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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, side <br /> 0 and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> water. If property is located at a <br /> '90 highway intersection, show the inter- <br /> 14 secting highways and the setbacks <br /> required along them and at the in• <br /> - t tersection, together with vision clear• <br /> ance triangles. <br /> !� PERMIT FEES <br /> (d Land Use . . . .. .. .... .. .. ...E 1.00 <br /> rL �. <br /> Building . .. . . .. .. . .. . . .. ... 6.00 <br /> y Sanitary . . . . ... .. . .. . .. .... 10.00 <br /> G? <br /> Well ... . . .. . . .. ...... .. ... . 6.00 <br /> Septic Tank . .. ...... .. .... . 1.00✓ <br /> APP s u Combination Building, Sanitary <br /> / and Well . ... . ... . .. .. ... . 15.00 <br /> oo�nd�itional ..y..... . 10.00 <br /> . . .. .. . .. 4ra <br /> Signature of Owner or ent Date Zoning Adm -tor <br /> ACTION Site approved (date) . . . . ./ . . .. /'. .. . .. . . .. . .. . . .. .... .... ...... . .. .. .... . .. ... . .. l... <br /> Permit Issued (date) .. ./.(7. ✓2Ul.'.7�� . . . .. . . . Receipt No. Fee $. ! �U.. . <br /> // p <br /> Septic Tank Permit Issued (date) .1.�:. . . . .. ... No. 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 ted (date) . . . .. . . . . .. . ... .. . . .... . <br /> INSPECTION Date h. . .. . Inspector . . . <br /> Remark , . . . .. . . .. . . .. . . ./. .. .. . . .... .. .... .. ... <br /> . . .. . .. . . . .u . . . . . . . .4s.. . . . . L dY . . . . . .. .. . . . . . . .. .. . . . .. . .. .. . ... . <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 />