002-106-22-0100-LUP-1990-294 c�34 _ >� ,, 7 k .
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11pp1ic�iLion for Land Use Permit
County of Sawyer �� a
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Tt►e undersigned hereby makes application for a Land Use Permit and ayrees � '
that all work shall be done sn accordance with the requirements of the Sawyer °
County Zonifig Ordinance and t}�e laws and regulations of t}�e Stzte of Wisconsin.
PRIN'f - U5E ONLY BL11CK INK/PLNCIL
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Ch�uner Bui der
,�7� 2 ��X �352 �
mailil�g address mailing address
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city, state, zip �' ��ate zi �
city, , p
�uilding Land Use Zone District �� -�
(��Jew ( ) Filling
( ) 1lddition ( ) Dredging Lot size C�(,� ���-, � �
( ) Alteration ( ) Grading v, n
( ) Moving on ( ) Acres �' �� 1
( ) ( )
New Construction ' i
Size �_ fl• wide ft wide
�� f t long f t long --
`�..
Floor area ?�� sq ft sq ft
m
Total hgt J?� to peak to peak x
Stories �_
�� C.)
No. of bedrooms ' J . '`:�-'wate'r�i-�--=— --
E3��t� - �
(year round) or (seasonal) �5��---- � --- �G� I
1 1 __i._.. _ �.
`�t�14 � f �� 1 Gi
Type of bldg or addition i ��� ��� i � o
( ) Dwelling � �
(�Garage (1), � car � �__� _ � � �'
t r•
( ) Storage buildinq � � � r'
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( ) Boatl�ouse � , '' ' � � �'
( ) Livingrvom � ,�:�}�lt; � ��
i i o
( ) Bedroom � �u �
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( ) Kitchen-dining i �
( ) Porch - et�closed/roofed �
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( ) Deck - open i �
( ) ' ..w��d,�.._ .. i
( ) i :►-� i I
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Type�of construction i ��� �
(�' Frame � � �
( ) Block i i
( ) Log ( ) Concrete i �
( ) Pole � \ �
( ) Steel � �� \ i `'" v
( ) Metal ( ) � �
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Construction cost $ -������[x,) j - � �� �
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Vol aa(l, P9 '1�,�j of deed � � t� ' ��', � �
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CSM Vol -- Pg --� � � pb, �
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Cer. Soil 'Test - ' ' � �$�, � �D � �t�
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Sanitary Permit ��� � U��'�P �n � . �
�' Lt�� ����� C�2�C�.u.� �1-�c� �� 1 , --r.
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Issued 16 November 1990 �
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Issued Denied �a
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,�: - s� .'• =� - -_�� " )(�' .t l � ` B��'� �_
--- � owner 7oning ndministrator
23 28 23 28 6 � O� `� II Q ��
24 27 24 27 7 10 � 4
25 26 25 26 8 9
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STREET 2
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2 39 2 39 2 N 15
21
3 38 3 36 3 14
20
4 � 37 4 :�7 �� 4 y ry
5 36 5 36 5 19
O 13 I 8
6 35 6 35 � 6 m (V�
7 34 7 34 � 7 � 16� 0
B 33 8 33 � 8 0� 15
9 32 9 32 (D g 14 I
10 31 10 31 10 13
II 30 11 30 il �
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X 12 29 (~ 12 28 �
� 13 26 a 13 28 12 � 10
9
14 27 14 27 O 8
i5 26 IS 26 � �
I6 23 16 25 6
17 24 17 24 5
IB 23 18 23 � �oo� q �
19 22 � 19 22 3
20 21 20 21 � 2 f
STREET � � I SHEE"
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2 46 2 22 20 /
3 45 3 2� �9
4 44 4 20 i8
5 43 5 19 ��
6 42 6 18 j I6
7 41 � 15
8 40 8 17 � 14
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9 39 9 16 � 3
10 3B . 10 � I
W
II 37 Q II II
12 36 12 10
> 13 �
I 35 13 9
14 34 � 14
8 I
15 33 a 15 �� �, � �
is 32 P � 6
17 31 0 5
4
18 30 3
19 2 9 2
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1
SAWYER COUNTY ZONING ADMINISTRATION �'
INSPECTION REPORT £
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Owner Robert Havemanr. x
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Address 531 East SOuth Broadway Lombard Illinnis 6014R �
Name of Business OR: Route 2 Box 2187 Havward WI 54843 z
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Builder Lakeland Construction �
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Address Route 2 Box 2352 Hayward WI 54843 �
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Plumber N/A
Address
Inspection ( ) Property ( ) Setback - lake
i ) Dwelling ( ) SetUa^k - road
O Private O Public O Mobile Hm O Setback - lot line r, y
( ) Garage ( ) Average road o 0
Violation ^ �
( ) Addition ( ) setback for
( ) Sanitary ( ) Zoning const garage �', �
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Discussed with owner (�O �
Discussed with builder ( )
Discuseed with
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Date 30 Julv 1990 �
Signature of officer �1,(D��
David Heath
Plb 67 State and County State Permit #_�Z1 1-�'7
� = Permit Application County Permit # 6-���
for Private Domestic Sewage Systems County ���'Y�''�"
*DENOTES STATE APPROVAL REQUIRED �j-368
Date Approval Received from State if Requ'ired State Plan I.D. #
A. OWNER OF P OPERT�Y Robert R. Havemann Mailing Address
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B. LOCATION: Y4 Y4, Section -,�� , T� N, R�,� (or) W Lot# r's=City_
Subdivision Name, nearest road, lake or landmark Blk# L � Village
j�i�f �f�� ' �ff�::.`�'1~,,.�-- ����,i�r• Township .� �'s Lr�«-�-
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C. TYPE OF OCCU A1VCY: *Commercial *Industrial *Other (specify) *Variance_
Single family � Duplex No. of Bedrooms � No. of Persons ��
D. TYPE OF APPLIANCES: Dishwa/sh�er YES ' NO Food Waste Grinder YES NO # of BathroomsL
Automatic Washer YES � NO Other (specify)
E. SEPTIC TANK CAPACITY y �o' Total gallons No. of tanks � �7J� �NS�TI�L� �
*Holding tank capacity Total gallons No. of tanks
New Installation i� Addition Replacement Prefab Concrete _
"Poured in Place Steel Other (specify) _
F. EFFLUENT DiSPOSAL SYSTEM: Percolation Rate 1) .� :.i� 2) :,S- 3) ,S- Total Absorb Area,l/'�.� %c�� sq. ft.
New� Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches_
Seepage Bed: Length i� Width ici Depth Tile Depth �.3 � No. of Lines ��-
,�. :
Seepage Pit: Inside diameter Liquid Depth Tile Size `�
Percent siope of land %r:�/� Distance from critical slope ���
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I tiave sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester,
NAME '�„�'���; ����=�;i-� C.S.T. # J`�� �a�-` and other information
obtained from �' �'%�r.•�r�; ,�h (owner/�der1. � _
Plumber's Signature�_ ���i,��. ,,.�� , -�,�.�' MP/MPRSW# �� f� �� Phone #d�'� - 7 t��
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well►.
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Do Not Write in Space Below - FOR DEPARTMENT USE ONLY
Date of Application 06-21.-'76 Fees Paid: St�tQ 7 - 00 County �0.0� Date JUTle 21, 1976
Permit Issued/�Xe�9 (date) 06-21-76 Issuing Agent Name Robyn Kephart - Deputy
Inspection Yes i/No d� '�-7'(o Q(�s Valid# Date Rec'd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (oink co�v) 4. olumber (canary coovl
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Department of Zoning and Sanitation , ��
Sawyer County �`.'
Inspection Report
Owner�, J-J�Ve yn�,� h Address531 �. .61. Droa�y+%T�l.��ba��Z
Descriptionj.�7-' �. 2 f 3 ��.�(_,�� „�,�, �. 31 i y,�ng fi]/
boi�
Name of business
Builder Address
Plumber �, �e�u � Address
Inspection
(�Private ( ) Public Property Sanitary installation
Dwelling Privy
I Violation Mobile home Setback - lake
Garage Setback - road
( ) Sanitary ( ) Zoning Setback - lot line
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Discussed with puilder ( � yes �� no i �
Discussed with lumber j es no
Date L�3Q��L� I�
Signatur� Officer���1rur�. �f'�� �
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