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Fah V/ , <br /> Burnett County Office of Zoning Administrator o <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT �. <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and 0 o <br /> t n <br /> located as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the n <br /> Burnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> regulations of the State of Wisconsin. 1 <br /> I/y.!....`.... . � 'w^ <br /> OWNER (please print) CONTRACTOR or SURVEYOR or AGENT ;r <br /> ..T .. ..............3.. ......�.................. .. ........... . . . . . ............................................................................ .... —a �c <br /> ADDRESS ADDRESS `f- V1^ <br /> .............( `� .......: ....`. �."...�...... ........ " �—R + <br /> ADDRESS . ..... .............................................................................. .... LJ 1 <br /> ADDRESS <br /> PHO E PHONE i <br /> k(-2-.A..................................................... ... . ............ . .................................................................. .... <br /> PLBER WELL DRILLER ;t— <br /> i <br /> ........................................................................................... .......... ......................................................................... .... O <br /> ADDRESS ADDRESS.... m ;1 <br /> 0 O <br /> ^ < : <br /> ...... .... O <br /> ........................................................................................... . ........................................................................ <br /> PHONE P..HON......E Z r <br /> DESCRIPTION 4. Sanitary Facilities: P o ° P <br /> 1. Work: 2. New Building Details No. Bathrooms ..... .... r c i� <br /> New Building ...1.Y�.. Type of,Construction: No. Bedrooms .. ... � R <br /> Addition v •,,,,,......„r.q,! <br />