Laserfiche WebLink
X Fig' A. Location of proposed structures and <br /> existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> N in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> 0. 1 r water. If property is located at a <br /> highway intersection, show the inter- <br /> secting highways and the setbacks <br /> required along them and at the in- <br /> d 04 tersection, together with vision clear- <br /> ance triangles. <br /> PERMIT FEES <br /> Land Use . . . .. .. .... .. .. .. .$ 1.00 <br /> Building . .. .. . . . . . .. .. ..... 5.00 f <br /> C Sanitary . . .... .. . ... . .. . . .. 10.00 <br /> yU Well ... .... . ... .. .. .. . ... .. 5.00 <br /> Septic Tank ......... .... .. . 1.00 <br /> Combination Building, Sanitary <br /> { ,p and WellJJ. .... .. .. ...... ..�115.5.00 <br /> 00 <br /> 1\. .G �zz. . . .�>>: <br /> _Conditionalf /GG .�...�9�f'.1iC��"1 <br /> Signature of Owner or Agent% Date Zo ' Administra <br /> ACTION Site approved (date) . .. .. . . ... r}� <br /> Permit Issued (date) .. .. .. ....� �lh ,l—.�.��. Receipt No. !/ .... Fee <br /> Septic Tank Permit Issued (date) . .. ..... ... . . . . .. .. .. .. . 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 Completed (date) . . . .. .. .. .. .. ...... .... <br /> INSPECTION Date . . . . . . . . .. . . . . . . . .. . . ...... . Inspector . .. . . . . . . . . . . . . . . .. .. .... . ... . . . . . . . .... .. . <br /> Remarks . .. .. . . . . .... . . .. ..... .. ..... .. .. .. . . . . . . . . . .. .. . .. .. .. .. .... ....... . ......... <br /> . . . . . . . . . . .. .. . . . . . . . . . . .. .. .. .. . . . . . . ... . . . . . .. .. ... . . . . .. . . .. .. . . .. . ... .. .. .. ..I. .. .. .... .... .... .. . <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 />