Laserfiche WebLink
41 <br />Fig. A. <br />Locatian 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 />and back yard dimension and loca- <br />tion and setback from all bodies of <br />water. If property is located at a <br />highway intersection, show the inter - <br />/0 secting highways and the setbacks <br />/__, required along them and at the in- <br />tersection, together with vision clear- <br />ance triangles. <br />PERMIT FEES <br />Land Use .................. $ 1.00 <br />Building ................... 5.00 <br />Sanitary ............. v.. 10.00 <br />Well ............... 5.00 <br />Septic Tank .... ...... 1.00 <br />Combination Building, Sanitary <br />and Well ................. 15.00 <br />!� Cnditional .... 00 <br />r' <br />S. atu of wner or ent Date Z �ldministr or <br />bn► g <br />ACTI Site approved (date) ........> ................. ........ ....... <br />Permit Issued (date) ....... �. : /... .. eipt No. �. . Fee $14........ <br />Septic Tank Permit Issued (date) ..... .....'.7C7..... N. P�..J.. Fee $1.00 <br />Conditional Permit Issued (date) .............. .. _ X10 . ............ Fee $ ............ <br />V <br />Certificate of Compliance Issued (date) ...... LlL ............................... <br />Permit Denied (date) .......................... for the following reasons .............................. <br />...................................................................................................... <br />Work Started date) ........................ Work Completed (date) ....................... <br />fY; %r7 <br />INSPECTION Date .. , . � ..... � ���. Inspector � ......./="..... ...... . <br />Remarks Y...% _ �� :.. . �,�ers� 4 ?'� �f ....... ;mfr ....... <br />-...� �..:'?r':�� ...?........................... . <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 />