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1-Ake-Fig. A. <br /> Pc�,'78 Location of proposed structures and <br /> existing structures, well, sewage syr <br /> tems, roads, etc., should be sketched <br /> 0 in Fig. A. Include road setback, side <br /> and back yard dimension and loca. <br /> E Hc, C—T 8isq i-I tion and setback from all bodies of <br /> o� water. If property is located at a <br /> �— --� <br /> ;�.: -- Q .,;, .:;•. � highway intersection, show the inter- <br /> y secting highways and the setbacks <br /> n t If'I Srir u <br /> G� yv' F.�•++l "(\" � required along them and at the in- <br /> D+J' ' F'AJ tersection, together with vision clear. <br /> prrtF IJ ' <br /> ance triangles. <br /> &r+t PERMIT FEES <br /> Land Use ..................j 1.00 <br /> Building . .. ...... ... .. .. ... 5.00 <br /> Sanitary . ... ... .. .... ...... 10.00 <br /> + <br /> Well ......... .. .... ....... . 5.00 <br /> $C Septic Tank ........... .... <br /> Combination Building, Sanitary <br /> 6c, 5q �rce � 1 1Ke and Well <br /> ..... .... ....... 5.00,1 <br /> ., .. .. . .... Ctv <br /> o tional <br /> 4 % •�� <br /> F <br /> afore of Owner or ent Date % Zo Admini ator <br /> TION Site approved (date) . .. . ..... .... . . . ... ...............AA ...... .. .... <br /> Septic Issued <br /> TankPermit Issued (date) .. ...� 7 .17ei t No. Fee <br /> l � . Fee $1.00* <br /> i. 0�.... . <br /> Conditional Permit Issued (date) ... .... . ...... . .... . .. . . No. . ...... .. .. . Fee $.... .. ...... <br /> Certificate of Compliance Issued (date) . ....... .. . . .. ... .. . . . . ... .. .. ....... . ... ..... ... . ... <br /> Permit Denied (date) . .... . ..... . . .. .. .. . . . . ... for the following reasons ... .. . . ........ ....... . ..L.... <br /> .... .... .............. .. .... .. ..... . .... . ... . . ............... .......... ...... . . .. ...... . . .... .. . . . .. . <br /> Work Started (date) ..... .. .... .. ....... . . .. Work Co pleted (date) . . ... .. .. .. ..... <br /> INSPECTION Date .. /. f / Inspector . . .. <br /> Remarks, <br /> `T ! .�l� :.I <br /> .. .. .... .. ....---..��./ ' ". . -e . . . .. . .C, .. ...:--1.... .. ..`/./.. ...... ..... ........ <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 />