Laserfiche WebLink
I' e-t VeitJAJf <br /> Location of proposed structures and <br /> le Fexisting structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> i in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> TJ tion and setback from all bodies awater. If property is located at a ie highway intersection, show the inter- <br /> secting highways and the setbacks <br /> mu5rrequired along them and at the in- <br /> S+Petersection, together with vision clearM 52�1��Cante triangles. <br /> aCro n. PERMIT FEES <br /> Land Use . . . . . . . .. . . .. . . . . .$ 1.00 <br /> RVt �U0.fC Building . . . . . . . . . .. . . . . . . . . 5.00 <br /> 1 - Sanitary 1 .00 <br /> —�9� Well .0 <br /> Septic Tank . . . . . .. . . .. . . .. . 1.00 <br /> C 0 Combination Building, Sanitary <br /> d 1Y and Well . ... . .. . . . . .. . . .. 15.00 <br /> C ndittonal . . . . . . . . . . .y. 10.00 <br /> Signature of Owner or Agent Date Adminis or /1 <br /> ACTION Site approved (date) <br /> Permit Issued (date) . . . . .. .�I Receipt No. ✓✓✓ <br /> Fee $.f 5.. . . . <br /> Septic Tank Permit Issued (date) . . ./1 ��j CO. . . . . . No. .Q �h . Fee $1.00 <br /> Conditional Permit Issued (date) . . . . . . . . . . . . . . . . . . . . . . . . No. . . . . . . . . . . . . Fee $. . . . . . . . . .. . <br /> Certificate of Compliance Issued (date) . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . <br /> Permit Denied (date) . .. . . . . . . . . . . . . . . . . . . . . . . . for the following reasons . . . . . . . . . .. .. . . . . .. . . .. . . . . .. . <br /> .. . . .. .. .. . . .. .... .. . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . ... . . .. .. . . .. . . .. .. . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . <br /> Work Starte (date) . . . . . .. . . . . I . . . . . . . . . . Work Completed (date) . . . .. .. . . .. . . . . .. . . .. .. . <br /> INSPECTION Date !. ' . .� .� In spector4 !a ?f��� G ��-G� , - - , . <br /> ,. . . . . <br /> Remarks� . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . .. . . . . . . . . .. . . . . . <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 /> Copy of Notice to DNR (date) . . . . . .. . . .. . . .. ... . ... . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Appeal Heard (date) . .. . . . . . . . . . . . . . . .. .. . . .. . . . Decision . .. . . . . . . . . .. . . . . . . . . . . . . .. .. .. . . . . . . .. .. . <br /> . . . . . . .. . . .. . . .. .. . . . . . . . . .. . . .. . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . .. .. . . .. . . . . .. . . .. . . . . .. . . . . .. . . .. .. . <br /> Copy of Decision to DNR (date) . . . . . . . . . . . . . . . . . . .... . .. . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />