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Burnett County `mice of Zoning Administrator 9 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT '� '� <br /> O <br /> To the Zoning Administrator: The undersigned hereby makes application for <br /> a Permit for the work described and located as shown herein. The unde?signed agrees that— <br /> all <br /> hatall work shall be done in accordance with the -requirements of the County Zoning Ordinance, <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu. :It a <br /> lotions of the State of Wisconsin. <br /> ... .. . . ... . ... ..... ....... <br /> Owner or Agent (.pl.f ''nut)nut) Contractor or Surveyor - •S :�, <br /> n ....... .( / .b..5� . . <br /> Address Address <br /> Pho r Phone <br /> . . <br /> .: ..:. .: ..... .. .... .. K <br /> Plume Well Driller <br /> o s <br /> Address �. _ Address � S , <br /> ........... ..... ...... .. .... ... .......... . ....... .... .. ....... . ... .... ..... .... ..... 7 <br /> Phone Phone - � <br /> j <br /> DESCRIPTION Building Details7. Sanitary Facilities ' <br /> 1. Work (check ane) Type of Construction No. Bathrooms ... ... S <br /> y+cr .-+.y` .n Dishwasher <br /> New Building .. . .. .. .. ....... .. ...... <br /> Addition ,,,,,,/ 5 t' - ,�17 Garbage Grinder . ..... . <br /> - Sanitary v Size ft. x .. ..XX. ft. Autom. Laundry ... - <br /> Alterations ...... Height .... Stories .... No. Bedrooms . ,�.. <br /> Waste Disposal . <br /> Moving ..... . <br /> Are <br /> .Wrecking . .-.... a ... .... .. .. ....... . .. .. . <br /> Septic Tank Size F � _ <br /> Mobile Home . ... .. 5. Permits Required O <br /> Privy . .2J.... .... Gallons <br /> Subdivision & <br /> Well .! .. . �" - Absorption Field Site L. <br /> Sanitary .0 • Soil Type S <br /> Subdivision . ... Building . . '� Slope ... ...__... ... . <br /> Well C/ <br /> .. .... <br /> Parc. Rate . .. ... . ... . . <br /> Other (Specify) <br /> Z. Classification Dry Well ... ... : Y <br /> Zoning Dist. Conditional Seepage Trench <br /> Land vy <br /> //�...-... <br /> 3. Lot Size 6. esc exactly, 1- Seepage Bed <br /> ' 4 <br /> ft. x .. ...... ft. tam. home, motel, etc.) FOR COMMERCIAL USE °w <br /> / r Plans Submitted . ?, 2 <br /> Plans Approved . ..... V : 'o - <br /> NOTE: A preliminarysite inspection must be made and site approval C <br /> p . I granted on all e dis- <br /> posalinvolving 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 <br /> permit will be issued. Do not purchase or install a septic tank, do any plumbing or start any :3 C <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of �^ <br /> any of the information conveyed herewith is found to exist. Changes in plans or.specifics- :a <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 /> r <br />