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a9` <br /> Fig' A. Location of proposed structures and <br /> existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> water. If property is located at a <br /> F�� highway intersection, show the inter- <br /> secting highways and the setbacks <br /> required along them and at the in- <br /> tersection, together with vision clear- <br /> ance triangles. <br /> 20 <br /> Lw PERMIT FEES <br /> Land Use . .... .. .... .. .. ...$ 1.00 <br /> Building . .. .. .. .. .. . .. .. .. . 5.00 <br /> Sanitary 1 <br /> Well ..... . . .. .. .. .. .. . . .. . �.00 <br /> Septic Tank . . . . . ... . .. . . .. . <br /> Combination Building, Sanitary <br /> and Well . .... . . .. .. .... .. 15.00 <br /> �ondd�(iitional �/) 1� .^j/� 10/-V <br /> I,�r�� • •���IIL!EI. . • . •.•.�`. . . .�.i'� .V •./.T. • • <br /> Si ature of Owner or ent r1 Date Zona! Adminis <br /> gn Ag g tor� <br /> ACTION Site approved (date) . . . . . . . .. ./ .. . .. .... .... .. . . . . <br /> Permit Issued (date) . . . . . . ../. -�'{ . . . . . . Receipt No. .7 . .. /f . . . . , . <br /> / p '., / Fee . . . . . . <br /> Septic Tank Permit Issued (date) . . 1�- -'7 . . . . . . . . No.7ZS��09. 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 Started (date) . . . . . . . .. . . . . .. .. .. . . . . . Work Comp ed (date) . . . . <br /> INSPECTION Date '-- .!. /.. /. .�7�Spector . . . . <br /> Remarks .. t . . . . .. . . ..�. . . ... .. .. . . . .. .. . . .. . . .... .. . . . . . . . . .. . . . . . . . .. .. .. .. . . .. . .. . . . .. .. .. ... . . . .. .. .. .. . <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 />