Laserfiche WebLink
Bu}nett County - - Office of Zoning Administrator `v A o o <br /> APPLICATION FOR SANITARY"'=LAND,USE — BUILDING PERMIT 3 b <br /> an <br /> TO THE ZONING ADMINISTRATOR. The undersigned hereby makes application for a'Perru t far the work threribed and located as — - o <br /> shown herein-The undersigned agrees that ell work shall de,dace in accordance wort the requirements of the Sumac County Land Use, <br /> Ordinance,--Sanitatio/1n��Code.and with all other uoplicable County Ordinances and the laws and re9ulAtions of the State of Wisconsin. <br /> h_':.C.LI.X V 0 p u J 4.t�...... . ........ ........................ . . . ..... . .. ..._. _ � <br /> OWNER Ipl t �— / CONTRACTOR SURVEYOR or AGENT , <br /> aN 7.3 3 .L?..a.6 rLc�..x... . ....v ........ . ..................... <br /> ADDRESS. ADDRESS .. ;Dz:, <br /> s.. '............ �.4...C........�rn %..,......5's .n3..'. of <br /> ADDRESS ADDRESS . :yam' . ,ems <br /> . <br /> P C , I .... . . . ... PHONE.. _. .... .... . .. ..._ 40- <br /> . ..... ... ..... :1. :G <br /> PLNMBER WELL DRILLER 1„ <br /> . A.DDR.ESS_;.......:...................1:..�_............................... xADDRESS..._................................. ........ <br /> � <br /> .^., O ' <br /> PHONE - PRONE z - - ' <br /> DESCRIPTION - r <br /> 4. Sanitary Facilities: - - +. O o ° <br /> 1 Work: ' 2 New Building Details No. Bathrooms k, v <br /> New Building .. Type of Co onto,[IQn No. Bedrooms JE <br /> m <br /> Addition ,5°„Kr d ( a�._. Septic Tank Size Gals <br /> Sanitary �� 77. <br /> Size . ..... f[ x ... ft _ <br /> Filling ... Height ... Stories Be Absorption Field Site <br /> Moving .. Area . ... Soil Type . ... <br /> Grading <br /> ` o <br /> Slope .... .... <br /> Mobile Home ..: 3 Use (describe exact( famil Pec Rate ................ ..... i� <br /> Privy .........: home,geraga, motel,etC.), Dry Well .......... <br /> Well - — _ Seepage Trench .. .... <br /> .. .... <br /> SubdivisioPriv <br /> n Y ,ry ' <br /> Seepage Bed f --- o <br /> __ t -:3 <br /> - - tf - <br /> Ln 'to iprepared t h tlexisting structures II y Systems, d tshould ! sketched road c, <br /> tb k 'de tl dean card tl and o t f setback 1 II t e. ( t. If company located at alt enter. :Ift <br /> are IC <br /> action, show the Tier ecting h gri and the setbacks requ'rod -long them and at the iincineration. CLEARLY LABEL EXISTING - <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS <br /> .___ O \ H <br /> _ - - - ----- --————--- N .Z <br /> o ” <br /> 5 Lot Size: Fig A. as <br /> ,� rn <br /> e <br /> ,tV ... ft x � ._ ft ...... sq.ft. <br /> 44 <br /> N O <br /> O pet) <br /> as <br /> So <br /> se <br /> :1 ;N <br /> , .. I . .. \ <br /> ' 9 <br /> he Nr <br /> ch1O < 6 <br /> Do <br /> Qr <br /> 2 o <br /> F <br /> So <br /> to <br /> Siete of w r or Agent Data <br /> �'-71 x til: m <br /> Remarks .l.. .._ ......... -G.........tL.:........................:..::.........._.................. .o .�. 0 <br /> ad <br /> �? r�o. C n <br /> Inspection Dale .f.2 .... —oe-iL ✓ m <br /> Zoning Administrator ad o so o y <br /> NOTE A relindulary site inspection must he mj(lu and site.apt oval gr, nt d on all stn stores involving s: tltaiy fatuities <br /> before constructiomcam,begln. In the case of seworageal..Paso l sy,tonis, a copy of the liercolotion test must be attached to. <br /> this application before:a-perm�t will be Issued. Do hi purchase or install a septic tank, do any plumhlng or start anir <br /> y build- <br /> ing until a permit has bnen`issucd_A permit may be invoked-i Lm isreprescntotion of any of the infprmauon conveyed herd <br /> with is found to exist- Changes In ol`ans or ryeetf ieatio ns shall lot be nude without approvalbf the Zoning AdminlsHatw. <br /> SEWER SYSTEM 'SHALL 'NOT 'BE, COVER.ED,.UNTIt. INSPECTED BY THIS OFFICE AND 'APPROVED. <br />