Laserfiche WebLink
( _ ) , 7_, 1 Q <br /> G y z <br /> Burnett County Office of Zoning Administrator s-g <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT '� '� <br /> To the Zoning Administrator: The undersigned hereby makes application for ( 7*-- <br /> a Permit for the work described and located as shown herein. The undersigned agrees that , - . f(,)\) <br /> all work shall be done in accordance with the requirements of the County Zoning Ordinance, U °p <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- i n <br /> lations of the State of AW'sconsin. Q ;; <br /> Owner or Agent (please Tint) Contractor or Surveyor t\ 9 <br /> t o w--t As Tr c(-ups c'/y f <br /> Address Address <br /> Phone Phone <br /> i/' 14- 1,1--"Ad"—:'""'' <br /> Plumber Well Driller CD <br /> Address Address <br /> 0 <br /> Phone Phone ,0 <br /> DESCRIPTION 4. Building Details 7. Sanitary Facilities <br /> 1. Work (check one) Type of Construction No. Bathrooms <br /> New Building • 52 - X/ S 7' h g Dishwasher <br /> Grinder3 '' <br /> Addition <br /> Garbage-.•rte Size '9 Y ft. x �'. ft. Autom. Laundry <br /> Sanitary No. Bedrooms - <br /> Alterations Height . .. . Stories Waste Disposal <br /> Moving Area System e--..Wrecking - Septic Tank Size <br /> Mobile Home 5. Permits Required <br /> 4 Q Gallons rn , <br /> Privy Subdivision Absorption Field Site F c�' <br /> Well Sanitary • • �'' Soilr4�-t `- •� <br /> Subdivision Building SlopeType 5, o + <br /> Well ° • <br /> Pert. Rate . � �^-- 0 p, � <br /> 2. Classification Other (Specify) Dry Well 0 ' :`W <br /> Zoning Dist. Conditional Seepage Trench . w" ," <br /> Land Pr . <br /> 3. Lot Size 6. . 'be exactly, 1- Seepage Bed / ,3. c <br /> fam. hom• motel, etc.) FOR COMMERCIAL USE <br /> ft. x ft. Plans Submitted �' <br /> ...di. <br /> J -;- sq. ft. Plans Approved b <br /> F' <br /> NOTE: A preliminary site inspection must be made and site approval granted on all struc- :•�� <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- <br /> posal systems, a copy of the percolation test must be attached to this application before ad <br /> permit will be issued. Do not purchase or ins tall a septic tank, do any plumbing or start anyg <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of co <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. \1 <br /> C <br />