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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, aide <br /> and back yard dimension and loca. <br /> tion and setback from all bodies of <br /> water. If property is located at a <br /> vhighway intersection, show the inter- <br /> sect <br /> ing highways and the setbacks <br /> syrequired along them and at the In- <br /> tersection, together with vision clear- <br /> ance triangles. <br /> PERMIT FEES <br /> Land Use ... . ...$ 1.00 <br /> Building . . . . . . . . . .. . .... ... 5.00 <br /> Sanitary . ... . .. .. .. . . . . ... . 00Well ... .. ... . .. ...... . ... . . 6.Septic Tank ... ...... .... ...rte' P Combination Building, Sanitary <br /> and Well ....... .... .. .. .. 18.00 <br /> 0 ons <br /> .... . ... .. 10.00 <br /> Si ature of er or est Date Zonis A for <br /> ACTION Site approved (date) . .. . . .. . . ...n . ..cei ...... �j ../._ .... .. .... ... <br /> Permit Issued (date) . . .. .... .. .. - d:7J. . .. . pt No. /7./r/./.(!!.. Fee $.��.�.. ... <br /> Septic Tank Permit Issued (date) . . ...o-4Z7-7 •• . . .. . No.,;04 J. . . . 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 C leted (date) . . . . . . . .. . . .. .. .. . . .. .. <br /> INSPECTION Date (.. <br /> // �.7 . . . 7.. Inspector . . .2crir� � i. . . . . ... <br /> . . <br /> Remarks :1Sr7. :. .. .. .. . . . . . . .. . . .. .... .. .. .. .... . . . . . . .. . . .. ... <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 />