010-841-28-1201-LUP-1990-197 /�
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1lpplicatio�l for Land Use Fer►nit
County of 5awyer ,i
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7'!ie undersigned hereby makes application for a Land Use Permit and aqrees �
that all work shall be done in accordance with the requirements of the Sawyer �
County Zoning Ordinance and the laws and regulations of the State of Wisc�nsin. '
PRINT - U5E ONLY BL11CK 1NK/FI,tJCIL
Cathy L. and
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Owner Builder
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mailing �address mailitig address
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city, 'state, zip city, state, zip
Building La[id Use Zone District fl - (
(� New ( ) Filling c�
( ) 1lddition ( ) Uredging Lot size G_.�.�,' ,� ���-7� � '3
( ) Alteration ( ) Grading N ro
( ) Moving on ( ) Acres 1i9. :
( ) ( )
New Construction '
Size ��S fl wide ft wide
��� �r.. f t long f t long _��
Floor area 46 08 sq ft sq ft
tr�
Total hgt d�,',1 to peak to peak x
Stories �
No. of bedrooms � rear lot line or waterline
(year roui�d) or (seasonal) �
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Type of bldg or addition i � o
( ) Dwelling � � � '�
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( ) Garage (1) (2) car � i p' �'
O Storage building i i C r+
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( ) F3oatliouse � � N
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( ) Livingroom � �'�-�
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( ) Bedroom � �
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( ) Kitchen-dining � �P' -
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( ) Porch - e►iclosed/roofed i
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( ) Deck - open � i -
(x) �'� , ` ; ; � i i
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'I'ype of construction � '+� 1 /I i �,
( ) Frame ( ) Block � � i r"' `"
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( ) Lo9 ( ) Concrete � 9�- —��N ___---- 25- �:;,i f ,
(k) Pole ( ) Steel � �� - `'"
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(x) Metal ( ) �- - �5 '"� 4
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Construction cost $ `]$"`� c? , j t �.,; � �
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Vol ,f � _ P9 1 ' of deed � .. � :
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CSM Vol ' Pg '- i i w
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Cer. Soil Test ' � I n
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^ , ----------CL road ----�------------- o _.�
Sanitary Permit `` " ��
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Issued 31 July 1990 De�ed-_��= �>� - ��1 �=�K �����
-"� ,'3-:, �`� - ���"���` �f -�� lK-� _����� � �'�'` �'
Robert J. Hamblin owner 7oning ndministr�tor
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� DOCUMENT NO . STATE BAlt OF NISCONSIN FOK1�1 3 - 1982 THi� SPACE RESt�tvlD roK RE�:vMU1Nb oara
� QUIT CLAIM DEED
' 2 � 302 `7 �
_-- — --� — — _= H�,�x e a� ,
I Se�v��c r �..xmt}� � �
ROBERT J . HAMBLIN , an adult man _ _ _ ___ _ _ ___ _ �;�r_,;,�, ��� r�,;o:� ,� � , � a
�--------------------•----------------- - - - - - - - -
� ��i�Ci; E^'i✓ A 1: 1�� . � at , o':�,�ct:
•........................... . .... ... ... � --.. _. . --• � - - -•--• -- • - ---....--• -• •--•--. ._._.......--•••--•••------... �C7_ r.t end re,.,rord�� tn � ,�I. ,,ZY_1
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� q��c-��:,�ms to ....R_4B.ERI _.J ,--HAf-1aLI_N and__CATHY__L.. ._HAMBL_I �J � ..-------- � r..z1��,: � E��.��� �y�—
. . . - , .
...._hi.s.._1�l�f�x..d� ._��l�'��.vorsh.�P..marital _.property-------�-�-------------- �_ �c.�zc.� ��-�
Rey��'3
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•-------•---•-•---•-•------••-•-•---•-••-•--•-----••---••------•---._.-•--•---•--•-----•---------------------••--
•--••--------------------------------•------•---------------------------------------••-----.._..--•---------- ••-
�''_.�"=��
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the following descr�bed real estate �n _.____._. . �al'AY�1"__________________________ Count�-,
State of Wisconsin : RET�:I7Y .o
The ldest Half of the Northwest Quarter of the North - H . E . Hanson , Attorney
� Hayward , ��lisconsin
east Quarter ( WYz NbJ'/. NE'/< ) � and the East Half of the i�______ �
Northwest Quarter ( E'/z NW'/, ) ; all in Section Twenty- — -- --
Eight ( 28 ) , Township Forty-One ( 41 ) North , Range Eight
( 8 ) West . Taa P.ircei rra : ---�- �- -- ------�---- ---- .. . .
Exempt Section 77 . 25 ( 8 ) , Wisconsin Statutes .
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I This .. ..__.. ._�.�. ............. homestead property.
(is) (is not)
Dated this - - � - - ---- - ---� Ottl--------....•--•-- ----- -- -- day or -- - ---- - - � --- --December_ _ ._ . . . . .- - - � � � -- - -- - � - - --- � --, �s_ _$6 . ..
I
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� .- � - -- -• (SEaL )
. .._ ._... . • ---- - (SEAL) � --\� c: �= : �.�_�:,. . ';� �_,- - �� _
_ . . . . ._. . - -•- -- � --- ----•- •--•--•--•-- •--• - - --•-•-• . , � . , �. . _ --
. . ROBERT J . HAP�IBLIN
.................. .......... .. ......... .. �---�----------�---� - -�-- ... - - -- -- - . . . . ._ . ._ . ... . . .. � - - . . . . . . . . . . . . . . . . . . . ... . . . . .
-- -- --- -- - - --- --- • ••-•...--- - -. _...-- -•--- -----...._._. .----
- --- �- �SEAL) -- - -� �- -• - �. . . . . . . . . . . . .� - � - --- - - . . .. . . . ••---•••- --• •-•- . • - -••.. ( SE:�I. )
. *
. ...._ ..--•---••- •--•---•-.......--- ••-------•••----- -•--------- -- _ ... . . . -- � - � - -- -- -� - � -- - -- -- - � -� - -- � � - - - --- --- - -- --- - - --
AUTHENTICATION ACKNOWLEDGMENT
Signature (s) _Of_.RO�?e1"t_.�_._.Hd�Ilbl_1_R.................. STATE OF �VISCONSIN �
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----•----------•---•---- ---- •- -----•-----� ---------••-------•--------• I
; _._.._..._.-•--••--•------------•-----Count��.
authenticate - ' _ _ l�a ___peGember.._.__, 19__�� Personallp came before me this ________________da}• of
� -------------•-•---------••--•••-•-•---•-., 19--•..__. the nbo�e namcd
-••---•���-•� --� --- ---•---•---•----•-•--•----•--•-•--•--•--•---
--...----••-------------•--------••-------•-------------------------...-------•-
�tio ard E . H son
-�--- -.. . .--•---•------- --------------------------•-----------...._......_. --•-------------�-------------�------------------------.__....--------..__.._._.
�'fT E : MEMBE STATE BAft OF WISCONSIN
------•---•--•--•--._.------•-•--•------•-•••-•----•-------------------------•..
(JCOC�(dt� -•------ --••--•--•-•--•--------------•---•---•--•-•---•--• •-----•--•--- --- --- -- •• -----� --- -- -----....-•-•---•--•---•---------•-•-•-•----•-
a��������'�����'� person _...________ nho esecuted the
� i to me known to Ue the
foregoing instivnient �nd acknowledge the sume.
/'r THIS INSTRUMENT WAS DRAFTED BY
I ----.-Howard__E_... Hanson-Attorney-•-------------------•- --•-----------------------------------� --- ---------------------------...--
Hayward , Wisconsin 54843 '-------------- - -�------------- ------------�---�---------------------------..._
--------------•------•-•--•••-------••--•--•--•---...•-•-••----...-•-•-••---•-- NoturY Public .-- - ----• - ---- -• -----••-•- -•---------••- -Count�-, �is.
i (Signatures mny be authenticated or acknowledged. Both n7y Commission is permanent. lIf not, state expiration
; flre not necessury.) - �
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' � - - - - - --- --- - ------ -- --• � 19-- •)
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�����'� ��� � �� State and Co�mty Statr: Permit # 1��3�
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(;r�unt Permit #� 8�-041
�y�_.S� r Permit Applir,ation Y
t<�y,�;, for Private Domestic Sewage Systems County Sa�ti'yer
'DENOTES STATE APPROVAL REQUIRED CST 80- 0$1
�ate Approval Received from State if Required State Plan I.D. st
A. OWNER F PROPE TY ' Mailin Address:
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�:. LOCATION: �Y� /% - Ya, Section �, T� N, R�_ �" (�„� �1/ Lr�t# C�ty
Subdivision Name, nearest road, lake ur landm��k (31k# Villaye
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�.QJ��; �L! '� ,.�� ��1-�'..c�s+��, Tuwiishi{� �L._ .:.i
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:. TYPE OF OCCUPANCY: 'Commercial 'Industri�l 'Othcr (s��ec�fy) 'Vananc�.�
Singie family _ _ X_ ___ Duplex No. of Bediooms �,' No. c�t Pciu>nti_�'�
��—
�� SEPTIC TANK CAPACITY �YO Total gallons No. uf tanks �_
HOLD�NG TANK CAPACITY Total gallons No. c>f t�,nks
Prefab concrete Poured-in-Place Stcel�___Filmrglass_ C)the� (s��ec�fy) _
New installation Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify�_
- ----- -- -- - -- --- --------- _ _ � .. „� ,
E EFFLUENT DISPOSAL SYSTEM: Percolation Rate �- Total Absorb Area �- � ' sq. ft.
New Replacement Alternate (Specify)
Seepage rench: No. of Lineal Ft. Width Depth Tile depth (to ) No. of Trenches
Seepage Bed: {� Length S�� Width ��' Depth_���_Tile depih (top)�No. of Lines�—
Seepage Pit: Inside dia zer Liquid Depth No. of Seepage Pits
Percent slope of land .Z�-� Distance from critical slope /11��� ��'-_�
:ATER SUPPLY: Private � Joint ❑ Community ❑ Municipal ❑ _ __,
�,vi�ers name as listed on EH 115 if other than present owner:
I �the undersigned, do hereby certity that the information I have re4�ortecl is in accord with Section H62.20,
:'disconsin Administrative Code, and that I have sized the efiluent disposal system from tht• EH 115 prepared
�,y tfie Certified Soil Tester,
`�l1ME � % . C.S.T. # �5 S -'�%� an�l uth��r information
;I�tained fi m �. '; (��wneribuilderl.
:'lumber 's Signature �� -% , - MP �pfl-Syy# /�����;:�� Phone #l'/%� �:��/- ��"!�`,"
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'lumber's Address � � '' � '� � � `� �� �
.
IPLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accorcl �vith H62.20. Well loca-
tion shall be included on the sketch, (ndicate or dimension location of all wells on thc: property or neiyhbors
property. If weli has not been drilled please indicate.
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� Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY
,ce of Application 5-12-80 Fees Paid: State 15 . OU County 35 . 00 Date 12 May 1980
,mit Issued/�dC (date) 5-12-$� Issuing Agent Name Elaine Nehrlin�
�+�ection Yes No State Valid# Date Rec'd
county (wFiite copy! 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI ��701
>tate (nink copy) 4. plumb�r (canan� oov)
Department of 7on�nn and San i_ta�;i_or�
Sa�vyer Covr.t�T �
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Inspection Report �
Ow.ner Robert J. Hamblin
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�`lddress Route S Hayward, h'I 54843 �
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Name of busi_ness
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Address i�
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Plumber Clarence Metcalf ��
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Addre�s RoLite 6 Box 157 Hayward, WI 54843
Inspection
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(X� Private ( � Public Property X SanitarST i;�stal � �
Dwellin�; �etback - � ak�
Violation �( Mobile Hm �etback � r. �ad °,
Gara�e S�tbacl;-lot l�.ne
( ) aanitary ( ) Zoring privy
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P�NI�GSULA ----[��'- - ~' -s
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Discussed with oc��ner yes n� �
Discussed with Buiider yes no
�iscussed with plum�er X yes ) no I �
D_iscussed with yes � no
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�;�;r�ati.ire �f Off icer ?.�, _�lr�L�%Ylc,�>--- --- --- - - - ---