006-439-04-2307-LUP-1992-307 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.
PRINT - USE BLACK INK OR PENCIL
,.,� J.
L•
��,`e1z�� � Own�
�Fier � Builder
i lA�.GJ +� 11'1.(7'�J
ailing Address Mailing Address
�� �,�, J��
City, SEatJ e,�yZi�p�' City, State, Zip
Ruildine Land Use Zone District ��-� r o
( ) New ( ) Filling n �
(x) Addition O Dredging Lot size q���yr �a^K�oo� v� .�t
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres �k ��
( ) ( )
New Construction
L,�,n9r��„M
, k�� Size �6 ft wide c� / �v ft wide
'(G �ti'`�1.
_�,� ft long �� ft long C�
,��tU.,�Floor area ��SD sq ft 5 Z. sq ft �
m
Total htg t Z � to peak i z-' to peak �
Stories � �_ Stories
�
No. of Bedrooms rear lot line or waterline u�
--�, o
(year round) o� (seas,�1� L,. 1/� ��-2� W �, rt
Type of Bldj o Addition a o
( ) Dwelling e• ,-r
( ) Garage (1) (2) car
( ) Storage Building � I
( ) Boathouse �S o
(✓J Livingroom �
(VJ" sedroom ���+�{�- ��sT��j a��p$eJ �
( ) Kitchen-Dining � �
( ) Porch - enclosed/roofed ' o�N T'� �-
( ) Deck - open `' ��'�
r\
� � � •V C�` r� Q �'\ �
�� '� v �
Type of Construction � `��, ��f' \ G��� � I_
(y' F r a m e ( ) B l o c k � � f �.
( ) Log ( ) Concrete ( M, �'
( ) Pole ( ) Steel \ ' �y__ �-------_ � �
( ) Metal ( ) I �--- 1-rl�y_4�nc: � �
t5f. � � ' �
COriStTllCtlOn CoSt $ �r;�-,p 1
9` �
yol �;� Pg �;l� nf deed �, -�
CS Vol Pg Ib '�
� �
Cer. Soil Test 2�1C� 1l \` �
Sanitary Permit ��_g_-_("7 Z ----------CL Ro
--���-�'�N�- ~ �
z
0
• z
�
Issued �j( �,LC-� l�2_ Denied �� �
�
� ✓• �a�t �- 61n�� -�D�` 1t� IE
er Zoning Admin st ator
ii
�� �
�i noci�M�r�1 ri��. WARRANTY DEED ����g sr�c:e nts�nvco FOA n�coeo�r�c OA7A
iI S'CATE BAIt OF' WISCONSIN FURl11 2— 1982
n
�! � �i �) 1� J �
,� �� .
;� !{�pi�.r�O�a� l � ,
„ L�w��r f
,I ��f
SUSAN R. RR[3DGSON, a/k/a SUSAN R. SWANSON, �' •�d oc r�oord tb� `� c��i ,
.. _.. .. _....__ _ .......... ..... ....... .... . . . . � ,
�; AD19 el ,�o'� �
.... . ... .. ..._ ..........---.....----•-••-�-•- --�-••--�--
....._ ........................ ... M �d z�c�oidad ia�d.
•�I ._
. ......... .._ _................. .-�--........ ._.................--- --.._... ....... ..._
I o1 I�i�oordr ao puqa
_. _ .._._ _ ...............•--........._.._........_.. .
�•onvc��s tu��i wan•r,�nls to .. RJCIfARD J. rNGLGR and BET1'Y L. � , �yzc,s � �
_......._ .._. . ........... ..... . . ... . •- ....... ......
�ENGLER, husband and wi.fe, as survivorship marital � Ro�fir
.proper.tY.,.. .............. .. . �
....... .. .... .................... ..... .. ...••.....................__.. ....---..... _...
.. .. ..... ... ............""'............._.....�...._........_._..........................."' "" fvElU11N ro
_.. _ . .... ................... .... ....................... .................. ...
IWisconsin Town & Country ;
...
. . _. ....................... ... . ...._..................._..........._....... . � Realty, Winter, WI 54896 ;I
lhc f��llnwin�; describc�l re:�l eslaLe in ...... .......Saw.y.sr......................County, �
�t:ilc of Wisconsin:
Tux Fnrcel No: .._...•--••••---•••-••--......
Part of tl�e Souti�west Quarter of tlie Northwest Quarter ( SW- 1/9 of
. the NW- 1 /4 ) oE Section P'our ( 4 ) , Township Thirty-nine ( 39 ) Nortl� ,
Range Four ( 4 ) We�'� , Sawyer County , Wisconsin , described as Eol-
lows : Beginning at a point 650 feet �ast and 800 feet Nortl� of •
tl�e West Quarter Corner ; thence East 202 feet to the Brunet
Flowage ; tt�ence Notth along the flowage 400 feet ; ti�ence West and
parallel witl� the quarter line , 166 feet ; thence South 90° 400
Eeet to the point oE beginning .
Tf�N3���
� �.�.� `°.
, �� �
, �
1'liis is not- •---...... ►�ofncstead prorerty.
.............. .
Q� (is noL)
I;xce��linu ��� t��:u•�•nni.ies: easements, reservations and restrictions of record.
lls�lcd this .. 6th d�y o[ ..June 19. 92 .
_...__ .............. ... . ....... .. ..... .... ...-- ...... _.. ,
,1
!'....-- ... ....................(SEAI,) .:..... ... ..U!���-' l� J(.J Qti4�� .......(SCAI.)
... . . .. ...�-�� - � -- �-- .....
,
, + Susan R. Bredesen, a/k/a Susan R. Swansot
.........---�- � �-----� ----�-------- -�-�--�----��-�----...--- . .................................................... . ........
��u����������������������������Vw. 1.)
_ . .. .. .. ..... . ........_. ......_............--�--.....(SEAI.� . .._ . ..... .. . �._ ..�OF�IeIAt� SEAC»_ ��'
r . . ._ _ ._. �... �- -. .. . . � . ... . � WENDY J.HALL `
+ �� IVotary Public, Stat�of Illinois �
My Commis�ion Exp(res 11/13/93 �
A C K`N O W�����'�'�'�� �
• AUTIiENTICATION ��q���
Signnture(s) ------•�---------------•--•--•----...--••-----•---•-----•••• STATE OF-iYf:�(.'(}ti9MF- I��
.._._----•--••--••-•---••-------•-------------••--•-•----•----•••--...---..._.__ �
ss.
� 1/?.L/ J�,G�(`p�'—'count,•.
- - ----------- -�-y--���.---�-- �� �
nutl�enticated this .---.__day of-•---•••-•--•-•--...-•----, lg.-••-- Pei•sonall • camc beforc me this .. •------_--. a�• of
••-•-•-.Jllllf:_..........-••----••--•---� 1J.9.2---• the abovc named
-•......___---•--•••-•-•-----•-••--••--••-•--•----•-••--...--•••--- ------------
...---S.us_an...�....flr.ede_s_on�...a/.k✓..a---S.usan.�t.._......_
'_..-�--•----••-••-•-•--•• ----••--�-•---.....---•--••--•-•----- ---•-....._._. --••••--S.l�an.S.o.n_-••--•--•---••---•----- •
TITL1:: MED'i13ER STATE I3AR Oi' WISCONSIN � � � � � ��--"'�'-"�""'
, ..................••--- ...••••••-•-•-•••-•---•-•-•--•---------------...._......
(If not, ..•-•---•---••-----•---•••----•-•----•-••-----•-•--
nutliorized b .........•••---•-••...........................................
y § �oc.oc, w;s. st�ts.� .- .. ....-� --
to nie kno�+�n to be the �ierson ._.___._._._ �vho executed the
forc�oinfi instrwuct�t �nd �cl<►►otvledgc lhc sa�ue.
T1115 tNSTRUMENT WAS DRAFTFD OY �,� J � A 4
Curtiss N: Lein, nttor.ney at Law -•••-F/`�����._ .... y �/�..�
P• - - - • • - - - - •--------------•- -----�-�----•.............. r � Z y� �'!-�/....
. O. Box 76 1 , Ila ward WI 548 - �-.-� ��!�-- �����'�/"�' �
Y , 43 .._ �-� _
•-- --••---•---�-•-----------�-----••------
, 1 .... -
--- ------•--�-------•--------...- Notnry Public ..�U/.l71.�. .
(Si�nntures ►nay Uc nuthenticnted or nckno�vledE�ed. I3oth - --- - cOUj�t!•;�S.IL
n1}• Commission is per�ii���iciit.(I ��ot, st:ilc e��iiration
nre �iot �ieceSsary.) �
clnte: ...1/.—��.T_. .�..
. .•--........_..._., 1�J..._.....)
_ - -- ___.. _
_ hh_ -- - - - -
•Nnmca n( peraonn ei�ninR in nnv rolrnritY hhuuld r � . ._ _. -- ----. . . .. . - --_._-.
.6/'?+.ur��i�i IQ'�Ina• �iR�Mu� Q .. — .
lJ�l v v
WARfIANTY DL:I411 ,;.i..�.�.�: ��.� ,... ....__.
TOWN 0 F .
S EC. 4 TWP. 3 9 N•
��
��.�� �
6.f 1 � 0
� 1
f �--' � �
� ,5.1 .2.4
.6.1 `�s I/ � � I
�.51r _� L �
� �'��i--�'�"�� m .2.3
, \
` .68 .(o•w t l l04 I � y .�---
5
• ' ,G.l, I � I _2.I
�v''S , 1'q .7 ��� _ _ _ _ (
(0•2 �� — v�..,\ �
7.5 1 �� 8.2 Z— • I
� '
o - �r�� � ,' .B.T � o M �
} S �
� -r.i T.t �� �� ` � .s� I `� ,
� f� �y'� `��� 89 � t `
,.4 � � f
, 7
,"o LORETTA�� '3
7.2 >I � 4.� �
(� `l �o �n M
,r & I
r.s �`��fr-�LAKE �� " �
' .T.11 `' — $•I M
s O Z8 1 � \` 8• I
u �s q W
. � .7.4 �r,�_ .— — ��
ios , � )
,0.4 �,,� 1
IP2 y /��./I �7 �/
�� jr' f/
io•b
,o.z
`� ��� If
�o.i ► `l.�
,0.8 �-
�j� f�" I �P�O i/
�� � �'�
��3 � )� -��
, f, �-�
� �J�
uN�r R�YFR / � �,1��--��
� �U�
`
��.2
FL ;
�
.n.i I 2.t
I '
I
� DILHR SANITARY PERMIT APPLICATION
_ In accord with ILHR 83.05,Wis. Adm. Code couNTv
— SAWYER `
CST SZ—IOO STATESANITARYPERMIT�
-Attach complete plans(to the county copy only)for the system, on paper not less than 124 0 63 �
8'fxllinchesinsize. ❑ Checkifrevisiontopreviousapplication �
�ee reverse side for instructions for completing this application. srnrE a�nN i.o.NuhteeR
I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION �/
Grl.e Cu.ers L�� Y<iUul'/a, S � T , N, R / E (or) W
PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK#
�� �
CIN,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
/ � �
II. TYPE OF BUILDING: (Check one CITY NEAREST ROAD
1 ❑ State Owned ❑ VILLAGE �P
❑ Public Q1or2Fam. Dwelling—#ofbedrooms � PARCELTAXNUMBER(S
III. BUILDINGUSE: (Ifbuildingtypeispublic,checkallthatapply) 006-439-04-2307
1 ❑ ApUCondo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreationai Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. � New 2. ❑ Replacement 3. ❑ Replacement of 4. IJ Reconnection of 5.� Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit# — Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 � Seepage Bed 21 ❑ Mound 30 ❑ SpecifyType 41 ❑ HoldingTank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 � PitPrivy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. AB�^ORPTION SYSTEM INFORMATION:
1.GALLONS PER DAY Q.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FIN,aL GRADE
REQUIRED(sq.ft.) PROcPOSED(sq.ft.) (Gals/day/sq.tt.) (Min./inch) �,j ELEVATION
L�� / ��P / ,�Feet Feet
VII. TANK CAPACITY Site
in allons Total #ot Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel 91ass Plastic APP
Tanks Tanks structed
Sa ticTenkorHoldin Tank 000 � �'
LittPum Tank/Si honChamber
VIII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's SignatuLe:(/No Sytamps) MP/MPR� Business Phone Number.
OiU O � /xL`712
Plumber's Address treet,Ci ,State,Zip Code): .
-� J/ / / I .� ���
X. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee pncivaes Grou�dwacer a e ssue Is 'n Agent Signature(No Stamps)
�Approved ❑ Owner Given Ini�ial Surcherge Fee)
AdverseDeterminetion $115 . �0 0-9-89
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-639B(formerly PIbE7)(fl.71/88) DISTRIBUTION: Original to Counry,One Copy To:Salety&Buildings Division,Owner,Plumber
�, Y' l � �'t C v �C. r s o .t/ ��s a 7 �{1 -2 f—i�n�,.✓ ��elO r`T L.C�� � � 3�l� ,
—�'t.J -�/GcJ /Sec y /l y�r/ //`� X cc� — � 1rR � e �- — S-a w .y-� 1�
� y � d�Vn '� c� l }tovh � su �.1 � � Co °j �D /3 /�1
L�/`c� C o r � r'�-� _----
----------� _'�-----�i/
--�_-
� �_—�_ __--�_--L__ _
-��_..__�-
I
J
�s
I
�
�
S. � /�Xs�' �
I
;
,
3 - 8 a b � ; �o o � �,�'',
_ 30 �/vm.� ��� 9° ,t ' � '��
•� '
i
I
.
0
8
�
�
00 ' '�
�
L `i-� L-4 ilJ Z �