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Fig. A. Location of proposed structures and <br /> r J` 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 /> � c <br /> water. If property is located at a <br /> o I �� highway intersection, show the inter <br /> - <br /> +g secting highways and the setbacks <br /> required along them and at the in- <br /> tersection, together with vision clear- <br /> 0 ance triangles. <br /> OL <br /> PERMIT FEES <br /> Land Use . . . .. .. .. .. . . .... .$ 1.00 <br /> Building . . . . . . . . . . . . . . .. . . . 5.00 <br /> Sanitary . . . . . . . .. . . . . . . .. . . 10.00 <br /> Well . .. .. .. . . .. .. .. .. . . .. . . 5.00 <br /> Septic Tank . .. . . .. .. .. .. ..E_1.0V <br /> Combination Building, Sanitary <br /> and Well . .. .. .. .. . . . . .. . 15.00 _ <br /> Condi 'onal ...... . .. .. 1 .00 <br /> Signature of Owner or Agent Date Zoning Administrator <br /> ACTION Site approved (date) . . . . . . . . . .. .. . /. n . .. . .... .. . .. ... <br /> Permit Issued (date) . . . . . . . . . . . ..�1.- 1!���? Receipt No. � Fee $. ....... .. .. . <br /> Septic Tank Permit Issued (date) .. ...,!!.�4!`�s . . . . . . . No.I . ..(. 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 /> Work Started (date) . . . . . . . . . . . . . .. .. .. . . . . . Work Completed (date) . . . . . . . . . . . . . .. .. .. .. .. <br /> 1r y r. <br /> INSPECTION Date . . �'.!✓ . ��..�.� ��' . Inspector . . .. .. ... .. . ..^' �/ . .. . . .. . <br /> Remarks .. .. .. .. . . . .. .. . . . . .. .. ... . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c. . . . .11r !tG.. . . . . . . .. .. . . . . . . . . . . .. .. .. .... . . .. . . . . . . .. . . . .. <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 />