Laserfiche WebLink
y - y <br /> d y z <br /> Burnett County Office of Zoning Administrator 5" 0 <br /> 0 <br /> APPLICATION FOR SANITARY — LAND USE — BUILDING PERMIT �" u', „ <br /> 1J <br /> To the Zoning Administrator: The undersigned hereby makes application for c� <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 <br /> Sanitation Code, and with all other applicable County Ordinances and the laws and regu- '� E <br /> lations of the State of Wiopsin. y <br /> . .t.la.rr e/./..P6:71. ./-.-, ,O 17 \ts,, , <br /> O er or Ag• .t (please print) Contractor or Surveyor 0 <br /> IN <br /> -/-/ 'Fik/9T.f} IA 4,43 <br /> Address J rse7Z 5 r Ad tress ) <br /> Phone Phone <br /> C <br /> Plumber Well Driller ' <br /> 0 <br /> Address Address a <br /> o \ <br /> Phone PhoneIt'e. 47-122/1— J <br /> DESCRIPTION 4. Building Details 7. Sanitafy Facilities <br /> 1. Work (check one) Type/9f ConstructioniopNo. Bathrooms Vl ' <br /> New Building .. )1/27f . • Dishwasher �* \ <br /> Addition �,C- Garbage Grinder • <br /> Sanitary Size / ft. x ft. Autom. Laundry .. <br /> Alterations Height No. Bedrooms <br /> Stories . ... Waste Disposal <br /> Moving Area System <br /> Wrecking Septic Tank Size <br /> Mobile Home 5. Permits Required re' <br /> Privy Subdivision <br /> Absorption Field Site <br /> Well Sanitary Soil Type a c � n <br /> Subdivision Building Slope 8•0 <br /> Well <br /> Q�i <br /> Perc. Rate o <br /> 2. Classification (Specify) Dry Well <br /> Zoning Dist. Conditional Seepage Trench e 0.1 <br /> v <br /> Land Privy ext " <br /> 3. Lot Size 6. Use (describe exactly, 1- Seepage Bed e <br /> fam. home, motel, etc.) FOR COMMERCIAL USE i <br /> ft. x ft. - Plans Submitted `• y N) <br /> � �C�e � ,. - Plans Approved C 'd 0 <br /> NOTE: A preliminary site inspection must be made and site approval granted on all strut- "'0 <br /> tures involving sanitary facilities before construction can begin. In the case of sewerage dis- J <br /> posal systems, a copy of the percolation test must be attached to this application before a —0 V <br /> permit will be issued. Do not purchase or install a septic tank, do any plumbing or start any ea <br /> building until a permit has been issued. A permit may be revoked if misrepresentation of 0 <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 />