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002-103-18-2601-PVY-2022-008
, �. SAWYER COUNTY ZONING&CONSERVATION ADMINISTRATION � 10610 Main Street,Suite 49 . .� Hayward,Wiscoasin 54843-0676 (715)634-8288 yJ www.sawvercountveov ore �� NON-PLUMBING SANITARY PERMIT APPLICATION � In accordance with Chapter DSPS 391,Wis.Adm.Code and � Sawyer Counry Private Sewage System Ordinance � APPUCATIONINFORMATION-TYPEORPRINT PAGE:lof3 � Propen Ownar Name Pmpehy I.cgul Descriplion � GL '/. %. S .3n ,T�IQN,R_�W Propcny O�mcr's Moi g Address Lot Numbcr�'_�5 BIaA Nu�m6tt Ciry, tote w Z Calc Phonc Numbcr Subdivision Namc or CSM N mber r 5 c7�g 5 4�19Ya �}bend S a TYPE OF BUILDING:(Check one) State Owned Ciiy Ncwai ud ❑Public �Ior2FamilyDwelling-No.ofbedroams� �iuuqe -7 �Townof n/1_�C�i��o FircNumbcr# �n�� PUBLIC BUILDIIVG/LAND USE:[sxpia��mo u��puma�c rormis Parcel Tax Number:(12 di it legac number) � pertni6(i.c.,cempground,kstivel,mcr�elioNenimeinmcnl cvcrt atc.)� � C7 O c�,I O� � ���(x} �`"t S�1J�..-LS2.3�-1—�--�� OQ—P�r � � � TYPEOFPERMIT: �"^'� �'^��� TYPE OF NON-PLUMBING DEV(CE/SYSTEM/TOILE NNIT: ❑Privy•Pit Toilet(CSTk ) �Non-Plurnbing(Privy,Toilet,Restroom,Etc.) ❑Privy-Vault Toilet(200 gal. min.capacity required) (Vault size:_gelions or cubic yazds ❑Other: Vault Privy Type:�Concrete 0 Steel❑Polyethylene�Other ,$�Composting Toilet System ❑Incinerating Toilet Device ❑Portable Res[room Unit ❑Other RESPONSIBILITY STATEME(VT: f,the undersigned,assumc rcsponsibiliry for thc installation of�he non-plumbing suniwy rystcm for which this permi�is issued. I funhtt agce ttiaz nn)'dwelling in conjunction+vilh Ihis permi��vill no�be pnvided with indoor plumbing and/or�mler hookup. 1 wiil usc the non-plumbing system indico�ed as n mcans of�vosic disposal,and I wiil carty wn�er io nnd from the structurc. I understnnd ihat bcforc indoor plumbing nnd wwer hook ups arc insmlled,thc proper Siu�e und Counry Pcrmiu will bc upplicd Por. i funhcr underslund thut any dcviotions from Ihe ubove will canstitulc a violotion of Suwycr County Ordinonces nnd would subjeci me(u the penahies of Ihe Ordinances. By signing�his appliwtion,I um nlso granting permission�o the zaning dcpartment personnel m enter my property et eny reasanuble lime for Ihc purpose of inspeclion lo assurc compliencc with the zoning end seniwtion laws relative ta the issuence of tks permii. �1mcr's Blllc:(Pflnl) ���S • J so OFFICE USE ONLY: Disopproved Permit Fec: CST No. Dalc Issued Issuing Agent Sipielurc �Aprovcd ❑OanaGivcnlnitial SI50.00 v �'�U'a3 �I��� Advcrsc Dciumination `�t.t� COM ENTS: *Expires2yearsfromdateofissue ����y�1 -�.-e� �or ��,J- 1��-1a''�y�C Dn 7/1! ,,� `NO REFUNDS AFTER ISSUE OF PERMIT SHORE WNF.P PERTY:❑YES�NO If"Yes,"Name of the body of water. CONDITIONS OF APPROYAL/REASONS FOR D[SAPPROVAL: ��d�Id���` D�;,�, , �, �—�- ', .. ;-J Rev.04/29/16 , - i`'.n�.�_`_'�`__ . ---- - :,• J SAWYER CGu'i;T,. Np REFJNDS AFTEF Chk� ��,� - ZON{NG ADMINISTFAT.ON 19SUE OF PEFiM1T R�Pt ' wor�i '�'15 aa � � �.�;�d•.445'"I� �M�� ?Are.�t . 1 yy NON-PLUMBING SANITARY PERMIT APPLICATION PAGE:2 of 3 Privy Plot Plan Please include the following information with distances on the above plot plan: ❑ North Arrow ❑ Nearest Road ❑ Site Address ❑ Structures ❑ Well ❑ Property Lines ❑ Lake, River and/or Stream o Wetlands Minimum Setback Requirements: • 10' from any slab constructed accessory building • 25' from any habitable building , • 45' from any property line • 50' from any water supply well • 75' From the ordinary high water mark of navigable waters • 130' from the centerline of state highways or 66' from right-of-way line, whichever is greater Rev, 04/29/16 _ +;._.: � � — Real Estdte Sawyer County Property Property Status: Current Listing • Today's Date: 7/12/2022 Created On: 2/6/2007 7:55:01 AM Description �-- Updated: 3/15/2022 Ownership Updated: 3/15/2022 _ __ _ -- - Tdx ID: 14 RODNEY J OLSON HAYWARD WI P�N; 57-002-2-40-08-30-515-155- 182400 Billing Address: Mailing Address: Legacy PIN: 002103182400 RODNEY J OLSON RODNEY J OLSON Mdp ID: -12.18.24 & 25 8029N COUNTY HWY8029N COUNTY HWY Municipality: (002) TOWN OF BA55 LAKE K K STR: S30 T40N R08W HAYWARD WI 54843 HAYWARD WI 54843 Description: ABENDPOST BEACH LOTS 24- 30 BLK 18 Site Address * indicates Private Road Recorded N/A Acres: 0.483 Lottery � Property Updated: 5/24/2019 Claims: Assessment First Dollar: No 2022 Assessment Detail Zoning: (RR2) Residential/Recreational Code Acres Land Imp. Two G1- 0.483 6,800 0 ESN: 445 RESIDENTIAL Tax Districts Updated: 2/6/2007 2-Year Z021 2022 Change 1 State of Wisconsin �omparison 57 Sawyer County �and: 6,800 6,800 0.0% 002 Town of Bass Lake �mproved: 0 0 0.0% Hayward Community Total: 6,800 6,800 0.0% 572478 School District 001700 Technical College Property History Recorded N/A Documents Updated: 9/16/2011 QUIT CLAIM DEED Date 415507 Recorded: 11/20/2018 JUDGMENT Date 408042 Recorded: 8/8/2017 LAND CONTRACT Date 296884 7g5/76 Recorded: 1/2/2002 WARRANTY DEED Date 262954 612/294 Recorded: 9/5/1997 SEE NOTE Real Estate Sawyer County Property Property Status• Current Listing ' • Today's Date: 7/12/2022 Created On: 2/6/2007 7:55:01 AM Description Updated: 3/15/2022 Ownership Updated: 3/15/2022 Tax ID: 142 RODNEY J OLSON HAYWARD WI PIN: 57-002-2-40-08-30-5 15-155- 181100 Billing Address: Mailing Address: Legacy PIN: 002103181100 RODNEY J OLSON RODNEY J OLSON Mdp ID: -12.18.11-15 8029N COUNTY HWY8029N COUNTY HWY Municipality: (002) TOWN OF BA55 LAKE K K STR: 530 T40N R08W HAYWARD WI 54843 HAYWARD WI 54843 Description: ABENDPOST BEACH LOTS 11- 15 BLK 18 Site Address * indicates Private Road Recorded N/A Ac res: 0.344 Lottery p Property Updated: 2/6/2007 Claims: Assessment First Dollar: No 2022 Assessment Detail Zoning: (RR1) Residential/Recreational Code Acres Land Imp. One G1' 0.344 1,500 0 (RR2) Residential/Recreational RESIDENTIAL Two ESN: 445 2-Year Comparison z021 2022 Change Tax Districts Updated: 2/6/2007 Land• 1,500 1,500 0.0% 1 State of Wisconsin Improved: 0 0 0.0% 57 Sawyer County Total: 1,500 1,500 0.0% 002 Town of Bass Lake 572478 Hayward Community School District Property History 001700 Technical College N/A Recorded Documents Updated: 9/16/2011 WARRANTY DEED Date 404781 Recorded: 1/6/2017 QUIT CLAIM DEED Date 332002 Recorded: 7/20/2005 � �� �15 q, �f5 '��- � �..7 I pA{ ��� f `� 5 ,s 9�� �7� S � V � �ov� - P�um1� � h5 SA✓` ���.ry Pev�n�-� sPs 391 . ► � Co� p os-f" To � l e�t " S � r� ` 1�d r �x �-Q C_ert�-Fie� -I-a 1� �� A f�S�'/ S+anc�<,.v�� '� � , � �b� � � � �Y'° m c.ow� Post ���'� �� � �,,,� �:.-, �R � a j - I�+� s�.- 0.�1a�.1�e� �o�� ey �. o �50 � ��aq N cow�,-� �+� Y K 0. wUv�� �� 5 `��y3 NY ��,� � �,� ������` ";1 �I J JUL 21 2122 SAWYER COUNT`' 7,.ONING ADMINISTRAI'ION Industry Sen�ices Division ���0' = 140(1 E Washington Avc Saw yer � �'' \ _ ' P.O.Hox 7162 tianitary Pcrtnil NumMcr(�o be filicd in 1 � �' . ' ,` f Madison,WI 53707-7162 � � �� - � �ST �-� - 3 � 3� � Sanitary Permit App ication SinleTrancectionNumher N In accordanc<wilh SP$38311Q).W is. Adm.Code.submission o(�his furtn to Ihc appropria�c Envemmentai unit �— 1 is rtquirtd pnor�o obisining a Yanitery pertniL Notc: Appliceli�fo�ms fur slatcowncd 1'OWTS are submil4d lo f'rujccl Address(if diRcrcnt Ihan mailin; Iht Ikpartmrnl nf Sakty end Profctsional Serviccs.Pcrwoel informetion you providc mey M uscd for secondary _� u �n azcurJencc wiih Ihc Privac Lew,s. 15.04 1 (m,5te�c. 8 b a c�N GO V n� 1. A licationlnformation-PlasePrintAllloformation N Pmpc�y U�mcr's Narne PercCl M �oa.,� 3 0� 0o,- Syo - a9 S30(� Property Owner's Mafling Address ' �y���o� /^� � `J aov P;� + /1.r Ec � cb�ii�� a � Cm.Stale Zip Code PMme Numbcr y..__Y.. Scciion � z c�ea�� ceKe w= sveos «"`���"��- II.Type of Building�check sll that apply) �,M M ���.�Q_N: R_$_tar�wJ � a � Subdivision Nemc (� �I or 2 Family Dwclling-Number of Etcdrooms _ Block N ' �� ❑PubiiUCommcrcial-I)cccribe Ux � O ❑City of._.—_ _ . __.'_ ❑Slutc(h�ncd Dcscrihc Usc CSM Number ❑ Villagc uf ____ � —_ _. �/ �'Town of_�SS La ks_. — 111.Type of Permit: (Cheek only one box on line A. Complete line B if epplicable) '�. �Replecemrnt System g p >' ❑ Nn.ti�stcm ❑T¢almrnNloldin -1 ank Rc laccmenl(MI ❑<hher Midi�calion m Fsistine System(explainl B• ❑ Permil Rcnewal ❑ Permit Rcvision ❑Change nf Plumber ❑Prnnil Transfer to New �'�S�P����P���Numher anJ Dale IssueJ Aeforc h:xpiretion (�M �.1.��. ? IV.T e of PON"fS S stem/Com onenUDevice: Check all that e I �Nnn-PreSsuri>cd In-Graund ❑ Fkcssurized In{'�mund ❑ AI{{ro�� ❑ Mound>:4 in.nf suitnblc soil ❑ Mound<24 in.of suileble soil ❑ Hnlding Tank ❑(hher Dispersal Canpancnt(explainl_____ _ ❑P¢u��rnl Dcvice(ezp�ain) V.Dis ersal/freatment Area Information: ;eK Y lu � u Sa4 a0 end Design Flow�(gpd) [ksign Soil Application Rele(gpdsfl DispetsN Area Required Is� Dispersel A(ea Ihoposed(5� Systcm F.Ievalion 300 0 .'� ti�9 438 45.50 ff VI.Tank Info Capeciry in Total 0 of Manufaclurer v � Gellons Gallons Units y 't+ ` $ Y � V Ncu Tmka I�.+islmg Tank� e o .= 2 � � � � a U w � �n i� C% 6. SeV��c or Holding Isnk 7 'S� �" 1.1� � W�C f' l.Of+ f<}G. x Doamg Chamber . _ _— . ._— "_ _ -_.. __ VII. Respoasibility Statement- 1.Ihe undeniRncd,acrume responwbility fnr inslalletion nf tM1e POW"(5 s6awn on Ih<atbchcd pleni Plumber's`Jame IPrint) Plumba's Sigialurc MP/MPRS Number Businus Ph�me Number ld A $ neaKe.� Sr /¢ �1LG 88 7/S-.5'Sa "Gy7"� Plumbcr's Addmss IS L City,Statc T.ip Codc1 .�OS N _$�Fs�ic�acd o��7 VIII. ou /De artment Use Onl �Ap � ❑ DisepprnveJ P���Fce DoI issued 1 ' g rn�Signatu ❑Owner(iivrn Reasun for Denial s l oo� � 2 X IX.Condi6ons of ApprovaVReasons for Disapproval �.� � ���i� ���� � zJ�a J,���I� � Y 2 1 202 AmeY a��peh W�s f�r tk mlea a�d w4�i11e tYe Cwab'u�Y a WOn ee11m Wa S Vt a t I i�eYn �C r I � Z L`7� � �I Z�I 2 NO AEFUPIDS AFTER zON NG ADM N 3TR 7A ION S6n-639R(R.OS/I41 ISSUE OF PERMIT � -.r 'r � �t .' , �p .�' ��' � q•',` � x� �� � � �� � ��.y p.]�yg�' �� { � t 'nG :t#� As ..�f �a f'VW /l.a .. y R ., �^, �C, y;" �� � .� �` a �� � � , #�� � .' �� ,, `�� � . �#` , , , . - �.- ' :� r ,`e �, � � � . Y � . .�.. � Py. 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