010-941-25-2223-LUP-1991-152 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- �
lations of the State of Wisconsin. 1�
PRINT - USE BLACK INK OR PENCIL �
��i��� � ��
�A2� S. � C.JaN M ,�n�+o�9�= L�R�'� c'�L Cs.tis�R;r.v���.� � v 1
Own Builder
�Q, ��.�X �5�
Mailing Address Mailing Address
��Y�v�2)�, �.1.i: 5��3�F3 ttA�[�q2�� , i,-�S 51��`�3
City, State, ip City, State, ip
Building Land Use Zone District �-) o �
( ) New ( ) Filling � � �'
(� Addition ( ) Dredging Lot size �`�" � 33� � �
� n
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres ��Sj
( ) ( )
New Construction
r�_.
Size ��O ft wide ft wide
t
�� ft long ft long �
Floor area �U sq ft sq ft 1
' �
Total htg a� to peak to peak x �
�
Stories �(�� Stories
No. of Bedrooms -- — rear lot line or ,sr��; o
(year round) or C�.r�rsar�a-1) �-� G ,-�r
Type of Bldg or Addition oZ�J� a' r
( ) Dwelling a o
C rt
( ) Garage (1) (2) car N.
( ) Storage Building �'
r•
( ) Boathouse f n 1� o
( ) Livingroom ��a ia' M � �
(�Bedroom�tj r
( ) Kitchen-Dining (
( ) Porch - enclosed/roofed � 15 � � �-
( ) Deck - open � ��� .� ,A r�
� ) I o �� r5
� �. l(ryM '�t,��•y CsAA+�1Q� � � �'
lD 7
Type of Construction _ �-1�', :f- � r � � Vy �
�) Frame O Block M � � � ' r�
) Log ( ) Concrete �'^ 85 3° 8s � SU
( ) Po1e ( ) Steel ` �' � �
( ) Meta1 ( ) � �
Construction Cost $ 3�,va v �
Vol �`�7 Pg �_ of deed �`� � b'\
�57� z
CS Vol S Pg 39g r� � �
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Cer. Soil Test 7g-�� ��� �
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Sanitary Permit 78-�� ----------CL Road --`------------ z
C/�.5� �"��^'j ° z
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Issued 23 Ju1y 1991 Denied
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Owner Zoning Administrator
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� 1.51 Acres ± "' 1.55 Acres± w
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' 328.16� 337.05� �
'� S89°13�IS��E,665.21� g w -M
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SCALE 1��=100� I z� o . 2.29 Acres+ o �
MONUMENTS� [_Y � ' � �
•SET II/4�� X 30��(O.D.) IRON PIPE W ;
�FOUND �f � S89°13�18��E,664,74� �
BEARINGS BASED ON SOLAR w Q
OBSERVATIONS. ��� �
-- �
� � ' MARCH 10, 1977 —
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�0 3.04 Acres ± 6 6� �
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o ,� 9�009 664,09� 66.01����� 6~
�ON�.D Z.. z N89°17�OO��W 730.10� c
� PETERSON � 6 6� � � � �
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���D � I SOUTH LINE NW I/4—NW I/4 �
W15. �, .� I � S89°17�OO��E,33.01�
�*,(�j `7 �O � SW COR. NW I/4 NW I/4, SEC.25,T4���,R9W .�
� s'UR V� ' I 3/4°Iron Pipe
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� � PAGE I OF 2 PAG
1
I, Ronald L. Peterson, Wisconsin RePistered Land Surveyor, hereby certify
that in compliance with Chapter 236:34 of the Wisconsin Statutes and under
the direction of �:�war.a Hanson, owner, I have surveyed, divided and r.;apped
the lana herein described, that said map is a correct representation of �
the survey made and that said land is loc2ted in the N�+ly4-I11�'j�, Section 25,
T. 41 N, R.9 W. described as follows;
_ - F_
_ � Commencing at the Southwest corner of said NW'/4-N�+('w, Thence S. 89° 1'7'00" E,
along trie South line of said forty, 33.01 feet to the Easterly rigr.t-of-way
line of 'rJheeler Road, Thence P�. G° 26'00" t+l. along said right-of-way line
50.00 feet to the actual point of beginning, Thence continue N.0° 26'00" 'd,
along said Ea:terly right-of-way line 549.82 feet, Thence S. �9° 13'18" E,
731.85 feet, Thence S. 0° 15'08�� E, 548.93 feet, Thence N. 89° 1']�OG" W,
']3C.10 feet to the point of beginning.
Subject to all existing eascments and reservati�ns.
This instrument araftec by-
Ronald L. Peterson
t'�arch l�, 1977
Approved tr;is ��day of I�;arch, 1977 by ��z-<<l�-���
Sawyer County �oning Administrator
16�73 '7
Register's O`fice �
Sawyer County �
Received for record the � y day of
�,c�A D 19/� at�-f��o'clock
-���N�, and recorded in vol�j _
. ot_�n/'• SC,�n.�,-4» on Pa�e.3 �' :� f
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� "�V �. �`�.-u, �: �.�
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Register
��SCO1ysj Deputy
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RONALD L �'a �e 2 of 2 pa�es
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DOCUMENT NUMBER AFFIDAVIT •
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�. �� e? i J � EXISTING SEPTIC SYSTEM
ONE AND TWO FAMILY Aaq1As•�pyoa i( �
Sewpex :;o�nlp 1 /
If the existing septic system does meet the minimum re- �B""'""" �O1 r�� ��e � I def a
quirements for groundwater and bedrock depths and if it A D 18�/� af o`doo!
is functioning, an addition to or replacement of a hab- M°"d1e���3 �Z.
itable structure can be made in most instances without ��dn°l°, � O D
updating the existing system. If the existing system �'}� '-�c
is utilized for the addition, every attempt should be �
made to locate and reserve an area which is suitable
for a code complying replacement system for when the
system fails. If the additior. will substantially in-
crease the wastewater discharge, the existing system RETURN TO
will be replaced with a code complling private sewage Sawyer County Zoning Admin ,,; �
system. p.0. Box 668 �
Ha ard WI 54843
owner(s) Gary S . Inhoff
Mailing address P,O. Box 153
Hayward WI 54843-0153
Property description Lots 11 and 12 in NW4 of the NW4 S 25 , T 41N, R 9W.
Parcel . 6 . 16 . Vol 297 Records Pg 1 and CS Vol 5 Pg 398 . 3 . 06 acres .
010-941-25-2216 . Town of Hayward.
(I) (�) Gary S . Inhoff plan to
(Xj, Add onto existing dwelling
( ) ?�dd onto existing mobile home
( ) Renlace existing dwellinq
( ) Replace existinq mobile home
The present private sewage system has been working satisfactorily as far as disposing
of wastes. If the present private sewage system does fail, it will be replaced with
one that is code complying.
. r_,�., � _��� ��
S. Inhoff c�ate
date
Personally ca^ie before me this
`���„�Uu�hq�i
.�` RET R. s��
20th day of June , 19 90 r,�OPQG�` w 4�4
w G
� " � r��OTARy �'ti:
Margar�t . Schu11 Notary Public�*,= �, *�
.
P ' PUBLIC `
Sawy_r County, Wisconsin y •�y� �
12/06�92 ,,,,���'rdf Of•IHiS����O�,,,
My Commission zs expires q����t„"11,����
Existing sentic system - Sanitary Permit 78-149
�ate sysiem inst�ile3 09-14-78 __
AQ��,���iA� ZA or AZA
,cs
,; - aa � ��
date
This instrument was drafted by y�� 4 6 7 p� (� �
v
Gary S . Inhoff
' L B 6 7 . . �890� ^
State and County State Permit #
� Permit Application County Permit # _ 8-149 _
tor Private Domestic Sewage Systems County Sawyer __
CST 8-245
"DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Pian I.D. #
A. OWNER OF PROPERTY #:,„rcw�y ..'�r�� Mailing Address:
� � �" `. �— , 1 ��, � , �� � J� S� —��
B. OCA N: ' Y�Y4, Section ��, T/� N, R �(or) W Lot#/ ^ City_
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: Commercial "Industrial "Other (specify) *Variance
Single family �_ Dupiex No. of Bedrooms �� No. of Persons
D. TYPE OF APPLIANCES: Dishwasher -1�-�5 �NO Food Waste Grinder_�� ' NO # of Bathrooms_—
Automatic Washer }.�� YES �-� Other (speci�y)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks _ � _
`Holding tank capacity Tot21 gallons No. of tanks
New Installation Addition Replacement_ Prefab Concrete
*Poured in Place Steel Other (specify) __
F. EFF�T DISPOSAL SYSTEM: Perc ation Rate 1) � 2) 3) Total Absorb Area �:-3 v sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length,��Width��Depth �_Tile Depth_,`�_No. of Lines �_
Seepage Pit: inside diameter Liquid Depth Tile Size _
Percent slope of land Distance from critical slope _
f •
I, the undersigned, do here certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Ce 'fi d Soil Tester, •�— /
NAME ` ,�� C.S.T. # ,�..1— �J� and other information
obtaine rom � (owner/builder).
Plumber's Si tur ,�— p� ;� � Phone # ��r
Plumber's Address - �
PLAN VIEW: Provide sketch below of system (include direction of pe and all distances in accord with
Hfi2.2 including well).
,
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Do Not Write in Space Below - FOR DEPARTMENT USE ONLYS
Date of Application 9-15-78 Fees Paid: State 10.00County 15 .00 Date 15 S?�teml-�Pr 97f3
Permit Issued/ (date) _Issuing Agent Name �1 a�,i nP M Nahrl ; ng
Inspection Yes No
Valid# Date Rec'd
1. county fwhite py) 3. owner �green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON; WI 53701
n _.._... �..;..i, ,.....,,1 _.A ,+w d nli�mhar (ranary r.nnv) .. � n_�_ ci� t�a
Department of Zoning and Sanitation o
Sawyer County �
�
Inspection Report
�
Owner Gary S. Inhoff n
K
Address p,0. Box 153 Hayward, Wisconsin 54843 �
Name of business ~
a
x
Builder ro
rn
Address
Plumber LaVern Dennis
Address winter Wisconsin 54896
H
O
Inspection �
�
� Private ( ) rubl.ic Property Sanitary-instal �
�� � Dwelling Setback - lake
Violation Mobile Hm Setback - road
Garage Setback-lot line a
( ) Sanitary ( ) Zoning Privy E
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�IS ��' �� �MQ.. O W��L o N I
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tc ca�,.e �c::�:.. {-2�� o��m.:..dl�.:t,� u' �
q�d �,;:i ,
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Discussed with owner yes no x
Discussed with builder yes no
Discussed with plumber yes no i0
Disc�zssed with yes no
Date � - ��( .�'-7�
Signature of Ofzicer _ � �,�
II