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010-118-00-1900-LUP-1992-053 / Application for Land Use Permit X � 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 (�ORDON F. S1l�E'II2 Casimer W. Flardenaa. Jr. � Owner Builder 5333 Minnehaha Blvd. Rt. 7, Box 7780 � Mailing Address Mailing Address Fdina, NN 55424 Havward, WI 54843 City, State, Zip City, State, Zip Building Land Use Zone District B � o � ( ) New ( ) Filling n (g) Addition O Dredging Lot size ; •,' - m n ( ) Alteration ( ) Grading ( ) Moving On ( ) Acres ,%--� � ( ) ( ) � � New Construction o � DDC'[C � Size ft wide ft wide '?/� ft long ft long ,� Floor area :; ° sq ft sq ft � Total htg — to peak to peak � Stories Stories ���liiri L/'���= No. of Bedrooms �_�flr--�a--=-n� or waterline c� 0 (year round) or (seasonal) N rt Type of B1dg or Addition a o ( ) Dwelling C rr ( ) Garage (1) (2) car N, ( ) Storage Building � ( ) Boathouse � ~� 0 ( ) Livingroom � ( ) Bedroom ( ) Kitchen-Dining _ _ , ( ) Porch - enclosed/roofed ��= (X) Deck - open - f ) � 36 � � �w ( ) Fi Type of Construction E�p�pl ��. � (X) Frame O Block � r�. ( ) Log ( ) Concrete ( ) Pole ( ) Steel � � � ( ) Meta1 ( ) _ � Construction Cost $ �30�," ! a, � ,,,• � C Vo1 , Pg of deed ,� - � ; G G�-4� � T �����3 � � � w �a Co Cer. Soil Test �-���- �� g�� � � � Sanitar Permit �� ' ---- C Road ~ � `�=-- y �: 1�a ------ L --- �------ z , ° z �D z � Issued � o � �L � Z Denied � '�l�'G2�t�T�R -[l�kR1.1. {�V�R-F�C� STIf�k. �1+' �1-5-91 / �j����, ��� I � I ��,�',�.,,,. ,� .>,/2-�G�„� �.- -��—F-'I k�K�. -C�£�UT�, � 'T ,�6ew4a� Zoning Administra or ��������,8� � .$ � � � , � � 2c.a 26 �� ll' p 8 �''•e �O� lf � q6� 26't � � s N� ��� \ � � $ �� .� 6,e � �.. S / ab' '�.6{ G � ('�� 26 � �.8 s,S � � 0.8 1T U �� � 2��Q �?�'L i'1 � '�,� � A �,,� z.s �� f- �``` /O �� \ 2�. 6,t � � ^ `��.'�.\ s � 26. 1 \ � /� ':t•S 6, .0 26.p � � i�"� � ` \�� ryto .= e - 2' J �� `� 2b'9 i . 6, "i. -�L �' � S 0 Z i. 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'2c � � F A � � •26•�, N 'g` � o % ��$ /�26� �26�'.� ...�:���� ! .. \ J; .-�.9 '.$ �"'o.g .^ ei 2G. �� � ;'. m.g. w\� .� . : / �.S�u __ � g 26._ _,1 / � J1f1s �!26 a2G. � -a 2G.� a 26� � � � �WfAf� �'.,.o,g �g' �z 6.�''•8 \1��'�;�� g � ��1!jON 2 6. '1 �lr p� �'B � " W•3� i� � Q �"2� �N I�b dMl 9Z ���S���� �� � 'o� � S10� :1 � a�ens H �d�e � �1dM� �c �5.19 f �5.1 •5 I I ��I �5.12 ' . �5.16 '5.15 1J; �5.10 �5.9 /) �5.17 / �5.2 �5.8 :5.7 :2.1 �5.18 � 2 f�`�� 3 �/r `` -, � 4 :5.s \ -5.14 s l� � �5.3 6 O 1 � \ � 7 5.1 55 :54 \ � �of i �m z �, O :4.1 �3.1 � �� i i.ao ao.00 °42 � ' \ � � �4.11 / EDGE ATER BEACH � '��'� 4.3 �I /� ( SEE SHEET 2 ) � .I1.4 �\\ �4.7 .I12 �4.13 �2 :48 :4.10 �� � :4.9 / ' •4.4 •4.6 �/ .I1.3 �� V.9 P 4�3 '4.5 / SCALE: 1 INCH=4OO FEET FOR ASSESSMENT USE ONLY N� DRAWN BY:RVH DATE:7-2�-87 INTENDED TO SHOW CONCI.USI SAWYER COUNTY ZONING ADMINISTRATION � � ,1 INSP�CTION REPORT o � � n Owner Pearl E . HultQren ro m Address 10801 Wyzata Blvd II300 Minnetonka , MN 55343 n — r Name of Business � Builder G � Addre s s �°O . n � Plumber ' � Address Inspection O Property iXl Setback - lake ( ) Dwelling ( ) Setback - road (�) Private O Public O Mobile Hm O Setback - lot line r, r3 Violation ( ) Garage ( ) o 0 (x) Addition ( ) -- �a ( ) Sanitary ( ) Zoning `� � o M Volume 416 paQe 447 74 acres �, � x m w ;t�rs �o� .�J l.2 /o N o w H � � ti�-� ' _ � i�O _.����_ � .��--- ` I �� �_—�-i td � ` yI � �➢D � 't� I � �8 � I r3Z - O � � � .4� < < I I rt � cn C' G o CY rt I I / � h/[t I9rFi✓ I�CU�• ��] I i I � ' ' � � � , � j ��. £ I I � � V �l ' � j N y. �c 3 °� � � � I � '� Q� � � r�, � n � a � N � �i�� � m ;�. � a ' � � �ii� � w � � � 'r �� `� `� �" � I I , � .� ��� I� I . � N � � Q � � � � ��� � i � � � rt�cf� -mar- r/ IN � �d o G y n o � r i � Ir �' r� r � � � z Discussed with owner ( ) o °� � Discussed with builder ( ) � � Discuseed with -J� �.�; s � ;,, , w�� � oR„ jw 0 �N Jate '� .— ri'�' � ( o � Signature oi cf�icer ��{�� �� ; � DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis. Adm. Code SAWYER � � STATESANITARYPERMITq CST 88-144 114410 . � —Attach complete plans (to the county copy only)for the system, on paper not less than STATEPLAN I.D.NUMBER � 8Yz x 11 inches in size. 588-20236 —See reverse side for instructions for completing this application. PETinoN i. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. Foa vnRinNee ❑res ❑ No PROPERTY OWNER PROPERTY LOCATION c�L��E7ZY L uGTC-,2E�✓ '/a '/a, S .zG T /, N, R � �o W PROPERTY OWNEF'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAM 7��eo l+/, /SD�' ' �S�" /9 ��,o — �d e.wz /��2� CITY,STATE ZIP^.ODE PHONE NUMBER ❑ CITV : NEAREST ROAD,LAKE OR LANDMARK rio/' 4Ce /Yln • SS37Z 7/.S b3¢3io7 o vi��ncE: Z u/=r�/ o%�n K- II. TYPE OF BUILDING OR USE SERVED: � Number of Bedrooms if 1 or 2 Family ��d OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in#�� Check#2,3 or 4, if applicable) 1. a. � New b.�eplacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2 � A Sanitary Permit was previousty issued. Permit# Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. ❑Conventional b.�Alternative c. 0 Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. L'J Mound f. � IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. � See a e Bed b. ❑ See a e Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minu[es pe�inch): REQUIRED(Square Feet): PROPOSED(Square Feet): �30 ?SO ZSD �U�•O(< FeeS [&private ❑Joint ❑ Public CAPACITY VI. TANK Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xistingGallons Tanks Manufac[urer'sName Concrete Con- Steel 91ass Plastic APP Tanks Tanks sVucted Se tic Tank or Holdin Tank � S�� �.S rn USJ�r1 ❑ ❑ � Lift Pum Tank/Si hon Chamber � �j00 ' �' � � � � � VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print�: Plumber' ignature:(No S ps) MP/MPRSW No.: Business Phone Number �va�e� �SMUSJE7 3 93 8� 7iS 7�P''.33SS" Plumber's Address(Street,City,S�ate,Zip Code): N e of Designer �. o . /�o� 4 4 e.a-B��.- k1i s5'� VIII. SOIL TEST INFORMATION Ce ifiedSoilTester(CST)Name CSTq ..�Tr�//s �s�s�is ��� C5T's ADDRESS(Street,City,State.Zip Code) s��Z Phone Number /2l• / l3o�C /� �-/�G� l�z l 7/S 798=�7a¢ IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved SanitaryPermitFee Groundwa�er ate Issun entSignature(NoS�amps) �Approved ❑ Owner Given Initial Surcharge Fee AdverseDetermination $145 . �� $25 . �� 8-19-88 X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerty Plb-67)(R.03/86) DISTRIBUTION: Originai to Coun�y,One Copy To:Bureau of Plumbing,Owner,Plumber . ' . , ;` _- . F..l. � , . '• k ,`.s. . . / � �� c../E��=E,�y ��� 7�G-/z�-�/ � � � � � � 7`�lp a k./E;s T /SD � ST- /��o,e ,L r�r�, ��/, �s3 7� � ; . � .�ors /9 �,20 ,�bC�-/.c/1�r�� ��� .�u�. • � „� 7 � � 0.g�r . s�� ,�, r� �,n; R�r�/ s��.«; _ ��y���t.�,� � S � ,,,� �oo � � �,�� . .� . , a ►tiY�-,� ..��� J�lz � c, �� __�: � �i-�y , * - - � �2- �--�--99 i� ' /��oT" 0���/ � --- �9. �i ' �i�/ST!/1/G SCf'Tl'G • � �j�Ti� /�vL� p�,v�_ 99 05 , , � � � � � � �-l/Mf' �Z Kl/ -91f.�?v � ' �3 ' � D� +� �/6�/iFo�-,o ��`Z/, _ , -io%�' : /, �,i� �` � � p� Y�- ,�,�- _ - 7 0� . (�� � I�`� �j� SYS��'1 L2� _ _.._ /%o/' � � � ' � �� �� �� ., � 1 � U �� � / � D � � .� : �`. ,,. �� ; � n� Sp � : . _ Y � ��f ��� {� �C-�-4 ' / $EP7/C . . .. // \ '3 . � �, � / S%��6`. 1' 3b _ /Zt3�,aen.�� � . . J ' , ����,.� i �„ , �/ G/'i/t�� �/� /�J2�rj ' ` ' � 1 Y 1-�' � . J . / �G6 - pN ITE SEWA , YSTL�,,, b.c . . . . . / . � , � .�`� , y3� V E � � 3 P ���„ NS � � M�N � NU �,pBOR � f �—�� �� OEPAR���T Of iPdDUS?RY, `NGS pIVISIC1N 4F SAFEZY AND a �'�� � g CORRESP4NDENCE . /