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1 <br /> • <br /> Fig <br /> ' A. Location of proposed structures and <br /> existing structures, well, sewage sys- <br /> i tems, roads, etc., should be sketched <br /> V in Fig. A. Include road setback, side <br /> r - and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> 1�� +.1l/'1 water. If property is located at a <br /> c, highway intersection, show the inter- <br /> � setting highways and the setbacks <br /> ,required along them and at the in- <br /> r ‘11. c� 3C(.>,..%.----4,..—>----(..------------ <br /> section, together with vision clear- <br /> 1 cv».v an triangles. <br /> N I PERMIT FEES <br /> I d Use $ 1.00 <br /> 1 Building 5.00 <br /> Sanitary 10.00 <br /> Well 5.00 <br /> Septic Tank 1.00 <br /> Combination Building, Sanitary <br /> and Well 15.00 <br /> oLnditional ; 10.00 <br /> '/ / - <br /> Siiture of Owner Age Da Zoning Ad strato <br /> ACTION Site approved (date) <br /> Permit Issued (date) /517.7" Receipt No. 4e Fee $10 <br /> Septic Tank Permit Issued (date) 9 �7.7---- No. . �.-a.7 Fee $1.00 <br /> Conditional Permit Issued (date) r >No. Fee $ <br /> Certificate of Compliance Issued (date) . . E^/7/7 <br /> Permit Denied (date) for the following reasons <br /> Work Started (date) . . . . Work Completed (date) <br /> INSPECTION Date 7 VO. Ai 7 -- Inspector . . ��. CA..) <br /> Remarks <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 /> li <br />