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F18' A. Location of proposed structures and <br /> 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 /> 0` � Le tion and setback from all bodies of <br /> water. If property is located at a <br /> JL X 2 highway intersection, show the inter- <br /> secting highways and the setbacks <br /> ---required along them and at the in- <br /> tersection, together with vision clear- <br /> ance triangles. <br /> PERMIT FEES <br /> � .p 1 I Land Use ... .. ...... ...... .$ 1.00 <br /> • Building . . . . . .. . .. .... .. . . . 5.00 <br /> Sanitary . ... . .. .... .. . . .. . . .00 <br /> Well . .... .... .. ...... . ... .. 6.000 <br /> Septic Tank ... ...... .... ... 1.00 / <br /> Combination Building, Sanitary <br /> and Well . .... .. .... .. .... 15.00 <br /> nditional ... . .. .... .. . . 10.00 <br /> SWign ­­dOwneY�o ;Xjge�nC Date g Ad trato <br /> ACTION Site approved (date) . .. . .. . .. . . .. . ... <br /> Permit Issued (date) .. . . .. ... . . . . ..��J . . .. Receipt No. . Fee $.�Q.�.... <br /> Septic Tank Permit Issued (date) � . .. . No. 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 /> .. .. .. .... .. .. ...... . . .. . . .. .. .. . . .. . . . . . . .... ....... .. .... .... .... .. .. .. .. . ... . . . . .. . . .. . . .. .. . . . . .. . <br /> Work Start d (date) . . . . . .. . . . . . . ...... . . .. . Work Co leted (date) . . . .. .. . . .. ...... . <br /> e <br /> INSPECTION Date. .��l.�J.75. ... in . ._. <br /> Remarks Y .!. . ... . .. . <br /> � <br /> .. . . .. . . .. . . . . . . . <br /> . . . . . . . . . . . . <br /> RECORD <br /> ✓ . ... <br /> C � <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 /> . . .. .. .. . . . . .. .... .... . . . . . . .. . . .. . . .. . . .. . . .. . . .. ... . . . . .. . . . . .. . . .. ... . .. . . .. . . . . .. . . .. .. . ... ....... <br /> Copy of Decision to DNR (date) . .. . . .. .. .. . . . .. .. ... ... . .. . . .. . . .. .. .. .. . . . . . . . . . . . . . . .. . . . . .. . . . . .. . <br />