Laserfiche WebLink
r. 4 <br /> Fig. A. 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 10.00 <br /> Well . .. .. .. .. .. .. .. .. 0 <br /> Septic Tank . .. .. ... . .. .... . 1.00 <br /> Combination Building, Sanitary <br /> and Well . .... .. .. . . .. .. .. 15.00 <br /> C ditional . .. 1 .00 <br /> . . . . . . . . . .. .. . . .. .. ... ... ... . . . . . . . . .. . �.: . - �. . . <br /> Signature of Owner or Agent Date Zo g Administr r <br /> ACTION Site approved (date) . . . . . . . . <br /> Permit Issued (date) . . . . . . . .S�J.�. 3:—��... Receipt NoA . . . 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/ksInspector 1� . .t .. .. ... <br /> Rem -?� ?..... . . . . . . .. .. .. .. . <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 />