Laserfiche WebLink
Burnett County Office of Zoning Administratora o 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT v 3. :\ <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby Takes app ilea l ion for a Permit for do work described and located as 7O O <br /> slit own herein. The undersigned agrees that all work shall bo{Ione in accordance with the reel l cements of the Burnett County.Land Us. c :W <br /> rtll^aoc". S�q pont) y CONTR '- ^f/the State of Wisconsin. 3 c ti 0 <br /> Ce/%//((/i,aliVooce,,and will, all other applicable Count Ordintr ces and the laws and regulations� <br /> ........... ./�( ...✓...LL.Y..'/.L.S..: . .... .... ........... .......... .',y//.J........................... O <br /> OWNER IPI ze r or BURVEVOfl orA cG-NT / n <br /> c <br /> ADZE <br /> ..ESS <br /> .......... <br /> .'.....✓'�.�....�..../. ...:.....//....'.�^.S.'.�:rQ. ..h...f...l./../y.....J...�/r.l�[..<........................ .............. <br /> .....:................-..... .....� ....... <br /> ADDRESSADD ...................................................... <br /> .........................................�,.LI.7..._....5....g,.<l........�..l,..Y..n:.... <br /> ........................ <br /> (bicey\ <br /> PHONEn PHONE - <br /> .. .. <br /> PLUMBER. <br /> .WELL DRILL <br /> ... .. .. .` .`.. / ".L.J�...G -!... .... ................ ..... .. ............................ <br /> . . . ..O..j'.l...U.:/...P... ................................. ...................... O <br /> ADORE55 ADDRESS .__.................. <br /> PHONE..... • <br /> E : ... Co <br /> (JL� ....TJ " . ............. ....... . ...... <br /> PITON ` <br /> Z r <br /> DESCRIPTION 4. Sanitary Facilities: <br /> 0 <br /> 1. Work: No. Bathrooms "�, v I <br /> 2. New Building Details -�-����� ' o <br /> New Building .......... Type of Construction: - No.Bedrooms �..,.. :fix, <br /> tic Tank Size Gals. .......... �� <br /> Addition .......... . .................................................... �SeP .......... <br /> Sanitary .. ._ Size .............. ft. x .............. ft. - . iqt <br /> Filling ..._. ... ............... 4a. Absorption Field Site: <br /> .... . .. . <br /> Moving ........ Area ................. ............... Soil Type _....................._...._._. io <br /> Z <br /> r <br /> 3 <br /> o <br /> Grading ......._- -' Slope ._............._......................., e � ' <br /> Mobile Home3. Use (describe exactly, 1 family <br /> Perc. Rate ............. ..................... F E <br /> .......... � <br /> ti <br /> Privy ....... home,garage,motel,e[cl Dry Well .......... m <br /> WellSeepage Trench .......... i <br /> .......... .................................................... k <br /> Subdivision , epa 1 <br /> ...... <br /> Se .. i . <br /> Seepage Bed ......— ^t <br /> Locatlon of there f structures and existing <br /> structures,a safteck from <br /> m .11 ts•mads, wager. If p be sketched it rig a highway <br /> rater. c <br /> setback, side and back yni highways and location and setback from all m and of water. 11 coon.C is CLEARLY <br /> ata LEXIS inter h a <br /> section, show the intervening ED STRUCTURES <br /> and RE setbacks requiredADDITIONS along ,nem and at the intersection.CLEARLY LABEL EXISTING 0 <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS. <br /> o <br /> _________________________ _ _______ _ ________________ _______________ <br /> 5. Lot Size: - Fig. A. 6. Location: ff !� <br /> ................ ft. x .............. ft. — ........_..................... sq.ft. ............................................................................... <br /> all <br /> p <br /> 0 <br /> i� o <br /> a' <br /> tU <br /> Z <br /> 0 <br /> m <br /> b \ <br /> c <br /> q cavi mz <br /> • A Ncao - _II__ E.F <br /> 0 oN. c : � 4m <br /> Z Co <br /> 53 <br /> Cd <br /> p, <br />- <br /> is re of Owner or AgenDffie o C <br /> ............. _........ _ <br /> 'S°.➢._s7L':: r•..........T..../.......--..5.........._....._...................................... \' v <br /> Zoning Administrator o c o 0 0 o Vmi <br /> / r m� <br /> Inspection Date _F. .. �( ClL ../ 0 0 o m m <br /> NOTE:p'liminary site inspection must be made and site approval giddied on all sbuetures involving fennel, laeiln", <br /> before consir`ucti6n can begin. In the case of sewerage dlspus;d sYstents, a copy of the percolation test must be attached to . <br /> this applleation bolore a permit will he Issued. Do ot'Pun:husu or Iswll'a shptle tank, du any nI ural lin, it start any build- <br /> ing until a PerfBit has been issued. A permit may be revoked If miOr,csentation of an, of the inkoh,tiotr conve,hd here- t <br /> with is found to exist. Changes it plans or specifications shall trot be made without approval of the Zoning Admirisvamr. <br /> SEWER SYSTEM SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br />