Laserfiche WebLink
Office of Zoning Administrator j <br /> Burnett County <br /> PERMIT o <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING < N <br /> TO THE ZONING ADMINISTRATOR- The undersigned hereby makes application fer s e it for if <br /> work descrihed and located as <br /> 3 <br /> shown herein. The undersigned agrees that all work shall be done in accordance mrth the c f -nsnis of ilia f the S County Land Use <br /> Ordinance, n. Th un Code, and with all other an County Ordinances and th e lams ar reAu boons of the Slate of Wisconsin. x 0 <br /> Roger DUFour Fine Tree Campground ......................................... .................................................. <br /> c ° s <br /> .......................................... CONTRACTOR or SURVFYIr, A ENT <br /> ' n <br /> OWNER (please pri ut ........... <br /> ........................... <br /> 4 .. d ro <br /> ADDRESS '~ <br /> ........................................................................................... C <br /> ADDRESS <br /> Northfield, MN .55057 <br /> . ................................ ........................................... ADDRESS .y5 <br /> ADDRESS a <br /> :N. .......................................................................... <br /> .. ........................................................................................ PHONE � l <br /> PHONE <br /> 9J <br /> Donald DAniels .................................................................... ,` I <br /> WELL DRILLER TO <br /> PLUMBER - <� q' 0'S <br /> IEtoJ <br /> Box W Siren WI 48 2 c n o :o <br /> 7.................. ADDRESS C <br /> ADDRESS <br /> . ........................................ . .. .. .. N <br /> ........... �.5-!f4.3-?33.3. [ <br /> ................................................... PHONE a o � ' <br /> PHONE 4. Sanitary Faculties: v :1 <br /> DESCRIPTION No. Bathrooms o ip <br /> 1" Work: 2. New Building Details No. Bedrooms .......... 'C m `� <br /> am <br /> Ty e ief ConWiaction: w <br /> New Building ......X. .��rf Septic Tank Size Gals. 7750 <br /> ...Lv,e."..................... .............. <br /> Addition ....... i. <br /> x Size ..30.....x. x ...1�.. ft. <br /> Sanitary .......... �'�y J 4a. Absorption Field Site: <br /> Height............ Stories ./............ Soil Type .................................... r- :0 <br /> Filling ai0 <br /> Area "' e .... .. ...... <br /> Slops <br /> Moving . ............................. ' t <br /> Grading .......... Perc. Rate ............. �..._.. <br /> 3. Use (describe exactly, 1 -family Dry Well SU <br /> Mobile Home 6 w <br /> Privy .... PO <br /> home,garage, motel, etc.)��,4C Seepage Trench <br /> l�5'lip✓tit!.�L7u . ...Q. ........... �' Privy <br /> Well ����'- � <br /> . ...... located at a highway <br /> Subdivision ............................................ Seepage Bed .......... <br /> mor- < <br /> Location of proposed structures and existing structures, well, sewage systems, roads,etc. should be, sketched of Fig. A Include road <br /> setback, side and hack yard dimension and location and setback from all bodies of water. If Draper ty Is <br /> section, show the Intersectiinq highways and the setbacks required along them and at the infersec[ion. CLEARLY LABEL EXISTING : o <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS. __—___--_— <br /> ________________________________ rie <br /> f <br /> Fig. A. 6. Location: - <br /> 5. L t Ize' sq.ft. <br /> �'. . _................................................__ w <br /> N x <br /> •: F o <br /> CD <br /> ° £ G <br /> le. <br /> 0 <br /> 0 <br /> `s <br /> Z <br /> Z <br /> ssaFp% <br /> /✓S 3 <br /> yZ -E oN. C : ,� � :E <br /> y _ zoos , <br /> � '-........................ <br /> 0 <br /> .. ......................... µ <br /> ....... .... ...... ........ Date X <br /> Signature Owner or Agent r : : <br /> m <br /> Remarks ......................................................................................................................................................................... _ <br /> ..................................... <br /> ...................................................................................................... <br /> ............................................. ._ <br /> .................................. <br /> ...................................... ... r, <br /> .................................................................. <br /> ................................... <br /> cc 0 <br /> . o00 <br /> P <br /> t' <br /> Inspection Date . ... . Zoning Ad in rator JCJ <br /> a copy of the percolation test must br Attached tc <br /> NOTE: A preliminary site mspectLon must be made and site applOval granted on all structures utyOlvui9 saaI taclllt ins <br /> before cons Iuction can begin. In the case Of sewerage disposal sY stems, <br /> this re cO stion before a permit will be Issued. Do not purchase or Install a septic tank, dO any plumbing Or stair any build <br /> with Is it a Perm it has Ibeen Charges iln Alans ortmay specific ations sh1a Ill for <br /> im r Re nra der�Wii haft a'P` ofvth ofnt he Zoning Administrator <br /> istrlatol <br /> SEWER SYSTEM SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br />