Laserfiche WebLink
Fig' 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 /> tion and setback from all bodies of <br /> water. If property is located at a <br /> 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 /> Land Use ... .............. .$ 1.00 <br /> Building . .. ...... ... ...... . 5_00 <br /> Sanitary . .. . ... ...... .. .... 0 99O <br /> Well ..... .... .. ...... ...... 5.00 <br /> Septic Tank ..... .. .... .. ... .� <br /> Combination Building, Sanitary <br /> and Well ..... .... .. .. .... 15.00 <br /> Co ditional ... 10.00 <br /> � / c <br /> �.. .. . . . ...7.:.1.. .. :�. . ..:: (�'! <br /> Signature of Owner or Agent Date Zor6I Admini r <br /> ACTION Site approved (date) . . . . . . . ... . . <br /> Permit Issued (date) .. . . . . .. .. . . .-. -7.�.• Receipt No. Fee <br /> Septic Tank Permit Issued (date) . .... -7 .• • • •• • No)//._.)Xg7Fee $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 Started (date) . . . .. .. . . . . .... ... Work Cc leted (date) . . . .. . . . . .. ...... . . .. .. <br /> INSPECTION Date Inspector <br /> Remarks . !//te. . ... .. . . ... . .. G .... . <br /> C % . v .. . . . .. . . .L!GLCL. . ..�. .. .. Gr C1 .... . <br /> . <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 /> .. . . .. .. .. . ... .. .... . . .. .. . .. . .. . ... ... . .. .. . ... .... . .. . . .. . . . . .. .... ... . .. . . . . .. .. . ... .... .. ...... ... <br /> Copy of Decision to DNR (date) . .. . . . . .. . . . .... .. ..... ... . . .. . . . .. . ... . . . . . . . . . . .. . . . . .. . . . . .. . . . . . . . <br />