumbing or start any ` -- <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of <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. <br /> n <br />