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Burnett County Office of Zoning Adminis ratoro Z <br /> 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT 3 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and to ated as <br /> shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the Burnett County Lind Use m c <br /> Ordinance, Sanitation Code,and with all other applicable County Ordinances and the laws and regulations of the State of Wi consin, 3 M t <br /> ................................ Zr�c .../�vK� -� . r ................. N F <br /> OWNER (please print) r CON TRACTOR or SURVEYOR or AGENT m m <br /> ADDRESS st..... .F.F... .c�......✓.3.8...................... ...1Z..-.t...`... ......6 .�x....3..G.. .............................. ........... d ; <br /> ADDRESS <br /> ..RN... .V.. .QA.............C4� .:....S...a. �?. G�.�.�,..�...ccr, <br /> ADDRESS ADDRESS / .0. ..,...(. ,!<:...r....S.. ........... <br /> ................................................................................ .7.� . .. . S 5.�...a...z�....................... ........... <br /> PHONE PHONE <br /> W <br /> i l..Csis/ ........../.. .!u y->............................ . ?.../..1Y1......1.....�..............................................l <br /> PLUMBER ' �0 / ., ........... <br /> WELL DRILLER <br /> _. <br /> ADDRESS ADDRESS m � <br /> n n <br /> . . .................................................................... .P.0%N ..U... ...7...... �.Z. .......................... ........... ?. o <br /> PRONE <br /> DESCRIPTION4. Sanitary Facilities: ° c 0 <br /> 1. Work: 2. New Building Details No. Bathrooms ..2..... •O <br /> New Building ...y,., Type of Construction: No. Bedrooms E z <br /> �••3����• ' • <br />' Addition [3,(„e,r„�,,..}.,lf,l Ii,,,MXtl Septic Tank Size Gals. .......... <br /> Sanitary .......... Size ...., .�... ft. x ....w..�.... ft. .......... <br /> Fining/Grading rStories ..... . ................. Height 4a. Absorption Field Site: I �� <br /> Moving Area .../. Soil Type ................. <br /> .......... � <br /> ..........Mobile Home Slope ............................... ..................... C Or <br /> Privy .......... 3. Use (describe exactly, 1 -family Pere. Rate ....................... ........... <br /> Well Dry Well <br /> ...*,... home,garage, motel, etc.) ......•... <br /> subdivision ,,,,,,,.,. �•. t„ N�l <br /> Camping Unit Seepage Trench .......... <br /> .......... ... Privy .......... i <br /> ......................... ........................ <br /> -- Seepage Bed .......... <br /> — <br /> -------------------------------------------------- --- <br /> Location of proposed structures and existing structures, well, sewage systems, roads,etc., should be sketched in Fig. A. Inclu a road --f <br /> setback, side and back yard dimension and location and setback from all bodies of water. If property is located at a highway inter- g-_ a <br /> section, show the intersecting highways and the setbacks required along them and at the intersection. CLEARLY LABEL EX STING <br /> STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS. — <br /> o <br /> ----------------------------------------- _----- __ _-- <br /> 5. Lot Size: Fig. A. 6. Location: i <br /> ai'J... .7. ft. x�.� r i ft. — �tJ3.�.7..4r:7x sq. ft. ................................................................... ........... �: <br /> 0 s <br /> W <br /> ou o <br /> 71 <br /> 7J Nr u <br /> n !p c: n m F <br /> C ' m � <br /> o � m <br /> _ 0 o o' n m <br /> 9 �Z m � <br /> W o <br /> 0 <br /> Rm <br /> .......................................... o <br /> e,.o,.. ^ .. ........ �:(\o _ C <br />