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• <br /> Fig <br /> ' 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 /> 6�,! n1� required along them and at the/k in- <br /> tersection, together with vision clear- <br /> ` ance triangles. <br /> AIN \ yT PERMIT FEES <br /> Land Use $ 1.00 <br /> \ _ Building 5.00 <br /> Sanitary 10.00 <br /> Well 5.000 <br /> Septic Tank 10 <br /> • Combination Building, Sanitary <br /> , and Well 15.00 <br /> Conditional 10.00 <br /> / Mbq .ears . a •. . . <br /> #1.eid(i <br /> Signature of Owner or Agent Date Zo Admini ato I <br /> ACTION Site approved (date) <br /> Permit Issued (date) / -.90-7..5 <br /> Receipt No. �hf l .I.. Fee $ <br /> Septic Tank Permit Issued (date) -:.lO. .c No.e=?. /lu.. . 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 /> INSPECTION Date ./I—c2 9 7Inspector Cf rtAAA1 <br /> Remar,s <br /> •• • ).• i• - • •• •640)(); i3 k)-LQ v ad 4 COM. CadWiel <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 /> Copy of Decision to DNR (date) <br />