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Home My WebLink About010-841-20-1203-LUP-2001-057 � �s = Application for Land Use Permit `'�V� � o a County of Sawyer � � 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 la�vs and regulations of the State of Wisconsin.CONSTRUCTION NIAY NOT � BEGIN UNTIL THE PER�tiIIT IS ISSUED. � PRINT- USE BLACK INK OR PENCIL � � � 7 �+�^ V /� y— `�- <� eTYr�y `�- svt�an� c l� rC, cc � � I /� f`a�� f� L.s^ c1 ��cl � o,,- a'. Owner Builder ° o < , .�,-,zc,� S-}�q�� oa�' 77 � Mailin� Address Mailing Address ~ � �s � { �j � �c..1 I.i J a i�c.'i.` E�:: `r F��a.,�^ _ ;��r��, �ra`/ :....s�n r� � �.tJ� ��d�� p City, State, Zip City�, State, Zip � �� (fl� `1- lo`7t � �� `%- 3y1 $ n Daytime Phone Daytime Phone r' Building Land Use 1� O I�ew O Fillin� Zone District fi - � � (� Addition ( ) Dredgin� -�'� (� Alteration O Gradin� Lot Size 33O' X 13 20 � � ( ) ��Iovin� On ( ) � �4� � ( ) ( ) Acres �p. 9 � !c - ci� � � Primary Structure Accessory BuildinQ Addition�/ ��,� ;o�. ' � ( ) D��elling ( ) Gara�e-attached;'detached ( ) Deck � ^ O �'ear round O � of car stalls (�'Porch - E„T,y I� `' O Seasonal O StoraQe Buildin� O Enclosed � O Frame built on site O Screenhouse O Livin� room � � ( ) :�lodular'manufactured ( ) Greenhouse ( ) Kitchen ' � �lobile/manufactured � ) ( ) Other (�(� Bedroom ( ) Otller primary structure ( ) (�Relocate/enlarge �, <- � ) ( ) (I) � of ne�v � � Type of Construction ;a � (X) Frame ( ) Lo� ( ) Pole/metal ( ) Block ( ) Concrete � � ( ) Other v N i --� ` o �S � � �-r , L o, �� v r � wr- O+ c I r Construction Cost S gp, c� vo, oo ;. � � Vol 3 qZ Pg�of Deed Certified Soil Test # 7S- !�3 N CSM Vol Pg Sanitary Permit # 7S- J�'"Z D/�D�� • z W Plat Envelope Or: ^' Condo Vol Pg Year Installed Aff of e� septic �'� P /� O��i�er ��'llen Installed: � 311�'O;t„ ��. Application for Land Use Permit — Page 2 Describe Construction: List dimensions of each structure, story, addition, or alreration. #l. #2. c k3. h4. Size� ft. wide I�� ft. wide ft. wide h. wide � h. lon; ' ft. lon o _�1__ � ft. lon� ft. long Floor area__�� sq. ft. �IZ sq. ft. sq. ft. S � 9� H�. &om gade ��r to peak /(o � ft. hgt. ft. h�t. ft. hgt. Stories �_ __.L stories stories stories # of bedrooms ___�__ -TO�i l y 3R rear lot line +r�e� _ -__ --------��rver �- ..�..�-� In the box sketch in: �---- 3 30 ' --� Location and size of all � FX;sT; . 1�; )8 +��5 existin� and proposed stnic[ures:/ � a« s�oh.K A S S��r �; h ��. Location of septic system.✓ � �0 7Y� q, ,N 5 � , I 11 A �lJ` � l � ON � . Indicate distance to: � �� .V�i��kae/�'et�laads ��F ��1� �t Road J f 0 , k�° pr� Lot lines� � � 5 '� -�� c � sz�c�� syscz�„ip�[�.y J � W� 5 eP �,�'eu ./ � ��r Di�tancebehveenstnictures.� �, �'�'$; , o (�a�a�` ,� s�,,,�� o z •� �iv iy 23 w Nofes �� o�`c Indicate North. V yY� a6 '_ � Z ; 80 � ze' � �7�� —� Fire \ttinbzr: # �b-' � l 3 9 O b�/ � / 3ti � ZoS� I � iSS , i /O� I I �i n. ure of O�cner Thz above certifizs that thz listzd information and intentions are tnie and correct. The abo��z pzrsoa's%hzreby I ��i�'z pzrmission for access ro the propzrry for onsi�z inspzccion. ------ centerline � „ road------- IssueDate April 11 , 2001 ExpireDate April 11 , 2002 Ofticc Comments ��,�%�tii�r+'X-!.�z��//t�! Si�natur� ol Zonin, r�dministrator WISCONSIN'S NORTHWEST vISTRICT ZONING ADMlN1STRATOR'S ASSOCIATION COUNTIES OF: ASHLAND DOUGLAS PRICE TAYLOR BAYFIELD IRON RUSK WASHBURN BURNETT LINCOLN SAWYER SEPTIC SYSTEM INSPECTION FORM Requescedby: �jVf 6COfSc�'1� Counry:_ S�W�e � Address: ��c�p � �-}r�.�-2�� own Ciry, Village: W�y �,.ar.«ck' Giry, State, Zip: ��yJT L� gy � Phone: `715 -1e3�1 -313� _ Legal Description: �� /. of��__ '/. of section a0 T �__ N, R _�_ E �W Owner/Occupan[: SU 'L �rf D2Y hl Sepcic Address,�Name: 7S - IS�, Address:��,�Q ��0� '� Septic Serves: 1 �ornf � Ciry, Scace, Zip: (ex. i1 of homes, bam, school, church, induscry, ecc.) Tax Parcel N O�o-�Sy 1 ab - iao� . a.� Date of conswc[ion: If consvucted aher January I, 1979 enterp�LHR s nitary permi[ number �S - / S � (if available). Currt�clr ho,.� \� i�n 1y$3�?)�Se� ScP�,� �o.n�(. �Y�.a#,a�.y p�act �n 15'15 �'N�w� ho�ye b��e� d0�nl SEPTIC TANK IN�F�RMATION ,��,,,�y ��,�o'y � Information ob�ained from: owner pumper o�her Tank Conswction ILHR 83.1 S(1): concrete� steel flberglass o[her Approximate tank size (if known) � (�Q� Has che tank been pumped on a regular basis per counry maintenance agreemen[? Yes No� Per owner � Per pumper Pumper's name Has �he tank been pumped prior to the inspeaion?,Y/es No � Per owner Per pumper�� Was inzpeaor on sice during wnk pumping? Yes �C No Was sludge/scum level greater �han 1/3 of �ocal volume prior to pumping? Yes� No Evalua[e condicion of bafFles: General condition of sep�ic eank: Iniet Oudet i.e.: cracks/holes in cover, sidewalls, bottom Good _ /� _� explain: �nOOfl Cc�_D i i i C� _ Need replacement Missing MANHOLES Is service cover more than 6" underground? Yes _ No � is service cover above grade? Yes__ No/� Does cover have a warning label, chain and locking device if above grade? Yes No Is service port in code compliance? Yes x No Is chere a manhole riser on tank? Yes x No Is service cover riser properly sized and wa[ertigh[? Yes /` No Iz [here a 4" or larger inspec[ion opening �c ba(Fle opposi[e service cover? Yes _ No_� Is inspection opening or pipe ac leasc 6" above grade? Yes No SEE'TI� SYSTEM Conventional Bed Trench Pic (cirde one) In Ground Pressure Mound Ac Grade Pr�"Y Approximace Age: 2�P �GF} 25 Other (explain) Torai Area: zq. fc. Is septic cank and dosing cank in setback compliance from: Dis[ance in feet: building? Yez X No Unknown_ well? Yes X No Unknown high wacer marfc? Yes_ No Unknown �' lo[ line? Yes� No_ Unknown pool? Yes No_ Unknown_ other? Yes No Unknown Is chere a dosing chamber? Yes_ No� Pump — floacs — alarm siphon checked for proper operation? Yes_ No_ Is absorp[ion field in se[back compliance from: Distance in fee[: loc line? Yes�� / No Unknown_ high wa[er mark? Yes y No_ Unknown_ pool? Yes No Unknown well? (except for schools) Yes� No_ Unknown ocher? Yes No Unknown iz there an approved ven[ presen�? Yes � No Is the vent functional? Yes � No__ Is there wacer presen[ in the ven[? Yes_ No� N of inches_ � Was a soil boring conducced 3' below exis[ing rystem? Yes� No__ Unknown ,i � Depth to groundwater? (;/ti�(�� inches Dep�h ro motded soil? 75'�,�— inches Is there exis[ing soil si�e evalua�ion available? Yes No t Was boring done by a CST (Certified Soil Tescer)? Yes� No Unknown Is owner aware of any backups, surface seepage or discharge, odors, siow drainage, e[c.? Yes_ No� If yes explain I cercify that the above informacion iz true and correct to the best of my knowledge as observed on !t'IA2U1- Z� , f�0� Opera[ional aspec[s and observacions reported are based on the condi[ions noted a[ the [ime of inspection. This inspec�ion does no[ in any way guaran[ee or warrancee [he con[inued opera[ion of che rys[em described herein. ��Q'�� czs q �>�r��/ �/ 2 0� � �� I eaor's Sign�cure ` Gedential N mber Dace Attachmencs required: ❑ Approved plans ❑ Soil [est report ❑ Copy of main[enance records (if available) ❑ 8"x IO" plo[ plan of liouse, well, tank(s) and soil absorp�ion sys�em N+scunsin DeDartment ot Commerce SOIL EVALUATION REPORT Page_of_ Division of Safery and Buildings in accordance with Comm 85,Wis. Adm. Code Counry � Attac�complete sile plan on paper nol less than 8 1/2 z 17 inc�es in size. Plan musl ��-�-�4L '� include, but not limiled lo:vertical antl honzontal reference point(BM),direction and parcel I.D. i � percent slope,scale or dimensions, noM artow, and locatlon and distance to nearest road. �,'��i —�y�—��— � ZU Please print all information. fieviewed by Date Personal inlormaUon you provide may Oe used for secon0ary purposes(Pnvaq Law,s.15.04(7)(mJ). Prop=rty Owner Property Locafion ..1Ct=i � Sca� (LC;ESC-I}L co�i.�o� �(ti,�va �C-� va s2C r � N R �� e�o�w Property Owners Mailing Address Lot# Block# Subd. Name or CSM# i 3 � 6 i,.: S�Tr�i� 2� �`�- Ci S1ate Zip Code Phone Number �City �Village �Town Nearest Road �'w�42.n �'i S- t1 c �� 3�— i3 lfi�Y��-2D sta�� c� �`� � New Construction Use: ResidenUal/Number of bedrooms 3 Code derived design fiow rote - GPD ❑Replacement ❑ Public or commercial-Describe: Parent matenal Flood Plain elevation if applicable � k. Gene21 comments � and recommendatlons: 5�5 j�� LG V. �U G . C� Sc,�S ��-��i��(� Bonng# LV Boring � c� � p�� Ground sudace elev. L ��(t. Depth to limitlng factor � � C in. Soil Applicatlon Rate Horizon Depth Dominant Color Redox Description Texture SWcture Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. ConL Color Gc Sz.Sh. 'Eff#1 'Eff#2 ! -3 � `v�2 3� L 5 2 3- I 2 .�;r2 `�3 � 5 lz-3� ��„�'n_ �� 5 �-I �-Sz �;2 �/ 5 .5 Z-7 c� 7„�7rz `�/� e� S ❑ Bonng# ❑ Boring � ' � pit Ground surface elev. ft. Depih to limiting(aclor in. Soil Application Rate Horizon Deplh Dominanl Color Redox Description Texture SWcture Consistence Boundary Rools GPDIft� in. Munsell �u.Sz. Conl.Color Gr.Sz.Sh. •Eff#i 'Eff#2 ' EfFluent#1 =BOD,>30<220 mg/L and TSS>30< 150 mg/L 'Ef�uent#2=BOD,<30 mg/L and TSS<30 mglL C T ame (Please Pnnl) S' ature CST Number ; , � �� ;��;c`r' � — . C � 2z�z3� � Address ate valua'o C ducled Telephone Number 21 � �(:� 13�1 ��fi �i-� w 1 . Z 1 S z$ ZC.e �/ 2'.�`/� Property Owner Parcel ID# Pape of ❑ Boring# � Boring � pi� Ground surface elev. ft. Depth to Ilmiting faclor �^� Soil Application Rate Horizon Depth Dominanl Cobr Redoz Descdption Texture SWcture Conslstence Boundary Roots GPD/N' in. Munsell �u. Sz. ConL Color Gr.Sz. Sh. 'EH#7 'Etfa2 ❑ Boring# � Boring � pi� Ground suAaca elev. k. Depth lo limiting factor in. Soil Appiicatlon Rate Honzon Depth Dominanl Color Redoz Description Texture SWcture Gonsislence Boundary Roots GPDttI' in. Munsell �u.Sz. Cont.Color Gr. Sz.Sh. 'Effitl 'Eff#2 � Boring ❑ Boring# Ground surtace etev. ft. DeP�lo limiling factor in. ❑ pit Soil Application Rate Honzon Depth Dominant Color Redox Description Texture SWdure Consistence Boundary Roots GPDttt' in. Munsell Qu. Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'EN#2 •EHtuenl#1 =BODi>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD�<30 mg/L and TSS<30 mg/L � - The Department of Commerce is an equal opportunity service provider and employer. If you nced assistance to access se�vices or need material in an altemate format,please contact the department at 608-266-3151 or T'CY 608-264-8777. seo-u�o�a voot OF HAYWARD TWP 41 N. R.8 W . I ' i1'./s t.cf i .9 ;.t. � .I. I � ' .1.2 2.1 2.3 � ,� � 1.5 r� il .1.6 � .2.2 �� .1.4 � 1 .1.8 .1.95 .�.J L ' .�.7 �� 2 4.94 4.3 � .32 , 4.2 4.95 4.4 3•I 1 .4.1 1 13.2 .14.1 � 13.1 � 1 .15.1 .16.1 _ I io�ar .r AFFIDAVIT . �n�o�� EXISTINC SEPTIC SYSTEM `� ONE AND TWO FAMILY Document Number IF THE EXISTING SOIL ADSORPTION AREA DOHS MGET THG Register's ONica 1 SS MINIMUM REQUIREMENTS FOR GROUND WATER AND 6EDROCK SawyerCounry 1 th DEPTHS AND IF IT IS FUNCTIONING,AN ADDITION TO OR R6ceived for record this,,,��deY o1 �pri 1 A D 20 O I et .7�o'dock REPLACEMENT OF A HABITAE3LE STRUCTURE CAN BE MADF.W �and recorded as vol. MOST INSTANCES WITHOUT UPDATING THE SOIL ABSORPTION otFecordsonpage1 3- AREA. IF THE EXISTING SOIL AE3SORPTION AREA IS 11TILIZED FOR Register THE ADDITION,EVERY ATTEMPT SHOULD BE MADE TO LOCATE p n AND RESERVE AN AREA WHICH IS SUITABLE FOR A CODE �'"''"� �"� oepury COMPLYING REPLACEMENT AREA FOR WHEN THE SYSTEM FA1LS. IF TH6 ADDITION WILL SUBSTANTIALLY WCREASE THE WASTEWATER DISCHARGE,THE EXISTING SYSTEM WiLL BE �l�,�a REPLACED WITH A CODG COMPLYING PRIVATE SEWAGE DISPOSAL SYSTEM. RETURN TO: Sawyer County Zoning Administration '1 'i �\p-��-a(�-1a03 P. O.Boz668 Parcel Identification Number Ha ward WI 54843 Owner(s): �p�} 'r5U2 E7roesch� MailingAddress: ��c�17 W ��e ��1-1 Nn, v�c,,r v�S sy 8 Property description: `VW`I�{ \`��1��i ��ao ��i I N ��w r„�',l "�e�- -tSoe (�roeschl °�a°�� .,`� (J) Add_�bedrooms on to an existing dwelling; O Add bedrooms on to an existing mobile home O Replace an ezisting dwelling with a new dwelling/mobile home containing_bedrooms O Replace an ezisting mobile home with a new dwelling/mobile home containing bedrooms The present private sewage has been working satisfactorily as far as disposing of wastes. If the present pcivate sewage sysrem does (ail,it will be replaced with one that is code complying. -� .. �� 9 3 �o '�"' Date Date I have inspectcd thc existing private sewage system tank(s)and I have determined that iVthey meet the requirements of ILHR 83.055(3)(g)"Determination on tanks"(i.c.,leakage,condition of baf(les,tank cover,and tank capacity). 1 have also determined that the capaciry of the existing tank(s)is 7 GOU gallons and is/are sized for a_�_bedroom dwelling per current 1LHR 83 reyuirements�� ,/i 205 _ 's' Zo0'� s Master Plumber,Mnsler Plumber Restricted Sewer Septage Pum er License Number Date Pcrsonally camc bcfQrc.r�e this �� °�'of. IL ,�'��..-- �►��.--�. r�� p ,a - Notary Pu lic : . 1�. . '��•(' • i . �� Counry,Wisconsin �.,.. My Commission expires 11� 30—a��0/ Existing septic system-Sanitary Pcrmit 1�-�5 a. Date system installed ZA or AZA datc Thi insm�ment was drafted by: ' ' _ � � � �� VOL � 3 � �� '� :� : �� G. _ s,i. I o�v CUKC ��) �d �,z x z� =- 2�t3 � Ne� w b� s�S� - �qr� : � _ �s� � ex s�s�. 33 .S (� �-F ``�``� ��od P � �'ti s��F S.T. ;� o K 0.'F'F�c�c�.,�c� �r' S.T" . � ��, � �,�5 6.� �ST- -4',�I I o�� c�.�(e�l c t k 5 t�c{ . �',�s�-c�v:. �aY,..-_ The East One-Qunrter of tl�e NortliweToWQghipeFortyConeN((41,)eNorC1�,��tCer l(�}NW}NE}) of Section Twenty �ZD) � Range Eight (8) Wese. VOL �736P� 1 � � �-- --- � - . � I 7HIf f►AC[ R!S[RVEO �011 11[CORDINO DAT♦ DOCUM�f; i i� � STATE BARWARRANTYSDEED RM 1 — ise2li VS - ___ __ _ - -:_- ::., . _ �� a��. a„ro 1 , i�. .:._:__ ----- - —_-- - I Sewyer Count7 1 R�•Wcri I.�r rt�rntd the � �7 d This Deed, mado betwcen WILLIAM._R..,.D�WITT�x..nn._udult_, , � p D 19� e� l �o'dc+� ...... ........................................ A1 and ro:.orde�l 1n vcL 3 G^ .. .. ...................••••-••••--•..........•••---..._.._....__. - . • i .. ......................................................... ....--•-....................•••-..._...... ol He�.vr�1e ot� Fx+qo .._..... . ... ..--••••...................... Gruntor, � ,�}...�.� �7�G-- � 1 ...••••-•••.................••-••-•.•••..........••-••••. ------. . 8nd......T�k'F�Y..G_....GRO_�S.C.Hk_.and_.SU.�AN.N�..I.,._.GRO�SCHI�,-••hu�tzand I �� ..........and..�i.��...za..ba..ha�d..as..�o�xxt��._sux��xaxsh�P�............. ., . . . . �s .._.......pragert�.......•••••.......................................••-••--•-•-................ . . . . I - i ••••-•......................•••--;...........••- •----....._......••--••••- •-••••--•...._..._.. .._, Grantee, � Witnesseth That the aaid Grantor, for a valuable consideration...._. (� __ -- - _.__.. ..,of._nne_.dQlZaz._ansi..aihax_.�ra�uab.le..considex�xzor�.......-- �i RETURH To conveys to Grantee the following deacribed real estate in ..��Wy-es'••-•••----•--------• I�yorth Land S & L County, State of Wisconein: !� P. 0. BOX 636 'I��Wi Sd$��--_ - . . ,_ .. , Tnx YAT�e► Na: -�.............•-�----------�-•---� The East One-Quarter of tlie Nortliwest Qunrter of the N�rthe�Gt Quarter J(E}NW�NE}) of Section Twenty (20) , Township Forty-one (41 ) Nurtti , Range Eight (8) West . TRANSFER � $ FEE This ....._iS .---••--...-----. homestead property. (is) (ia not) To�ether with a❑ und ain�ulnr the hereditnmente nnd nppurtonnnres tf•..�rrunto l�rl��n�.in�: �Y.tlll'UY . .._. ......... . . _ . And_.. �a................ ................................ . warrants that the title is good, indefeasible in fee simple and free nnd clenr of encumbr:�u�.•s e�rr{�t all easements , exceptions and reservations of record. and will warrant and defend the same. August 86 lst _......., is.... .... Datedthis ................•••--•-••--•••-••--••-.--.._.... day of ........................................��......... -- ....... SEAL G!�....'•---•�1"'/•-...i•....•,.<Cl'.C-.._v�--.(SEALI ....................�----------...----••-.--•••.-�---.... ( ) . ....... ............... ...................................... � iII,L�kI.A�i.R...A.�NI.TTE ... . _ -....._....... - -----------------------------� -••-----•...................�----�---- (SEAL) ........................ .............._ _............._.. ...._._ l�E.�L � • .._...._ � • ........................._...._......... __........._. .... -•----.......-.-••---� -.....--�-••..................... AUTHENTICATION ACKNOWLEDGMENT Signuture(s) ............... STATE OF NISCONSIN --•••••---••--••-------•-•-•-----••-•-••••••- ss. --------------------•---•.._....•-••••--•--•---••-••-••----•-•---•---...•••-.... SAWYER --••••-•--•-._......-�--•---•�------..Countc. authenticated this ._._....day of........................... 19...... Personall�• came before me thi� _._lSt dup of ............. AUgl1St .._..... ....., 1g.86_.. tlie aboca named ..............•--•---•-•....--•-••••-•-•----••-------•....._..••--•---•-•-•••--• WILILA61 R. DEWITTE ......................•-•---._......•-••--•----...••••--•._..._..•--•-----•..... • -•-••••••.....--••••-••-•-•--•••--.....-•---•--.._..-••-•--.......-•-•--••••.. .........................•--••-------••••-•.-----...•-••--•--.._.._._..------... TITLE: MEMBER STATE BAR OF WI5CONSIN ___________________________A�_��^_........_._.._.__...._.................. (If not, ••--•--••-••........-•-- -_••••••- --....._...___. _-c.1�,i ~., . •-••• -••••••••-...•••••••- ....ti.-•••••--••-••-••••--.............. authorized by § 70ti.06, Wie. Stats.) t' ,� •' +. to me kno�vq:'to�.Cl �� i�tD�,-.4.--._._ n•ho ezecuted the fore�o' g itfs�i41�Q``� I��: ,;}�d�v3�tS�e the anme. I� THIS INSTRUMENT WAS ORAFTED BV � /'�"�`� '%; ��[��.;r� r: ' J = . �/ • , - 'I i- �"'f .'n�� 1. f�^'�'�' ..��.' ..... .. .. .1.. ... i. ..,.. ............... . ..,.. ... .. .. . _..........�h9mas,W;,_.11uffY.,--••-•-••-•-••-•--••••••••--•--••••••• . Cha�l'�AJ• ' � •--•••••......,--�..;......(��1;...,..T......................... . Hayward,...WI__,_54843___ , __. _..._.. Nota�v P�tbt� '' Sa e ,r• ',� .. • ..__.. • ........-•-•... ......... • • -•-••-•-••••-•••- .•�•::_-;::�".�Y._. .. .. ..... ..Co::r,.�-. R'�=. (Signatures may be au te�d-or ac ow d. Bot M�� Commission ��' permanent..(•�f not, sta:e es�ir:::: �-. nre not necessary.) �� (� � �� ........... ...Decembe�.-1-3-..-_-----... ...., 1P.... B'i �, dute: . •Nemea o[ Dersona efRning fn sny esn�city nhoulA be tyVe�l or printed hclow their siqnaturce.