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014-941-04-5206-LUP-1992-381 Application for Land Use Permit � � County of Sawyer o The undersigned hereby makes application for a Land Use Permit and � � agrees that all work shall be done in compliance with the require- o ments of the Sawyer County Zoning Ordinance and the laws and regu- M lations of the State of Wisconsin. � 1 PRINT - USE BLACK INK OR PENCIL � T. � R�c H,htP+�r°�'����P/�c��/l s e� � � Owner Builder � ��3 �9a X 3/?o �� Mailing A dress Mailing Address 1��4i�WA�v Lvi. Sy��3 Ci , State, Zip City, State, Zip Building Land Use Zone District {,}-- � r � 0 ( ) New ( ) Filling `� � ( y�Addition ( ) Dredging Lot size � n (�Alteration ( ) Grading ( ) Moving On ( ) Acres `�•$o � ( ) ( ) �nu.w� �"u} BAito tit New Construction �µ�h {��� � D�� C Size j� ft wide « �_ ft wide ��i�. � n ti - ft long �B 2�o ft long �g l�- a Floor area �Co� sq ft 2� Z/�0 sq ft ,ZSBQ �12� 1r^ � � Total htg �°-P-----= to peak _ � to peak af� � Rt c�� n Stories �. � � Stories 2n�o � No. of Bedrooms rear lot line cr waterline c� 0 (year round) or (seasonal) G rt Type of Bldg or Addition �y Q' t" ( ) Dwelling v'� �pr'. ,°-r ( ) Garage (1) (2) car r, ( ) Storage Building \ . � N I� ( ) Boathouse � ( ) Livingroom „i �� ( ) Bedroom ''�,a� ( ) Kitchen-Dining � (=�'J Porch - es�ssad/roofed � �; �w ti4� — (0�• ��C�F= 45, � r� (�_ �vc�oSED .00rzu�) 35' a n�w .� i Ty� p� of ConstYuction o u �s�'�� µ � (!� Frame ( ) Block �V ( ) Log ( ) Concrete p ��, ��`� ( ) Pole ( ) Stee1 �f ta'�N cn ( ) Metal ( ) 1` ��' ae:� v, ' � � Construction Cost $ m G�.00 �, Ip � Vol �{,'�S Pg Z�_ of deed � � �q CS Vol Pg � �o $ '� ro � w H Cer. Soi1 Test , _� a� � � � Sanitary Permit-"'�— 2�-1�2 ----------CL Road - ~ ------------ ` ._ c Tt-� T ° z z Issued (�� ���e� �44Z Denied � ( -{-� � (v � . ��v k-bwa-kr —.D�iyJ�, � � Owner " Zoning Admini tra or I 7s�r:� � ; u � / - " �Z :4.11 �'� , :3,� 4 .I.I � :3.2 :33 � � . :2,1 I LAKE ;2,2 - � :2.3 � 2.4 :2.6 � G :2.5 � � � NELSON LAKE RD. :I.I co y�y . � :6.6 :7.1 :7.8 , :7.7 :T.2 .7.3 :7.q SEE SHEET 2 :7.6 :7.5 3 , SCALE : I IN. = 400 FT. 9 �C IDOCUMEWT NO. srare BAR OF WISCON8IN—FORM 3 WA&MNTY DBSD 2 1 4 2 S 4 THIi BPACE PE9ERVED FOR qECORDIflO G11TA � - Me�71d4�Otll W � S�v.7�� Counly ' ' � .....A1.tr.ad...Litwitz..estid...Eate.Lln_.S�ir�itsr...hliebnnd... ec.��.a io� recard 16e��jy� � andwife.�----------•-------....--------•-••-------•--•-•------------------------••---------. � A n�s��L e� o'�lool --------------------•-•• ___ � -- h� � .� �---•----------•-•-•-•----•-•-------•---•-•--------•--•---------•----------------------------------...-------- ..., ,;._,;..i.:i ��� .�i. .S i -------------•--•------••-•-----------------------•-----------•---------•-•-------••--�•---------------------•-• o� fluan:Jo .>:. ;., ;r _ y_I .— 1C�[_ _ � conveys and warrante to _.R1_Chdrd..S..__.P_18AllCh_.3Ad_._...__._.....___. _��-ZZt�,_��. ..� , Vi��:Q�'.7.�_.F....PieGUCh�.._�1�?S1.�dild__a_n�7---�1-€e-'---as---•-•------- F�:�:ate� I .j oint._tentant s,__ ----•--•--•---•----•-------------------------------...----------------.. � ��---------------------------------------------------------------------------•----•-•---------•--�-------------• [Yq;b � I ---- -•--•-------------------•-------------•--••--------------•••-•-------•--•--------...---------�------_••- ----------------------••--••------......--•-•---------•------•--------•-------- I --•••-•------------------------ � - . ... . . . _ �._________�________��_________�________________ _ ___ flETIIPN TO � � . . ... ....... ... . . . . . .. . . ' the following described real eetate in ......._.._Sawyer County, �`L-2.C'�L[G� iState of WieconaIn: TazKey No. --••......................----..._... The South 125 feet of the North 500 feet of (3overnment Lot Two (2) Lying East of County Trunk Highway "T" , Section Four (4) , Township Forty-one (41) North, Range Nine (9) West. Subject of exceptions, reservations and easements as appear of record. TRANSFF�R � $ 7��`� li i ���' ' � This ............................ homestead property. (ie) (ie not) � Exception to warranties: Dated thie -----------------5�.�.4{L------------. a8y or ----��---------Ma�'--------•------•- ----------------� 19.89 . ---------------------••....------•-•-------•------............---•-(3EAL) _----•(-C.�`��'_`' ` _ _ �1 �i�' A 1 ----• --- • -•--------.....----••--- •------(SE L � --��------•-�-------------------------•---�----•-•----•--•----- • .A_lfred_.Litwit -•-- - . . �J �/ -- - - -•--------------- ...--��---�------•-••-•---•-------------•---•----------------------(SEAL) -•----��� k"_'=" 4•- ---••-•-•---•----.(SEAL) . ..--- -•--------•---•• - � �•--•--••-•••-•---•••...--•--••--....••---••-•-•---••----......._ . Estelle Litwitz ....... •-•----•---.......-•-_-_-•-•.... .. .................••- AUTHENTICATION ACHNOWLED6MENT Signeturee authenticsted thie ..._.._._._...._. day of 31'A1'E OF �YISCONSIN '-"""'....."-_""...-'-"'••'-"'-""""� 19_"'-" � Sa er es. •----••----.�^'X.----•---•----•----County. i ....----`�--'-••----�•----•-'-•--'--•----•-----•-'-----------------------• A � � Pereonally came befora me, thia _.�i.............day at � - - - ----••---- - - -- � -••••------Ma-Y....19$9.--•---•------------- the above named • - - --•--�- - � -�---- -��----�------ -----• T1TLE: b1EMBER STATE BAR OF WISCONS[N --..�1�.�X�C�._.Ta1�W�.�Z...dIIC]..ES_�,B_Llt3.......,._.. (If not� ._.............."-'-"'---•--'-----. Ltlt�ltZ---.....----�----•--------•------------- '- "'...""""."'." "'... -•.-- O`: i�uthorized by § 706.08, Wie. State.) ,cy ,,,ar,;�-,, "•-"' ' • ' -"-"'•"--•""-"-'•"'••'-"•-"'-"-' • ' ""--'_•-:•,�"'J•'-""• � :;� .7 ., TH18 IN9TRVMENT WA8 DRAFTED BY ""'"�"'-'"'""""-""""""'""'"""-""-'"""-""""""'-" r . T'�"'_'"�"".'"""`'' ','�•I � to me known to be the pereon _S_._..._._ whp�ez�te� tNe � � ' ,__.__,.__Este_�,�2..LltWltz.,__, foregoing inetrument end ecknowledge the gLm :;; � I � � � - �; • ; , � -""' "• ""-""."'-•"•"'-""•-"""••"'•"-"-•"X�,.,.;�•-" ,i ."""-"_..........."-•'-......."_'. " .. , 4" , - �------�--� -- -------�---- • -- � � - - � •., .......•� � - -� ---- ��.�NJ���v�,��y,. .'r , ' . i (Signntures may be nuthenticeted or acknowledged. Both Notary Public ..._...$dFi�GL'___._____.. '• V are not necessarc.) ify Commission ie --� � Couifty;Wie. � permanent. (If not, etate ex iretion 'VOL 4 3 � p�a`2 81 .'� - - .-'-".'-"'-.....-'-.'--"-"-'-"' , 19�0_.1 i I N�mee o[ ner�om ei¢nlna In �n>' e�p�dtY �hoWd be t ----- -�—_-- ---- i� yDeJ ur printed Lcluw Qie1r �I¢n�tureu. -- i WARRANTY DF.FD � ,..n�•rt nnn .... ....�.�...�..,.. �- , APPLICATION FOA SAWYER COUNTY . � ; �SkNIY'ARY PEHI�-.IT O AppZication # .�;J'� � Date l�- '! � jr � � � . , i : Fee of $Z0. 00 received ��� ; �,-.;,;; t ( ,�;`t �� ''�i.�ft/ '�` NDate l / County Cler � Application is hereB� made for a Sawyer Count` '�,Santitary � Permit for woric to b,e done on the premiaea descm)b�:d herein. 1 � • ' � O�v er e TeZephone The o f the See. � Twn. �/� R. � _ =j� (rr ri o r Lot _� BZocY, Sub-division �✓or con•� r�p a��— i r f f �`c.J Number of Bedrooma �_ Number of' Bathrooms _�_ Dishr�¢sher _ .�rb,_ Gar"Lage Grinder a ��� Automatic W¢sher ��� SoiZ Deseription =.'� _ � Sep tic T¢nk Size Ur� gal, Seepage Pit ezght � Piameter Seepage Trenen Lengt� , lJidth �Depth , Septic Tank Permit ;�_ �/:% ' y - `r 4 �— Percolation Test Form PLB 43 attaehed ,/ �es No , ContempZated. completion date Applicatyon A�pproved�, Per�ri't # � �� �(� `"'� � �. , � sanitarian ��.:.,' , f`v, � ,_, , - 1N � • / , .. ��- � f „ 1 Omner Agent IJo; a ve Date . . � .,.� ir � ;, .;•. � . Remarks • � ' . t'->':'. �.33i;i �-0 bitA �.. _:^; L�t;::.,._' :,qi�::: Cr.� ..-.�:':i :'�:>":LjI': i��tt^ i81- _ .,. _ . , . .. o\� _.,. . n:J'..., _ . ... .. . _ .. . _ . . ,.c .�n c:.ii i c'. 1,` .c5�. ^.ftS � a 1�9 � �• ?P� .+S3 � ,�n3'S �.1ItA . i � SiS � � D I� rr� a Firiat Inspect�on - ' °�' '°&., _ Sani'tax�zarin ��. i', i x � �. , �,,� _ .i':ii .� ,. i ., . . .. - . , . ��- i , Ou�tter/.Sgent lVotiftied (Date) Remarks ' _ �-� --" ;r t .s •� -� G'a�� .l.l �-- v., �� . 1� t 1 °� r� � �.., � � �__ �\�� . . . ... � .`, ,� . \.� ...; . \�'�`�'•. �` ""* Se»d ori,g;;n¢Z- and three Gopies urith . *�* : \ fee of $Z0. 00 to County Clerk �� ` .T — ;� � � . .. . � ' - . _ : _ _ � : V**• . � ., .y � � . - � . ,i�7to �,�.. 7 . . ,�1 ..?. _ .. ..)n ;1:, . . . ` - - � , .,.., l '.. �J.� . . � � . . •� ' � - - - r• ..,. .. _. .. .�.: ._ ',,. _.._._. _ ..�.-��,.. �� . _....:-. r::' i `" � - ',k'( �J : ._ . . . ,: n," i _ � „w�' - . ` ` 'O , ^ � � � � � , ' �� � , f , � _- _ i � . . � I _ . . . . . . � . . '.f. .'. �( . . I . . , . ._. _.._ . __ � . ;:� . . � � . ` ,.. . . '„ -- . . .. _' ' ._ . _ .. . ,.. ..,.._ .. __ . .. ...;.-. ..:.. ..... . "; __ _^'. ` •� , � �r .. . . .. .. •A � r. i��' �. _ _ , � � ; y i _ __ � ; } � � _ _ , ; y� �s� i � � : a _ ! . Indicate Lot size and shape, Zocation of dwelling (D) , septic tank (ST), septic field <SF) or seepuge pit {SP) and dzstance of any portion of septic syatem from duielling, :.�eZl and property Zine. If property Zies within 50 feet of a Zake, river or a str�am so indicate and show distance therefrom. �sy ' Tf any portion o,f_ tJ�e, contemplated -eonstruction w�GZZ Zie within 25 feet of d�ellirig, weZ'Z; 'septic tank, aeptic fieZd or seepage " pit of abbutting owner so indicate. _ ______ _ _ . __ _. _ _ _ ._ __ __ T;te undersigned agrees that aZZ mork performed and equipment inetaZ,Zed._8ha.�l�,b�_.in..aceordance-wi-tk-the-Sanitary--Corle-�of Sa�yer >�� ,.,� County and all applicable laws and regulations of t;ze, t.a; e o f; ro. �., �"',. . �. 3 f;',: Wisoonain and recommendations. of the Sar�ver County Sanztariign.,�,p. _ ,_ _ . _ __ _ __. __. __ ._ _ -- --.__ _ .. _ ' ., i i .�^� a.: , :; : ` _ _ ' _ ' ,..,; � �`,,^� . ..__._., � ., +,,,�._ _. ,. = t} e . � -- `�i""r 6!lsQ3?��� t" � " . . .. � :'_: �_. . . � , � � — •'- . �� \ t 1 ������ �. �j � ,.. � J . ktk . fta v(: g.^ �(�f '� .,._ J `. S��'C . . � // "r�" . 7 � :,'1 : P .. .aJ lY�,: : .,'� . �1�\ ,;1 S'},• � . . a �. . .:i. 'Yh. . �. . . . . . . ±t` . ... .� . � . . . � . _ - . . ' . � -- 1fLoon�ia D�y�rtsaat of Hewlth and Saoial S�rvloas Plb, {W7 ,3/70 Dlvltion of Health � . • SEPTIC TANK PERMIT APPLICATION ' 7YPL or USE BWCK IMC - ►. qNNER Op PROpiRTY . � -��� Addnss (Stn�t, City� Z1p Cod�) B. LOCATIOH OF PAOPERTY 17H5NC SYSTQI HILL Bfi CON57RUCTED ALTERED OR fiXTE}IDED �p��y Chaok Onst � CITY YILI.ACE LCGAL DESCRIPTION � . x.. �TOWNSH � � . . �C. IS LOCAL PERMTT REQUIRED FOR THIS WORK? �ES NO ���r,n� PERCiIT NUMB&R D. � SEPTIC TANiC CAPACITY Q/�n _ Gallons � NE17 INSTALLATION �RbPWCPMENT ADOITION . MATERIALS� preta6 Aonorete � Poured in Plac� _ Steel Other . ... NUIIDER OI� TANKS��.TO BE WSTALLEDs � � . —. .. :. ,—�. . .. �E. TYPE OF OCCUPANCY �.. . . .. ��.,.�. �. .,.• ..'. � �. . � Cheok Onee� tr�e or 'M�o Fe+ni�y Reaidenee ��� Coe�ercial _ Iaduatriel _ Oth�r Spsaify Number of Pernona to be Aoeo�odetad � N�ber of Bedrooms �_ . -� F. APPLIAlFCES� ETC= Food Haat� Grinder YES � AutomatSe Clothee-Neaher Y}S_�NO Diahwasher �_ Y65 .�/NO Automatio Potato Po�laT _ YES_j�NO . Other (Speoify) � � . . � G. MASTTR PLUMBER MAKII7G INSTALLATFON�. . . . . . . � Names�� i ����,u�,,e,,,, Addreest ����� Lioenes Number� , .` �'� , . ���- - . � � t!� _�7��� Signatur��of Appllo .' �}_�y�,���z ��� Kp qy}r . . /�✓ � �ddnsa� Q.(-�-C_ , �/-�.G�c . . , . H. . (To 5e Completed by Issuing Agent) v G� � Uats o1 Appliaation � '� � � �/ Fee Paid��= � Permit Iawed (,ata) � j� ... �� j pet�it N�beC � /% 2r r agent �(17me) i�,��.^.-�_.'����eaf.'�,T'=-^�.Q k\ Forf �r . � ,� � Toxn Y1 ls e Count etc. �,�<, V (� i 6 , Y� Y, � a'rJ✓.-,- �1c1'N�Y�-l��i�.�7 �l/Ylf.,��,t:�,��'�. . . , (S a1tY) Notet The�plioatio�, oennot bs ooneiderad for fiiing until all of ths sbove queations are ansnered and ths . , � fe� paid. Agea'�a xill forn�ard appiloatioa, tha fee of =1.OU for �aeh septio tafuc and t6e inlyd oopy . � ot th� permit (osnary) to ttu Division ot Henith. Chsoka md noney orders should b� rd� p�yyabl� to � . th� DSvielon ot Neaath, � . . . � - . .. , � � . . Do not'writ� Sn�dpaos below - FOR D6PlRTlIBNT US6 ONLY� �. � � �. � � .�� I. DATE RSCEIVID � . . . ��� AIICEPTED BY � � �. . � R��m � � � ' � � � � (7nitials� � (Date) _ See. Correa. �, FEE RECEIVFD .. ... . . � YALID. No. . ' P6RHIT N0. � �� s . . as or No � . . .. � REVIYMC� BY � APPROYm � DAT[ � ��" (Snitlals)� ��- Y�s o� No � . conrr.e�rc m�a sme , II • ` � ' . SSPTIC 7AHK PLRHPf N0. , . � R i P 0 R 2 0 N S 0 2 L P i A C 0 L � T I O N ? t S 4 � { ' � ♦ M D S 0 I L H 0 A I M G S � ?� I DIYISIOI OF H6AL7H � PLUSBINO 9LCPFEM � � P.O.Hox 309� 2lediaop� A1a. 5l701 � � Pureuant W H 62.20� A1�. A�Loisirativ� Code . � . � P i R C 0 L A T P 0 N T T S T � . � 7eat D�pth Chnraot�r oP So11 �Hours Nat�r Test ifu� Dro in Sister Level Inohes utas i N�mOar Imhss 7hiolmaes in Inohsa Sinea Hola Sn Hol� Eat�1va1 Second So Next to Laat o Fsll � lst Viatted Wsrni Sn HSautes Laat P�r1od fesat Pariod perlod Qir Inah '��, t:xveple '. i�� �� 0 36�� To Soil 10• C 26�� 25 Y�a or No 30 1 2 1 2 1 2 60 . _._ � :r . :/ q n v f,i n y� ' � �- , - < �o - U 7 - �o a 5.�,� '— �/a' '= �:,� � "- 30 =� �v 7 "- �a '-'� S.�-�- '; � �i ., . ,�_ � � ,i ,9w i, H � � 3 � = '�, / / ?o - /d 7 - /� 7-/� 5.,�.� � . RECORD DATA FP�1 MINIMUM OP 3 TESS NOLES �tt aput� siz� ot absorption ana in aaaord xith H 62,20 Ris. 1�inistrative Code. � c 5 0 I L B 0 R I N G S - llSn3mum 36^ Below Pro oaed Abso LSon 5 at�s f doring Total D�pLb De h Lo. Grouad Nnt�r Ds th to B�drook i M�ber Inohn � Observ�d IsSimat�d Observad &etimsL�d Chsraatar ot Soil with Thiolv�eac in Inohaa , Bmeple B - 0 72^ 72^ IU- Blaok po 5011 12" C 18�� Ssnd 18^• 61'avel 24�� (�[j :i � n � . /�!/ 1 O / U. � c� ' 2 r �c ��- ' r � U� (�, � 9� " �� � ,, �y" � ;7�;; 3 72`' /c � " i�'' S.�.`� . � � RECOAD D � FROM NINIIf1Ei OF 3 BORS OLES YP6 OP OCCUPANCYt � � '. RESZ�6NC6t N�nbat of Bedroams • � 07'HERi (Speoity) Number of P�reonn S ��. D NAST6 GRIND6Rt Yes __ No // Diatnrastwr� Yas _ No !/�uLoaa{So Clotkue ifaaher: Yes `_ No // F7U.fENT DISPOSAL 5Y57EMe t7EH � EXTCNSION �_ ADDIPION i� REPIdCQiEl7T �� Tile Size i �� No.Lin.Faet �renoh lfidth 3�--n.ocn� 36 � Number of LSaes � � � Ssepag� B�d� Length Width Depth TiU Siae ��No. Liaes �i, Se�pag� piit Inaid� Diaaeter Liquid D�pth . � i i � i I� tha u��r�ig�ed� heevDy esrtify that the pereolatiop `ests r�ported on Chit foss �ar� maE� bq sa �or under qy �upeP- �� � vi�ion in a000rd xith the proo�dur�s and uethod�apsoifled in Chaytse H 62,20 (13)� llisoowin Ad�lnUtntl�� Cod�� sad - '� tffit th� data noorded and 1y tloo ot test holes ars oornot to the beaL of � Imowledge�nd belid. � �'� NAME _����/'J �/�,f��f��' TITIl ./' Gt.H 6�j� � I', - Typs or�Print� - � REGISTAARIO � or [SASTER PLIRiBEA LICEHSY N0, . � � . � ADDRE55 - �C-i� i � � � DATE � � SIGNATORS � i