HomeMy WebLinkAbout010-841-26-5513-LUP-2001-001 Application for Land Use Permit � ` `
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County of Sawyer 4 ° ,
PO Box 668 - Hay�vard `VI 54843 �;:; ;..� ._ _ . , _
_ 715/634-8288 �
The undersigned hereby makes application for a Land Use Permit and agrees that all work �"' �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin.CONSTRUCTION I�1AY NOT
BEGI;V UNTIL THE PERi�1IT IS ISSUED. -'
E�l Zce.,b e� �? � �?Cl� P��T — USE BLACK I�K OR PEtiCIL r'
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O�vner Builder o
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iOp �4 CEM c�r N i ��- S a' . c-On�i�tcr Nt�. I<E�I ��c.�Y� ;
Mailina Address Ma?i.ing Address �
i�GL't-IESi��� , N�V J��1 c�Y
City, State, Zip City, State, Zip
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Daytime Phone Daytime Phone
Buildin� Land Use �
O I�'e«� O Fillin� Zone District 0\ �`�
�-(�--�t�'I'[Ton ( ) Dred�in� i �
� Alteration ( ) Grading Lot Size � I�,
( ) ��Io��ing On ( ) �
( ) ( ) Acres � � � ,
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Primary Structure Accessoryr Buildin� �dditio:l �T
( ) D«�ellin� ara�e-attached!detached ( ) Deck �
O �"ear round (1) tt of car stalls O Porch � �
( ) Seasonal ( ) Stora�e Buildin� ( ) Enclosed
O Frame built on site O Screenhotise O Living room
O l��todular/manufactured O Greenhouse O Kitchen t �
( ) 1�lobile/manufactured ( ) Other (� Bedroom �, I
O Otller primary structure O O Relocate/enlar�e 1 y-
( ) ( ) (I) # of ne«� I
Type of Construction �=
(� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
( j Other v �
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Construction Cost S ` u�T' ���'K�iOu,►�l �_ �'
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Vol�Pg t �� of Deed Certified Soil Test � � q -�
CSM Vol / Pg� Sanitary Permit # Q'�`-�(�f� � z
Plat Envelope �r� '��t�c. S�sTE�t iz���-� � ~
Condo Vol Pg Year Installed o`�aO �
AfCof e� septic �' P O���ner When Installed: �
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Application for Land Use Permit—Page 2 _
Describe Construction:List dimensions of each structure,sto addition,or alteration. _
f$j ��v4rZ/F6L fEDOJTKx, #ZCrZEHOl�'L- UIF57�A/G� SrA[L �+r�
Size /2 r�ft.�� ��uT�t.��3d����) ft.wide ft.wide
��ft.lon� �!'o h.lon� ft.lon� ft.long
Floor area 2b¢- sq.ft. /44 sq.ft. sq.ft. sq.ft.
C ri�rJr l�ZES�It'
H�.&om ga�e�to peak b' ft.hgt. ft.h�t. ft.hgt.
Stories ( / stories stories stories
#of bedrooms
rear lot line or�caterfine of lake/river
In the box sketch in: ��''�"' �' �
Location and size of all � �
existing and proposed structures. �"��'�±� �
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Location of septic system. '�" I F i9'
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Y ��_-__�j%//r�.i.'�2 �AJ��;T�C��1
Indicate distance ro: • ,��r k
lb'aterline/Wetlands � `�"-
Road r��
Lot lines vR4 +«< �
Septic system�privy � �-���
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Distance bet�veen stnutures. � `��-�
Indicate�ordi. �'`' ��
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Fire\umber:
/6E�b N i�Es12�r.% ��.
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Signature of O��ner
The abo��e certifies that thz listzd
inform�tion and intenrions are tnae and
A�
correct.Thz abovz personr's�hzreby -- -- _ _��^�;�.,� ti���
eivz pzrmission for access to thz
propercv for onsice inspzccion. -------centerline of �EA R�cN road-------
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Issue Date January 2, 2000 Expire Date January 2 2002
OfficcComments: �.2�� �[�GZ''l�Zljr�.t�"i-i
Si�naun�of Zonine Administrator
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Oftice of
Sawyer County Zoning Administration
P.O.Box 668
Hayward,Wisconsin 54843
�n s�63a-szsa
URL: www.sawyercounty ov.org
E-mail: scezone(n�win bri�ht net
FAX: 715-638-3277
December 5,2000
David&Elizabeth Leonard
100 Salem Point Drive SW
Rochester,MN 55902
Dear Mr.and Mrs. Leonard:
I have discussed your application with Merton(Mac)Maki, the Assistant Sanitarian for
Sawyer County. Since your septic system has been improved this summer,he feels that
it will probabiy be able to handle the extra use of an additional bedroom.
The only thing we will require of you is to complete the enclosed Affidavit of Existing
Septic System. Basically, this affidavit states that you are aware you are adding a
bedroom to a system that is undersized for the number of bedrooms in the house. This
document must be signed before a notary and notarized. Then return it to us with a
check in the amount of$10.00 ro the Sawyer County Register of Deeds.
Also,I will need the revised sketch for the alteration of the house. We will be able to
issue your permit within a few days after we receive all to the information indicated.
If you have any questions please contact me at the above address and phone number or
by e-mail at z�oersec«��;�.br�eht net.
Thank you,
Debra Hammerel
Permits Secretary
Sawyer County Zoning Administration
Encl.
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PD.B—• •
I, Ronald L. Peterson, Wisconsin Registered Land Surveyor, hereby certify
that in full compliance with the provisions of Chapter 236 . 34 of the
Wisconsin Statutes, and under the direction of Perry A. Risberg, owner of
said land, I have surveyed, divided and mapped the land herein described
and that such map correctly represents the exterior boundaries and division
of the land surveyed; and that this land is located in Govt. Lot 5, Section
26, Township 41 North, Range 8 West, Town of Iiayward, Sawyer County, Wis . ,
described as follows: (description on page 2 of two pages) .
I further certify that in surveying the above described lands I find
discrepancies between some of the deed calls and the monuments as they exist,
and that the monuments were accepted as best showing the intent of convey-
ance. The discrepancies are noted on the location sketch (page 2 of two
pages) .
April 25 ��6(,,,'�NS ona�// � ���
-V� I,�. x
Ronald L. Peterson
• �� RONALD L. Wisconsin Registered Land Surveyor
PETEiiSON � IIayward, Wis .
5-003
HAYI'l.4AD �
l �'IS' � (Page 1 of 2 pages)
��� SURV��O �a a,..�.e u.. , �rc
DOCUMENT NO. � QUR Ci.n7Y D�ID
iTATE BAR OF W16CONi1N—FOqM f
� THIi 6I'dCE N[BEMCO FOII 1�601101ryp- OAT�
246202
David A. Leonard and Elizabeth B. Leonard, ���� T �
:...........:................. . :. .. ......................�----..-�-------- -------............-..;-----• i iysryss�c»rarr .
. . I F
husband and-wi.fe----•----••-•------------------••----....--•-------------� -�-------------- �,il v��res ki rr�sr,M � �r
..... ............... .•-•---------•-----••----------.. . - • - - - . � ��� A D 19 b ,
• ------ - ------•• --- - - •- •--�-------------'•-
quit-cla�meto David A. Leonard and Elizabeth B. Leonard � yi id �uu����d �!-
an d successors, as Trus[ees o f t he Davi d A. Leonar d ��, p1 bno�jy� oa p��
. ............•--•--...- �----.._.....----'•---•-•----'--'-----y------'-'------------•---•--------------'- � ' .
Trust under a reement dated Januar 11 1��5
- "-------- -----'---- --' �i E
� �9W1
--------------------------------------------••--•-•-------�-��--��---------�---�-��--�---- ----...--------�--- ��
•--•-•----._.....g............ ..••------------------�--------�---'Saw er-�---�------------��---�------y iI .. -
the followin described real eatrte in ---.-------•.--------Y---------------••-.--•---- Count �
State of Wiaconaln: i -_——_--.. .-°. . ---.._ -..
ienunH ro �---- ' ------_---. __-.
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P
TaxKey No. --"-'-'---"-------'-----------------
That par[ of Government Lot Fiv� (5) , Section Twenty—Six (26) , Township Forty—one
(41) North, Range Eigh[ (8) West, described as Lo[ One (1) , recorded in Volume
One (1) of Certified Survey Maps, Page 191.
FEE
�
EXEMPT
This ...J.�_.RQC-------------- homeetead property.
(ie) (ie not) � �._,
Dated thia .._..•••-................/3- ---------•-- da9 of .---------•--- ------ - ...cK,cvL,-------'•------ -....__, 19."��..�_.
..-•---- --�----��-
---......••----••--•----------------------•---....---------------..(SEAL) _. �C/lG'M^� l�( . �"'nn-'+l.-•----------------�SEAL)
-----'-------'----------
�
. David A. Leonard
-•'------••_----......------'-•_••------......---•-------'--' -'------- ------------ ----------'--'----- ----------------"-----
C n .• �f '
..------...-----...-•-•----�----•------••----•--•-----------------(SEAL) Z� �L------�`--:-���.�.9�1GI..�---...---�SEAI.)
Eliz�eth B. Leonard
• --•-•..........................•---...-----------....---••-•----- � --------------------------------------------'--------'------•-
AUTHENTICATION ACHNOWLED6MENT
3i aturea authenticated t6ia .................. day of 3TATE OF��I�HI'X MINNES�TA
..---------�------------------------•-------� 18..__.... ss.
OLMST�D___.,.__..__County. ,
----._..... •- --- ---
---'------------------------------••--�---------�---�--------�------------ Pereonal }.camE before me,thie -�---��---------day of
. '
� �, �i�c. c_:t't' '(-�1�.�._ the above named -.-----------.-------
-'-- ---------'----------------------------'--'--------------- � f'- --
TITLE: MEMBER STATE BAR OF WISCONSIN ' _David A_ Leonard_.and__Eli.�dk�Xh..I�,__laaana�d
Qfnot- ------------------------------- � husband and wife .-------.- -
- - ----------------------- ' ---------------------------------- - --'--'-"-'---------------
suthorized by $ 708.06, Wia. Stats.)
---'--------------------------------------...-----'----'-------------------
TH18 INBTRUMENT WAS ORAFTED BV to me known to be the pereons__._.._._._. who ezecuted the
Dorsey & Whitney, 201 Firs[ Avenue SW, fore ong i '`�e�t and agkno�ledge the aeme.
.---- --- --------�-------�---- -------------- ------- ------- ----�--------- � ,�� , �� - ,
.--�- - -� �-=--- -- ---._�t,.---�--�-�-�-- �-� - - --�------.....
Suite 340, Rochester� MN__55902_______________
- - - - -
•
. .. ...................�---....---.... . . . ....-- - -
(Signatures may be authenticated or acknowledged. Both Notary Public .......... . ........... . .. ..County, Wie.
are uot necessary.) My Cammissionii4npermanentt^.'� on
The use of witncsscs is optioml. ��� � y�/� 'I �t�._._.. ,: s_j _._..�OHNR.WICKS 7g ) '
�„ r� 4 "� r•u i � 4 ;. fiUTARY PUBLIC-AIIHNE5�OL1
��:�'� OLfl,�TED COUNTY
- __ _ �;.
•N�me� of Denov� �i¢nin¢ lo �ny uD�<�tY ehould be typed or pdnted below their ei¢neturen � � i.4yCer,��,CsaionEzpiros Apr.19,189!
r:J,.J�.�::fJvUVJ.A.%J�,'�V��nNVJVHINVWNNV It
r. AFFIDAVIT
���aGiD1. a�,,s.,_ :
EXISTINC SEPTIC SYSTEM ` r a;:
ONE AND TWO FAMILY sawyer Co�r,p
Re eivetl for reCortl this /� .CBy OS
Documcnt Nwnber �A D 2000 at �
M and recorded as vol
IF THE EXISTING SOIL ABSORPTION AREA DOLS MGET THG o sonpagca YrY�
MINIMUM REQUIREMENTS FOR GROUND WATGR AND BEDROCK �-mn��i�' -
Register
DEPTHS AND 1F IT IS FUNCTIONING, AN ADDITION TO OR
REPLACEMENT OF A HABITAIILE STRUCTURE CAN 6G MADE IN ��" � � �eouty
MOST INSTANCES WITHOUT UPDATING TH8 SOIL ABSORPTION
AREA. IF THE EXISTING SOIL AIISORP7ION AREA 1S 11TILIZED FOR
THE ADDITION, EVERY ATTEMPT SHOULD BG MADE TO LOCATE
AND RESERVE AN AREA WHICH IS SUITAQLE FOR A CODE
COMPLYING REPLACEMENT AREA FOR WHGN THE SYSTGM FAILS.
IF THB ADDITION WILL SUBSTANTIALLY INCREASE THE
WASTEWATER DISCHARGE, THE EXISTING SYSTEM WILL BE �,. -,-;
REPLACED WITH A CODE COMPLYING PRIVATE SHWAGE DISPOSAL ' ��
SYSTEM.
RE'CUItN 1'O:
Sawyer County Zoning Administration
010-841-26-5513 P. O. Boz 668
Parcel Identification Number Ha ward Wl 54843
Owncr(s): David & Elizabeth Leonard
Maiiing Address: 100 Salem Point Drive SW
Rochester , MN 55902
Properiydescripcion: That part of Government�Lot 5 Sec 26 T4 N. RftW- dP��r;hP� —
as Lot 1 of CSM Volume 1 Page 19
��� �W�� DAvid and Elizabeth Leonard plan io
�� Add 1 bcdrooms on to an czisting dwclling; O Add bcdrooms on to an czisting mobile homc
O Replace an existing dwelling with a new dwelling/moUile home containing_bedrooms
O Replace an ezisting mobile homc with a new dwclling/mobile home containing bedrooms
The preser.! private sewagc has bcen workine satisCac�ority as far as disposing oC wastcs. I(the present private sewage systcm docs
fail, it will be replaced with onp [hat is code�ompl i �
J!J'iv�—Q G /� � C�L�
� Date
� � � ;� �
�-� �r�Jl G� ( %� l�`�+ r n � [ � /� /
Dare
I have inspectcd thc cxisting privatc sewage system tank(s) and 1 havc detcrmincd thal iUthcy meet thc rcquircments of ILHR
83.055 (3) (g) "Detcrmination on tanks" (i.e., Icakage, condition of baf(lcs, tank cover, and tank capacity). I have also determined
that ihe capaciry of thc czisting tank(s) is gallons and is/are sized (or a bedroom dwelling per currem
ILHR 83 requircments.
Master Plumber, Master Plumbcr Restrictcd Scwcr, Scptagc Pumper Liccnse Number Date
Personalty came bcfore me this
r'1 dayo! I�-C� .�j, �U�� L� jeYNMlM�fMT�NrReIk4G qt¢CMTIRRNk.�.+q
f�
����-�it�/l/�^--� - . 1,' I •; ¢
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��� �� �� . .�. �� F� . y
� Notary Pu�:ic - >,r; �� , ' `„�^5�
�/— � /�1/�. .}. � ..
�iY /VV�LW"�/' tb�.tYVSYpI001�i960ii.6�+A.;R�If�W6�A�vOi
Counry , �Y'+ase i
My Commission expires �— 3 � � -��'����
Existing septic systcm - Sanitary Pcrmii
Date sysiem installed
ZA or A7A
datc
This inswmcnt was drafted by: David and Elizabeth Leonard
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