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Office of Zoning Admin-is tratorq/ o F o <br /> PPP <br /> �..; ION FOR SANITARY,. LAND USE — BUILDING PERMIT - 3 E <br /> P' d'ZONING ADMINISTRATOR: The undersigeed,hereby makes application for a y = o <br /> fr,k'for the work described and located as shown herein. The undersigned agrees that all IdA =�. <br /> shall be done in accordance with the requirements of the County Zoning Ornance, <br /> yuan itation Code, and with all other applicable County Ordinances and the laws and regu- °- <br /> lations of the State of Wisconsin. 3 '� O <br /> Owner or Agent I se PrinH Contractor or Surveyor i/x <br /> A /J . . SYN^!t. . SS.cS 0. 1. . . . . . . . . . . Q i <br /> Address - Address n '� <br /> . . . . . . . . . . . . . . . . . . . :1 i <br /> Phone Phone <br /> . . I["I/' . . . . . . . . . . . . . . . . . . . . . . . . . if <br /> Well Driller � l� <br /> 4 o i <br /> Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o <br /> 0 <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities: a � <br /> Typrf Construction No. Bathrooms y� - o 1 m <br /> 1. Work ✓ . . . .T`.tl'.`� 5-. . . . No. Bedrooms . .'7 \ i <br /> New Building . . . . . . Size .;TS it.x .,�.� . ft. Septic Tank Size Gals. . . . . n7r <br /> Addition Height . . . . . Stories . . . . . . /a °h `t it '! <br /> Sanitary . . . . Area . . . . . . . . . . . . . . . . . . . 7a.Absorp[ion Field Site: (_ n r- <br /> Filling . . . . . . Soil Type M. <br /> o 'e <br /> Moving . . . . . . 5. Permits Required Slope . . . . . . . . . . . . . . . . . . . . ppV�� <br /> Grading . . . . .. Subdivision . . . . . . Perc. Rate . . . . . . . . . . . . . . . . . <br /> Mobile Home . . Sanitary «// Dry Well . . . . . . 7 <br /> Privy . . . / Building L/ Seepage Trench . . . . . . 1D N i <br /> L./ <br /> WeII Well Privy <br /> Seepage Bed /.�X.3 W <br /> Subdivision Other (Specify) . . . . . . <br /> A <br /> Conditional . . . . . . t <br /> 2. Classification A Land Use . . . . . . <br /> Zoning Dist .`: ° I 2 0 <br /> 6. Use (describe exact <br /> 3. Lot Size home,motel,etc.) FOR COMMERCIAL USE <br /> . . . . . . .. . ft.x . . .__ . . . it. _ - . _ _ Plans Submitted . . . . . . i _ <br /> :'�. . sq. f[. ..Plans APProved . . . . . . <br />._______- f_____________ ______'W______________________________ <br /> Fig. :4 <br /> A. A ' Location of proposed structures and <br /> ry /v existing structures, well, sewage sys o <br /> Q Nc tems, roads, etc., should be sketched �_.. f <br /> J <br />' 6B in Fig. A. Include road setback, side <br /> �g h1 and back yard dimension and location Cv <br /> t1 and setback from all bodies of water. <br /> ts< - If property is located at a highway in. i91 <br /> T <br /> tersection, show the intersecting high i)) <br /> u ways and the setbacks required along, i It y„ . iz <br /> them and at the intersection. <br /> PERMIT FEES _ i ': 9 <br /> w c� Subdivision . . . . . . . ^ Rk <br /> } J` :h <br /> Land Use . , .00 <br /> Building l?„ : <br /> Sanitary l <br /> WeII <br /> `— �--� Septic Tank 0.00 { � <br /> .. Combination Building, Sa nrtary <br /> and Wet I . . . .. <br /> Privy . . . . . . . . . . 5.00 - <br /> Sigqat6r� df Owner or Agent Date Zonin � nistrator { <br /> Inspection Date ."{.�.�. �.. ... ... nnspecror .... >F?.(l:�f., .... O.._!........ ... .. ....t <br /> Remarks ..k.—A.�I..... L.ICf 2117//�1� ...(C �r. .... ....���l�Cl. ..... (!.....4XL../�7��e4 ..... <br /> orn...Pn�.. . . ....CQ. . �...sA :dar.. s................... .........._..................... .......... ... ...... ... <br /> �� <br /> ................._� ...�� v ,................................ ..._.......................... ....... <br /> . ........:._......:'... :. <br /> NOTE: A preliminary site inspection must be made and site approval grunted on all structures involving sanitary faeilit <br /> before construction can begin. In the case of sewerage disposal systems, a copy of the percolation test must be attached <br /> this application before a permit will be issued. Do not purchase or install a septic tank, do any plumbing or start any bui <br /> ing until a permit has been issued. A permit may be revoked if misrepresentation of:any of theinforms tion conveyed he <br /> with is found to exist. Changes in plans or specifications shall not be made without approval of the Zoning Adminislrati <br /> SEWER SYSTEM SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br />