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Fig. A. <br /> 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 /> 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 /> 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 .. . . . . . .. . . . . .. . . . . 10.00e/ <br /> Well ... .. .. . . . .. . .. .. . ... . . 5.00 <br /> Septic Tank . .. .. .. . . .. .. ... <br /> Combination Building, Sanitary <br /> and Well . .. . .. . .. .. .. .. .. 15.00 <br /> / Conditional 10.00 <br /> ature of 0 . . .. . . . . . .. �l,'7/ --T" . .. .. ..... ... - <br /> Sign caner or Agent Date g <br /> Zonin Administrator <br /> ACTION Site approved (date) / .. ... ...... .. . ... <br /> Permit Issued (date) . . . . .. .X1,3!<..� . .. .. .. . Receipt No. . /., .. . Fee $j.4.... .. .. <br /> Septic Tank Permit Issued (date) . .. .�(.3l,/.7�.. . . . . . . . No. vc �09, Fee $3.00 <br /> Conditional Permit Issued (date) . .. . . .. . . .. . . . . . . . . . . . No. . .. .. . . . . .. . Fee $. . . . ........ <br /> Certificate of Compliance Issued (date) . ... .. . . . . .. .. . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . <br /> Permit Denied (date) . .. . . . . . . . . . . . . .. . . . . . . . . . for the following reasons . .. .. . . .. .. . . . . . . . . .. . . .. .. .. . <br /> Work Started (date) . .. . . . . . . . . . . .. .. .. . . . . . Work Completed (date) . . . . . . . . . .. .. .. .... .... . <br /> INSPECTION Date . . . . . . . . . .. . . . . . . . . . . .. . . .. . Inspector . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . .. . <br /> Remarks . . . .. .. . . . . . . .. .. . .. .. .. . . .. . . . . . . . . . . . . . . . . . . . . . .. .. .. . . . . .. . . . .. . . .. .. . . . . . <br /> . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . .. .. .. . . . <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 />