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HomeMy WebLinkAbout002-840-28-5505-LUP-1990-273 . � Appl ic:itioii for t.,and Cl�e l�ezmi t_. , " Courity o f Sawye?- ,, , • ,; 7'he unclersigned hereby makes ��pplication for a Land Use Permir ��sul �qree�. '� thak all work shall l�e do��e in accordanca wi�li t}ie requi.rements of the 5awyer `;, Cou�zty 7o�i.i.r�g Orclinanr.e ar�d the laws and r.eguJ.ahians of the St,ate of W.i�;<:«crsin. � PRIN`� - USE ONI�X I3LACK I.NK/CI�:NC:II> � 1 �n ,� ��,� /L .�- � C�.. �o�/C- ��SS Cr�GG�/vC`,� �`����������_����r__.._��.�..� ��.._..�.-- _ _�_ ___ �h. Qwner Sui.1c�P�___._�_.__.______._�.__. ;� �-5 �G� �� �__..__�' xs���� ___-,---__ ____.___ ____--- � � mailing address r�lil.zatg addreas � .� '�v,9��c�,� Lv � ; �.�"�� --------------_ __ � city, state, zip city, state, zip � building L:inci Use 7,one District �%��� ( I New . . -- ( ) ['illinq _._�_ � , (✓}�Addltio�� ( ) uredyi.ny Lot size ;-,�/G X ��v 7 x x o5�--- rt � ( ) niter�-►tion �p � L~ ( ) Grad3.ng ___-_ ��_ v, ii ( } Moviny on ( ) Acres _.___--__ _.____.______.._---...,----._-__-_______.__._.__---_ J t ) • t � _ _.__ _______`--._____ U New Construction ' � i size �t/w.ide 3�, �t wide ; ; �t lon9 ��' f t .l.ong ����� ___. � Floor area �j�/ sq Lt 9(o sy ft \ ' � ��� % tn Tota.l hgt ta peak /�FT to peak x � --- c� Storzes ^����___ �� �i•\I Plo, of�.beclrcUms __�;� �, rear lot lirac or waterlii�e tYear roux�d> or t��l} � . .�__.______..___.._._i � � c': 'I'y�e of bldg c�r adciition i � �, ° ( ) Dwelling � � ( ) Gazage (Z) (2) car j { � � t r. ( ) Storage building � � ' � `� ( ) E3oatl�ouse � � F t �_.......,._ _.. � �n ( j Livingroam � �*�ry '�AY i ° � � (!� Bedroom �g�pG�!`� �XIST/�l� � � � \ ( ) Kitclien-clinii�q / ; ��������~�. , � � i �' ��,��D i �N { j Porch •- enclase�l/i.00fed � � c > DE'CIC - V[��21 ; n ' ► (�3 l��C�1's�����''—'L- � ��� ; CO� ( ) � � � � �, � --- --`- _____ � - � � � � Type of construct ion � " � � -�"� ✓ i ' � L Frame { ) IIlock i � � �_ � � 'l` �•"'�� � �v t y , � I� �-�� � � tA O Loy i ) ConcreL-e � � � o '�.� i ( ? Pole � ( ) Steel � �!� . �� �' i � `� ( ) Metal ( ) � � � -- � �`�'. ' i j1. i (D Construction cosk $ c�, 70 O � ��j'� i r c� n T—`, 15'Sr�t1 \� Vol _�G'• ��''_ Pg _��J" o� deed pC3 C�J � , � ` �4� °C � csM vos. S �'q. 300 � � " �" _. _ . -- ...,.----��"'�' � i � h � �,�,,,,�,....�,.,,..r.,. y t� ,3 Cer. Scail. Tes}: �j(D - !Z4 j_ � _.�_ ...�� N -.-,--� — ___-� if f'CL�vac� -------___,_______---- o �, 5anitary Permit gCo_- ) 52 0 ' � ' — ,� z ` — _. -- Ul x Issued _2,__�_����-ly��. Deni.ec�_,_...-----------------.—_______._.__�__. q� c,_r��_rt".c��� _—___------__—-- -----__---_____.__._.... ���--��-�- � � „ , �--= � u� �i���,/��� ' ?s� ;�.�' ��i�-- - — � `�-. , �`� owner 7ani.nq ndmini ti:zZt r SAWYER COUNTY ZONING ADMINISTRATION INSPECTION REPORT o � � n - Owner C/SS , ��/�L.1��G(P ��,� Address �� 5 �GsC S -�� �^ Name of Business r� � Builder �'r,(//Lp�, � '� 4 Address Plumber Address Inspection ( ) Property ( ) Setback - lake ( ) Dwelling ( ) Setbac'�c - road ( ✓f Private O Public O Mobile Hm O Setback - 1ot line r, y Violation ( ) Garage ( ) ° £ ( ) Addition ( ) -- a ( ) Sanitary ( ) Zoning `�, o ro �v _t�f 4�( l��ryt,� Iv�� � � �d��,��� ra l � � � x i /�'� �. � o � , , � � \ rt � /� �� � C/� r � ~•� �'.: � o �i _ _ � _. ?y ' _ p- "` `� ��,. �w � � � �y�� ` a ;Z , � �.� � � � �� i �� ' 3l y., , � � �a � � �� + � Fl � � e� � � 1 / � __ � ry �� � � --I ;� � 4i 1 � � � � k b v ' / � U1 �>� � � �� �� � — �s' -�o__�'�� — ' �, `�j �C[/I�� i� 4�� L/iiea� . � W H rS n m �. r � Z Discussed with owner ( ) "° %D Discussed with buil�der �7( ) ��l Discuseed with /y�f /(� />jff`'j `�1 Date %— %c� � ��? £ Signature of officer � ��,.�J���� � N B6°15 OO�E N87°OO�OO�E CURVE DATA TABLE CURVE LENGTM OF GHORO GHORD CENTRAL M � NUMBER flA�IUS LENGTH BEARING ANGLE � � I- 2 1332.395� 85.52� N]°5519��W 3°40�42�� I- 3 1332.395 102.7fi NB°I"l�J4"W 4° 25�12•• 2-3 1332.39�� 17.25 NIO°07�SS��W 00°44�30" 4-5 1382,393� 185.77 N14°21�20��W 7°42�20�� 4-6 1382.395� 216�06� N 14°5!Ofi�W 8°57�61�� 'N 5-6 I382.395 30.3fi N IB°50 16"W I° 13�31�� � 7-B 1532.395� 194.94 Si4°0904��E 7° 17�38�� � V � W O N m O N N ' 9 OUTLDT 2 o D\ DRIVEWAY ENCROACHMENT f 4 0.14 Ap� � � IIH'�PPE SB�I�IOIC W�4B.SI EAST. DEED OZm c1^ i"AN � - - - S87°1016"W,809.99 --- 43- " �� 155.87 � 6Z93. ` + \� � i2- S . _ - _ - 634.70�'-- 6�p3/i�� �`� Q \ 10� ` o '� C� �•\�S\3 35�'�z.� I caeiN ��6+�N.� , yp' (7 °� i . � �_ \2�� — � 562 \ E.� 9 . N � �n 1 SCALE 1��=100 �9sxF�6 1.25 Acres i . �S ��' . a, = u� a ^ W MONUMENTS: � ��34' ' �� a: "' " . m. °' ^.` A SET II/4�X 30�(O.D.) IRON PIPE �O `39+ z�7°p2 30" 587°i0 i6'�W,357.4 E , N6.� "sroae� ��� ��; 1 - W H �FOUND G �, � W OUTLOT ; �Sao�SE -� ��. ��.t �_': . v. ' �8 (n <v i " �CP (N. 0.25 Acres — m yl4,P�4.N T N g BEARINGS BASED ON NORTH �J` 42� � � � � Q d'E�� `� '��j �� . � N87 IO Ifi�E,284.19 � w/�� 0.86 Acies LINE SECTION 28� T40N RBW. ` �- \ -al�- `a \REC. ROOM , �� p' g� � � ° ASSUMED TO BEAR NB��OOOO�E. ��iN:� -o', >�g a o 'S0' E,5��_- Z �n O �-,tn � CA91N � a � -O�J N79 29 (� � APRIL 6� 1978 � �N 0.72 Acres - � � � o =+ � i` ' . �`// p��� o B 549°39 2��`J 30 uai �. J �00 °W me � 11 �,� - ��� � ��,,� �/� �oy, p6°� ❑WELL 254.07 4A25 _ �O Qu. J, � � ` p � S/4 IROM %� � s -- N � �- � - N87°1016��E,461.18--- � ,\� � �- WEST,50 OEm ! `l 1�C0 Ar '�, , 100�, ,�Zha N87°4415�E 50.27 - �! V�`!��,5� r. " � o39�6E�p iV2" iaa+ PIPE T � DA I N66so�W � j � , RONALD L. ` ; o � � PETERSON ��� �S E u� 5�803 r ti I �' z �. ' HAY�';ARp �'+ � � �� 4V1S. � � .. ��.���i 0� C. . �URv�'� PAGE I OF 2 PAGES o � � a o � - � � - o � N o � 7D p n . m` o � N rn .� r � r � n m � w • C t1� � N � � � � � , w � � � � t7t � N _ � � S� w � w � v � O � � ta � � � � � U O � � �� � � � � � � � � � 0 ; � � , 0 0 , , x �� w�`o"5'^ APPLICATION FOR SANITARY PERMIT • "' � � D � � H R SAIUYER _coun�,� � (PLB 67) _ r� oea4annenToc UNIFORM SANITARY PERMil' #' N � IfIOVSTRY,LRBOR 6 HUTRfI RELRTIOfiS ��T � ` _ � � � �� O � � • 1 b —Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Y2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROP TY OWNER C�p,(��O OSS M I ING DRES r a c �' / �c, c � � ; - �3 OPE TY LOCATIO �; `, 1 VILL�CGE: '^-'1/4 I1� 1/4, , T Q, N, R �er) W TOWN OF: �.SS � � �e LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. Nl!MBER �� � � ` � •'r'S' TYPE OF BUILDING OR USE SERVED � 1 or 2 Family Number of Bedro�ms: 3 � Public (Specify� : �`(' - � ���5 THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair ��Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Altemate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepaye Bed ❑ Seepage Trench � Seepage Pit ❑ Holdiny Tank � System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total $�of Prefab. Site Steel Fiberglass Pl�stic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer. � 6�' �r1 IF THIS IS AN ALTERNATIVE SYSTEPJI COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total �'"r of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septie Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inchl: REQUIRED (Square Feetl: PROPOSED ISquare Feetl: � � Private � Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. me of Plumber (Print):� Si ture: /MPRSW No.: Phone Number: ,�' � � � �J�� ��/s� a-1— ) lu er's A dress: Name of Designer: . � C� C� '� � -- g y � ; � � .�� COUNTY/DEPARTMENT USE ONLY Sign r of Issuing Agent: Fee: Date: ❑ Disapproved ❑ Owner Given Initial y� � 5 . � 0 ] � - 1 - g 6 � Approve� Adverse Determination Reason for Disa roval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5!82) DISTRIBUTION: Original to CountV. One Copy To; Bureau of Plu�nbing, Owner, Plumber \ �...�� �� �� �� t``"� � `-�t � ` � � _��... '--�--=�- - � i 9 ` �� 1 . �---_ ' . .�.---• � , .r'" _ - � � � 1 D �' 4 �.,T.o--- , _ - � ''' 1 • -�—� �,i `Y__ __—, � ' ' ,,�. '� �, 1 � `�� ...-.----��� � �.__- - � , , i ,� � ' � � � �'���� �• � � `� ��� ,: � i , �I c �,�, _.,�;-- `�'= - �,� ' , ,J t , �'' \��,��,. � ���� ` ` , i i , ' �� � � s�� �E � '�G,1" � ' ' I / rl � ` ; � 7 t ki � � � � I �!�----� ` ' 1 a - �16:,5`� t , � � ' 1 � 1I . ` t�9, � , , '} -5� --"'�� � , , �" ,� _� �,�. '�p' �' y , '' , .., _ __--t..i'— � \ � � �, ;l . �.,+� � `'�"'��..-._... � J\„ � � ,�}t, �� f�v•��a., � �� ' r' �. � A �/ j � J � � 1 _ � ���L' � �`, ��..\\ ,, ` 1 ^ / y � ', ..r" . �\ � / � �L� `,� _ ` � ''�` `.�7`� � �j� � ^ � �^ � -- ' ,; ' .� r 4 ��' ���' +,'. ,�.__I�-� __ — .r- \ "� ,� �r� �,/ -- \ � �I � `' � ��E1k ' `_ — -- �' _ _ �" ._._..----' �- �'' -/ �= 'i �r, �� � -� �ti �'-1, �-> i � � � I ��� '�, � ti } ...--�- — _ r'. �;. G.� � ��I � ���. ' �-'' �� t � - �s.b� �,� .ti � , ,r.,�- �, ��� c���� ,i `: i �; ' ' � � ,-='_" -� � �. � _ �.. ; •, , � �`, -'/ .j � _ l-� �,` '�,` i ,�/f i � � ��t� , i , ,� .,�_- � ,,,... "V � ' � )' � _. l �'._ _. _ ...._.�..�.��.__.._._.---__._.�.__,._._.�.---------....._.__----..._.�_�__._-- � --- ---�—. t ! ,______..`._ ._._._.-____ .. �---.____.�.- � � -�_ _._._ ___---___,�.V._ �� Q r7 ' _—��—._----- �- ` l ` � ' � �' � �- -- �\"� �"=' � `� � � , , ; �1 ;�� `_ �' ti t, \ �. �: ( �. ; , , . ,` �'. , :� ��, �; .� � , .� . � � ,. . �; Plb. # 60 • 1/78 � PROJECT DETAIL DATA SHEET � � NAME GF BUSINESS � (�YyiO S �Z�SS � LEGAL DESCRIPTION��y.� CX-NL����_ S�c_ ��d'y� ��/ON� ��'(�.� � OWNER ��oJmas �a«, _ MAILING ADDRESS ��1-S� r$ • _ !Ll' �'Gr� ZIP ��-/S'� ARCHITECT, ENGINEER, ��y�4�la }�_.��r�crc�L� ADDRESS��-�, �e�c 6��9�� PLUMBER OR DESIGNER .��4 y�.)4�!o Z I P S/-16 l{3. TELEPHONE NUM6ER(�J/S� C���1F— Q,��6 l. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building _� New building _ Addition _ � Apartments and condominiums . . . . Number of bedrooms ,3 ( ) Assembly hall . . . . . . . . . . . Seating capacity ��� � Bar . . . . . . . . . . . . . . . . Seating capacity (/ � of ineals served /Y/�} ( ) Bowling alley . . . . . . . . . . . Number of lanes ( ) With bar �' ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites f Total number of sites ( ) Camps . . . . . . . . . . . . . . . ( ) Day use only fdumber of persons ( ) Day and night Number of persons ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Ci�urch . . . . . . . . . . . . . . . ( ) No kitchen Number of persons O With kitchen Number of persons ( ) Dance hall . . . . . . . . . . . . . IJumber of persons ( ) Dining hall . . . . . . . . . . . . Numt�er of ineals served daily � ( ) Doc� kennels . . . . . . . . . . . . Number of enclosures � ( ) Drive-in restaurant . . . . . . . . Inside seating capacity Car-service -- Number of car spaces ( ) Dump station . . . . . . Number of dump stations O Employees ( total of all shifts) . . Number of employees O Hotel O Motel O Cottages . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit O Medical and dental office bldas. • • Mumber of doctors, nurses, medical staff Number of office personnel Number of patients ( ) Mobile home parks . . . . . . . . . Number of sites ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . . Number of persons_ ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . . Seating capacity _ ( ) Dishwasher and/or disposal? ( ) 24-Hour service ( ) Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . . . . . . . . . . . Number of classrooms �} Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . . . . . . . . Number of cars served daily ( ) S�r�imming pool bathhouse . . . . . . fdumoer of persons _ ( ) OTHER . . . (Specifyj . . . . . . . __ _ COP1PLETF OTHER SIDE � mG ��%f , Indicate whe�her the following facilities ar•e present . . " � � . �� . Floor drain yes no � Number of drains � : Food waste gr� nder yes no Dishwasher yes no � � Automatic clothes washer yes no � Numbnr of clothes washers , 3 . Septic �tank capacity �7,�j�o Ga(_ � ' / 00 p �_ �� r 11C� C 4 � , Holding tank capaci �y � Septic or holding �ank manufacturer T� � a � �, , ti� o � ���v. � ' 4 . SEEPAGE TRENCNES : total square feet width of trenches length of trenches dept�� number of trenches � v � SEEPAGE BEDS ; to�al �quare feet � ' l �S' ___ width � L� _ � 1 ength of bed L,�� � d�p�h � � 3 ' , -�-� — SEEPAGE PITS : total square feet __ outside diameter depth below inlet �otal depth from top to bottoin of pit Signature af person cor�plet� ng form : FUR DEPAR�t��NTAL USE Oh�LY � (� � ��vCti.��e�.,<<����� .� �tiX,�.,..x Address � �- � �a�'�j � ,�x v. 9 e, Y a Z� P ��_3 Tel ephone I�u,nber �� (, � � — �!o't,� b r �dte �:.�� _�.�-- tit DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&B:JI� �ti� LABOR &HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS o�y P.O. BOX 7969 BUREAU OF PI.UMQ�= MADISON,.WI 53707 �CONVENTIONAL ❑ALTERNATIVE s�a,evia�i.o rv�m��,: z ❑Holding Tank ❑ In-Ground Pressure ❑Mound ���dss�9��� 86os�sa -S NAME OF PEqM1T HOLDER. ADDRESS OF PERMI7 HOLDER�. INSPECTION DATE � cha��� o S �-� . S �x saa� I-� wa�a �a -8 - 8.� � BENCH MARK 1Permanent efcrence pointl DESCRIBE IF DIFFERENT FROM PLAN qEf.PT.ELEV.: CST HEF PT.ELEV � � -�o o ndo�-��o r 5 W c���e r d w ac� o-� S-4r�� K�o � Na�ne ol Plumher. MPRSW Nei C�u��ty T��e San,�ary permii Numl�er. �onalc�, S rec�..e, S 33So `�aw e�- 8b-IS a 86�3� SEPTIC TANK/HOLDING TANK: MANUFACTURER LIOUIDCA7ACITV TANKWLETELEV TANKOUTLE7ELEV. �'�'�+RNINGLABEL LOCKINGCOVER � � " y PROVIDED GROVIDED' �Y-1 1`�1�.C,Y� - IOOD � g .3� CiB.Oa �YES ❑No ❑vEs �rvo BEDDING: VENT DIA. VENT A1.�T1 HI(i�1 WATEH NUMBER OF ROAD PROPERTV WELL � BUIL[IING VENi TO FRESH h �,� a�nHnt FEET FROM � uNe f � laia iv�er ❑YES ❑NO � L�YES L�NO NEAREST � ��0 �SO �8O � IO � DOSING CHAMBER: MANUFACTURFN BEDUING LIC)UI[)(:nf'.1(;I7v PUM✓M�11)EL �'U�,tPSI�'��()��'.tn,ylif.'.�.?Iii�Ei1 VlAG2NINGLABEL LOCKINGCOV�_R PROVIDEO PROVIDED ❑YES ❑NO ❑YES ❑NO UYES _JNO GALLONS PER CYCLE: aunnaarvocorvrHo�soceannorvn� NUMBER OF ""��PEFjr� �ve�� eui���iti�, vEr, roFaesN (DIFFERENCE BETWEEN FEET FROM ��NE aiA iti�ET PUMP ON AND OFF) ❑YES UNO NEAREST—� SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing f':-,�,� ,�nn,E rc�+ •.,arE H�n; nN�>,�,�K�r,c, or excavation. (lf soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: IVIUTFI LENCTH NO n� f)IS<<� VIV[SV.'.(_�r��, C(7l'F�� IhS�I)t Illf� =VITS LI�IUID BED/TRENCH � � r�+eNc��ts � ti+nrtr+ia� P�T oEPrn DIMENSIONS a. �a. �_(`(�Zw <�HAVEL n[VT�I FILL DEPTH 1)IS1{i PII'f �)iSTH PIPC DISTR PIPF MATERIAL NO I)ICi1i NUMBER OF PHOPERTv WELI BUILDING VENi TOFFESH �F��wviPFs� atsc�vEcovEa Eiry irv�f r EiEv E�vu v'�'E5 FEET FROM ��NE � 1 � AiR "�ET � u � 8 �-3 � .3S � ,.�- �v C NEAREST--► � SO �� TS � �S MOUND SYSTEM: Mound site plowed perpendicular to slope �heck the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: inound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES ❑NO SOILCOVER TexTu�aE at�+ninr�F<i ��nr:kri�s oi+sEi+vnno�tiweus C_�YES ❑NO ❑YES ❑NO UEPTH C)VER iHENCit BEO DEPTH()VFN THEN(:11 HEfI I)[P711(7F iflf'S�ItL tifll)I)f I) �FE I)f Il MULC4IEU CENTEH EDCES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WII�TH LEN(iT4{ NO.OF IATEHAL SPACIN(�� ('�Hl1VEL UEPTH HF L()W VIVf FILL DEPTH ABOI'E COVEfi BED/TRENCH rAeNc�es DIMENSIONS h1ANIFOLD PUMP MANI�f�LI7 DISTR PIPE MANIFOLD MATEf71AL Nn UIST�� L`iST�� PIPE l)15T1�IBU11nN Pi7E M4TEHIAL&A1tii�KINI� ELEv ELEv Dla ELEV PiPFS Dia ELEVATION AND � DISTRIBUTION INFORMATION "o�e srzE �+o�e svnciuc, o�:iuEo c�>i+�+eci i v covEr�n�arEwia� �EHr�c�:i ur t coaaEsvorvps To aFVAov�o ❑YES ❑NO ❑YES ❑NO COMMENTS: PE{iMANENT MARKERS. OBSEFVATION WELLS NUMBER OF PROPERTV WELL B�11�DING FEET FROM ��NE ❑YES ❑NO ❑YES ❑NO __ NEAREST— _ _ 5e� P1 v mb�erS ��o-�- pl �h �'�S-�I�e� o�s � t�a c�n � Sketch Syscem on Retain in county file for audit. RevCrse Side. - si��ra ri�a iir UILHR SBD 6710 (R.01/821 O \n���� . � �