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caurnett v <br /> CD M d o 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT °. <br /> E — ' <br /> TO THE ZONING ADMINISTRATOR- The undersigned hereby makes application for a o <br /> Permit for the work described and located as shown herein. The undersigned agrees that all <br /> work shall be done in accordance with the requirgments of the County Zoning Ordinance, 77 o {`w <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- _ _ <br /> lations of the State of 11yisc nsin. o <br /> Owner or ge (please print) Contractor or urveyor �. <br /> �. <br /> CL <br /> Addr s , (0003 <br /> Address a <br /> Phone J_ t7 c` Phone <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W f/ <br /> fiat. . . �.o ik , <br /> s Well Driller <br /> Address ' 6. .0 i"r g . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c :'S <br /> S coo. �lkY (A) c.G .. . <br /> � ' r <br /> Phone o <br /> o <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities: J z o ;� <br /> Ty <br /> of Construction No. Bathrooms o z .° <br /> 1. Work r. .rX No. Bedrooms ° fD <br /> New Building . . Size ., t. x .p? ft. Septic Tank Size Gals. <br /> Addition . . . . . . Height . . ./ Stories�. . . <br /> 7a.Absorption Field Site: <br /> Sanitary . . . . . . Area . . . . . . . . . . . . . . . . . . . III :� r <br /> Filling Soil Type . . . . . . . . . . . . . . . . . ° <br /> Moving . . . . . . 5. Permits Required Slope . . . . . . . . . . . . . . . . . . . <br /> Grading Subdivision <br /> Perc. Rate . . . . . . . . . . . . . . . . T <br /> Mobile Home . . . . . . Sanitary Dry Well M m <br /> Seepage Trench `° fD <br /> Privy . . . . . . Building ' ' ' ' �n <br /> i P <br /> Well Well Privy . . . . . <br /> X. <br /> o <br /> Subdivision . . . . . . Other (Specify) . . , . . , Seepage BedCn <br /> Conditional �) 1 rn <br /> c � <br /> 2. Classification Land Use <br /> o_ <br /> Zoning Dist. . . . . . . < ° <br /> 6. Use (describe exactly, 1 fam. 7 <br /> 3. Lo Size <br /> home, motel,etc.) FOR COMMERCIAL USE D <br /> Q . . ft. x .3.S�Oft. ci r� Plans Submitted . . . . . . <br /> . . . . . . . . . . . . . . . . . . sq. ft. I j Plans Approved . . . . . . i� i <br /> ------------------------- --- -------------------------------------- <br /> p� Fi • Ar- Location of proposed structures and :ra <br /> 40 3p � r-�"'� �� existing structures, well, sewage sys- C <br /> tems, roads, etc., should be sketched c <br /> �1 in Fig. A. Include road setback, side <br /> �! ,/ and back yard dimension and location <br /> + //�� and setback from all bodies of water. <br /> (k J� If property is located at a highway in- . <br /> tersection, show the intersecting high- ti <br /> ways and the setbacks required along <br /> them and at the intersection. <br /> PERMIT FEES <br /> 3 ( Subdivision . . . . . . . . $15.00 D <br /> Land Use . . . . . . . . . . . 1.00 <br /> 3S0 Building . . . . . . . . . . . 00.00 <br /> Sanitary . . . . . . . . . . . 10.00 <br /> Well . .' 5.00 <br /> . . . ' . . . . .Septic Tank 10.00 <br /> Combination Building, Sanitary <br /> and Well . . . . . . . . 15.00 <br /> Privy . . . . . . . . . . . . 5.00 <br /> u <br /> rif���(�l..J..P �.......... ... ninn... minktrator ........... <br />