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Location of proposed structures and
<br /> _ r l existing structures, well, sewage sys.
<br /> �^ 11KVy � tems, roads, etc., should be sketched
<br /> _t< in Fig. A. Include road setback, side i
<br /> 7 s o and back yard dimension and loca-
<br /> tion and setback from all bodies of
<br /> t >< water. If property is located at a
<br /> highway intersection, show the inter.
<br /> 1 secting highways and the setbacks
<br /> I required along them and at the in.
<br /> tersection, together with vision clear.
<br /> , ance triangles.
<br /> Y(�
<br /> PERMIT FEES
<br /> �l7
<br /> land Use . . . ........ . . .. .. .$ 1.00
<br /> Building . .. .. .. . . . .. .. .... . 5.00
<br /> Sanitary . ...... . . ........ . . 10.00
<br /> Well ... .. ...... .. .......... 5.00
<br /> Septic Tank ... .. ...... ..... 1.00
<br /> Combination Building, Sanitary
<br /> and Well . .... .... ........ 15.00v
<br /> q Conditional ... ........ .. .. .. 10.00
<br /> . .. . .. � 1 ..�!�?om4I.. . ..�( �J.UN.73.. . . .... .�s��
<br /> Signature of Ownkr or Agent Date /1 Zoning Administrator
<br /> ACTION Site approved (date) . .. ...... .. .. .: .. .. ... .. ...... .... ... ..:. ... . ......
<br /> ....... ...........
<br /> Permit Issued (date) . .��.�s.�. ... .. ... Receipt No. 7/-9.(... . Fee $ S.. .. .. .
<br /> Septic Tank Permit Issued (date) . .. l .Jo.w. 2 3., ,, . No. 5 6. G,?,. Fee $1.00'
<br /> Conditional Permit Issued (date) . .... . No. . . . ... Fee $. ..
<br /> Certificate of Compliance Issued (date) . .�P/5 . ,7.3, ,, ,, , , , , ,, ,, , , ,, , , , ,,, , , ,, ,, ,
<br /> Permit Denied (date) ....... .. .. .. . . .. . . . . . . . . . for the following reasons . .. .. .. ...... ...... .. .. . . .... .
<br /> .. .. . . ........ .. ..... . .. .... .. .. . . . . . .. . . ... .. .. .. ..... ...... .. .............. .. .. .. .... .... .. . . .. .... .
<br /> Work Started (date) . . . . . . . .. . . . . .. .. ... . .. . Work Completed (date) . . . .. . . .... .. . . .. .. .. .. .
<br /> INSPECTION Date ... . 2. .. . S!:y. ?-�... Inspector . . . 5'' --er': .
<br /> Remarks . .. . . .. . . . 111 .. .:. .. .. .�v.?".��. . . . .o�ki..�-I. .. -,r..... . .
<br /> . . . . . . . . . . . . . . .. . . . . .. .. ... . . .. . .. . . . . . . . . .. .. .. ..... . . .. . . . . .. . . .. .... .. .. . . . . .. . . .. . . . ... . . . . . . . . . . .
<br /> . . . . . . .. . . .. . . . . .. .. . . .. .. .. . . ... . . . . ..... . . .. .. .. ... .. . . . . . . . . . . . . . . . . ... . . . . .. . . .. .. . . . . .... .........
<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 /> ... .. ........ ..... .
<br /> Copy of Notice to DNR (date) . .. .. .... ...
<br /> . ... .. .. ..
<br /> Appeal Heard (date) Decision ... .. . . . . .. . . . . . . . .... . .. . . . . .. .. ...... ... i
<br /> . . . . ... .. ..... .. .. .. . . .. . . .. .. .. .. .. .. .
<br /> . .. .. .... .. .. . .. .. .. . .. . . . . . .. .. .. .. . . . . . . . . .... .... ... . . . . . . ..
<br /> Copy of Decision to DNR (date) . .. . . . . . . . . . . . . . .. ...... . . . ... . . ... . . . . . . . . . . . . . . . . . . . . .. .. .. . . . . .. .. .
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