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E_____, <br /> d o p <br /> Burnett County Office of Zoning Administrator S' g <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT ;' ." 5 <br /> To the Zoning Administrator: The undersigned hereby makes application for v1 <br /> a Permit for the work described and located as shown herein. The undersigned agrees that • <br /> all work shall be done in accordance with the requirements of the County Zoning Ordinance, P o <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- (:',) g <br /> lations of the State of Wisconsin. <br /> ti <br /> r t' n ff�D h d•. <br /> Owner or Agent (please print) Contractor or Surveyor 4 <br /> -47 <br /> .4i.� 4: ,mr. :. . . /a.Au.. . .e. 4....../W.t.hra......: .V.!. t,. . . , <br /> Address Address -> <br /> ra <br /> 7 <br /> Phone- Phone <br /> . A A ‘,i i . ti. g) <br /> Plumber •• ••• Well Driller <br /> A •-;Gam(✓ n to a <br /> Address Address <br /> S <br /> al <br /> Phone PhonePg <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities .. <br /> 1. Work (check one) Type of Construction No. Bathrooms • <br /> Dishwasher .. <br /> New Building :'>c Garbage Grinder <br /> Addition 2,x,1. ft. x t..o3,41`ft. Autom. Laundry <br /> Sanitary Size .• <br /> Alterations Height No. Bedrooms <br /> Stories Waste Disposal <br /> Moving Area System ;I i <br /> Wrecking Septic Tank Size <br /> Mobile Home 5. Permits Required ^f, .Z 4 <br /> 7 �1 .. . Gallons FPrivy Subdivision Absorption Field Site Fe <br /> Well Sanitary Soil Type . - .ti h.c . . . `fie' n <br /> Subdivision Building Slope . . .(1.!-.7:,.. O' p <br /> Well (Specify) Perc. Rate .44"^ p It <br /> Other (S <br /> 2. Classification p y) Dry Well t <br /> Zoning Dist. Conditional Seepage Trench C <br /> Land Privy CN <br /> 3. Lot Size 6. Use (describe exactly, 1- Seepage Bed I a x c <br /> ftx ft. fam. home, motel, etc.) FOR COMMERCIAL USE <br /> Plans Submitted - <br /> J C Cl :. sq. ft. Plans Approved '0 <br /> I <br /> NOTE: A preliminary site inspection must be made and site approval granted on all struc- Com` C <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- <br /> posal systems, a copy of the percolation test m ust be attached to this application before a c <br /> permit will be issued. Do not purchase or ins tall a septic tank, do any plumbing or start any c <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of c1 <br /> any of the information conveyed herewith is found to exist. Changes in plans or specifica- <br /> tions shall not be made without approval of the Zoning Administrator. SEWER SYSTEM <br /> SHALL NOT BE COVERED UNTIL INSPECTED BY THIS OFFICE AND APPROVED. <br />