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4 ' <br /> PRIVATE CA-9PSITE INFORMATION SHEET <br /> *DAME: t.! /7p�"C LOCATION: 1 � ��'�l� <br /> ADDRESS: 7 s` 3 %��:.r� SECTION,1� T 0 AlIOWN OF: <br /> TYPE OF EQUIPMENT: FIRE NO:_ �. <br /> r/ Camping Trailer <br /> 5th Wheel Trailer Make and Size " <br /> ---"Pop-up" tent Trailer Color <br /> Other License Number D <br /> IMPROVEMENTS ON PROPERTY: <br /> ✓ Well <br /> Structures: <br /> Other, <br /> / <br /> �/ Sanitary System (If none, indicate provisions for sewage and wastewater <br /> disposal) g��9 <br /> PLEASE Provide a sketch of the property on the back of this sheet showing loca- <br /> tion of all proposed structures and existing structures, well, sewage systems, <br /> roads, etc. Include road setback, side and back yard dimension and location <br /> and setback from all bodies of water. If property is located at a highway <br /> intersection, show the intersecting highways and the setbacks required along <br /> them and at the intersection. <br /> ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... . . ... ... ... .. ... ... ... .. .. ... ... ... ... ... ... <br /> (OFFICE USE) CONDITIONAL PERMIT applied for(date) No. <br /> Committee Action: Denied <br /> Approved for (date) to <br /> Special Conditions <br /> Inspection comments & Notes <br />