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I . ­­ __V Dy- <br /> pN OOMpUTER/SCpNNEp <br /> itrnty —' _ Office of Zoning Administrator <br /> APPLICATIGN FOR SANITARY — LAND USE — BUILDING PERMIT 643 <br /> ,E 7�0NING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work described and <br /> ,ed as shown herein. The undersigned agrees that all work shall be done in accordance with the requirements of the c <br /> .rnett County Land Use Ordinance, Sanitation Code, and with all other applicable County Ordinances and the laws and 3 <br /> .egulations of the State of Wisconsin. a <br /> Ike Walton Lodge N <br /> OWNER (Please Printj CONTRACTOR or SURVEYOR or AGENT <br /> Star Rt. <br /> ADDRESS. .......................................................................... .ADDRESS............................................................................ Z iQ <br /> Danbury.:...wl.....54830........................................ ............... — `° <br /> ......... ...... . : <br /> ADDRESS ADDRESS I � <br /> 715-866-7101 <br /> : o <br /> PHONE PHONE <br /> Donald Daniels U <br /> .........._ <br /> PLUMBER WELL DRILLER <br /> Box W.... Siren,. WL,...54872 v <br /> ................... ............................................................................................ r� <br /> AODRESS ADDRESS o <br /> 0 < <br /> 71. - 49,-55.3 ...................................................... ........... <br /> PHONEPHONE.................................................................................� Z r <br /> O .. p <br /> H <br /> DESCRIPTION 4. Sanitary Facilities: o .4 <br /> 1. Work: No. Bathrooms 9 <br /> 2. New Building Details •"..... ` c <br /> New Building ......... Type of Construction: No. Bedrooms ........... $ '�,, <br /> Addition .......... ................................................. <br /> Septic Tank Size Gals. <br /> Sanitary x Size ... w <br /> ......... <br /> Filling/Grading Hei ht Stories 4a. Absorption Field Site: <br /> g ............. ............... p <br /> g Soil Type .................................... r— c <br /> Moving .......... Area ........................................... .. o <br /> Mobile Home Slope .......................................... : .. <br /> .......... <br /> Privy .......... 3. Use (describe exactly,-1 -family Perc. Rate ................................... a <br /> Well Dry Well CD ?l <br /> •........ home,garage, motel, etc.) Z <br /> Subdivision Seepage Trench .......... o E <br /> Camping Unit Privy .......... <br /> .......... .................................................... <br /> Seepage Bed .......... CJ : <br /> ---------------------------------------------------------------------- ;� G <br /> Location of proposed structures and existing structures, well, sewage systems, roads, etc., should be sketched in Fig. A. <br /> Include road setback,side and back yard dimension and location and setback from all bodies of water. If property is located at F : <br /> a highway intersection, show the intersecting highways and the setbacks required along them and at the intersection. <br /> CLEARLY LABEL EXISTING STRUCTURES AND PROPOSED STRUCTURES AND ADDITIONS--------------- 1 o <br /> 5. Lot Size Fig. A. 6. Location: Jj <br /> ................ ft. x ............ ft. — ............................. sq.ft. ............................................................................... t <br /> 1 N : N <br /> �c. 0 <br /> T <br /> See State approved <br /> PP plans <br /> F <br /> m :0 <br /> CD <br /> 0 <br /> rn <br /> M t!» rnr- Da000 � <br /> � �Q < > > 0 m <br /> co a < - acnna � <br /> o< w cy > > 3 <br /> O T. '2 O O <br /> 0 6q o D —1 <br /> cn a <br />