HomeMy WebLinkAbout030-737-13-2304-LUP-2001-135 �_ C`��
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Application for Land Use Permit r .�
County of Sawyer � � �
PO Box 676 -Hayward WI 54843 �
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agrees that all work R, �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance �j
and the laws and regulations of the State of Wisconsin.CONSTRUCTION MAY NOT o '
BEGIN UNTIL THE PERMIT IS ISSUED. �
PRINT-USE BLACK INK OR PENCIL � �
��i�Ven e1 I/nYiv�rc � P-�t��l �((lYl �.`�� a
Owner -� Builder ° o �
1 ��a /l� g�avn P r u �cJ �
Mailing Address Mailing Address U�
�i�e�u,� �L, Lv , �y�5 �
City,State,Zip City,State,Zip �D
`7l �9��� -� �a� �
Daytime Phone Daytime Phone �
�
Building Land Use /� 5
( )New ( )Filling Zone District /y�—�
Addition ( )Dredging L-�
)Alteration O Grading Lot Size � �
/ 0
� ��'10`tinoa�II t � g�
� � � � ACTOS S �
a �
Primary Structure Accessory Building Addition °
( )Dwelling ( )Garage-attached/detached ( )Deck � o
O Year round O#of car stalls O Porch J
l
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse Living room �
( )Modular/manufactured ( )Greenhouse �Kitchen � �
( )Mobile/manufactured ( )Other �Bedroom W
Other nmar structure � '
� ) P � Y ( ) ( )Relocate/enlarge � >
� ) ( ) ( )#of new lr> �
�. �
Type of Construction >
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
�
( )Other b �
� �
�
Construction Cost$ � ��Z�� � -�
�� �
Vol�Pg � � of Deed Certified Soil Test# y c/- y�/ � �
CSM Vol Pg Sanitary Permit# 9 q�3�J[�
z
Plat Envelope Or: �
�e� �ya Pg��ct���"►u-d Year Installed �
Aff of ex septic V , P � Owner When Installed: � ��
� S'15I b I
sl�t�
Application for Land Use Pernut — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. #2. #3. #4.
Size�� ft. wide ft. wide ft. wide ft. wide
� ft. long ft. long ft. long ft. long
Floor area�sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.firom giade��o peak ft. hgt. ft. hgt. ft. hgt.
Stories� stories stories stories
# of bedrooms�
reaz lot line or waterline of lake/river
In the box sketch in: �
Location and size of all
existing and proposed structures. I � �
a- � r
Location o£septic system. j � ay. c� �
9� `_"
Indicatedistanceto: � � �m���� �, � �� ��
Waterline/Wetlands �`�N � � � � �'
Lot lines � I � � q � �-
Septic syctem/privy � ' � t�6 �
Well � � �Q'A�
Distance between structures. � '' — - � �D�y� �
�J � � o �,el� [.
Indicate North. �j
�"�i�
Fire Number: ]
/�,3 ' 4�"*� �,
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Signature of Owner 'I R[� �
The above certifies that the listed "��
information and in[en[ions are hue and I g .
correct.The above person/s/hereby
give permission for access to the
property for onsite inspection. ------- centerline of �J�p�jy� ��r`4 road-------
.
IssueDate �Y 16, 2001 ExpireDate M�Y 16, 2002
Office Comments: • ��'y� " - � E �
Signature of Z ing Administrator
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_...__.._._ �YARRAN'fY llI'sEll. TO . •
S'CA'CE OF WISCONSIN—FORM No, q -
__— __
... . .... ....___. . ... � ..___ _--: . .._.__ . . . ._ . .. . H.c.w�u.aw..wi�kau�ca ..�.,o.
NUMBER This Indenture� Mndeby :ioGe Anne Jerry, a ���idow ,
_ _ ��f)���r�..D,
-- grrintor ,ot B,i •ron
Stevell ll, Jt�i•Tv tsnd ilonna Je�nriine Jeri•p, lli� Wi fe, COuuty,�Visconsln,lioreUy convoys¢nd tvarrarits t
grancee e ,o�s ,joint teru�2its
the sum of Or,e doll�:r and qti:er va]tt�hle$ �41Ve ' Oounty,Wlsconstn,to
the following trnct of Innd In Saw�cr County,State of Wlsconsiu:
Tlie South }�ulf oi the 1Jos•thwest Qua��ter (S�_, t��) �f gEction '1}iir�een (lj)
Tow:iship 'P}:ir*.,;✓-sesen (?7) Idort}, of Range Seven (7) 1lest.
y�1.10 re-,+e�nze at�imros attachec2 and ce.r.celled,
IN �VI'['.'VIiS5 \�'fILRIsOF,the sald grantor ha $ herounto set his hand and seal thts ?th
llecembe r ,A.D.,1J 53. duy or
Slgnod aud Sealed ln Prosence of
Ho>e Anne JerrV (SEAL
L�u��a C. A±oi,ar;,�n il�lter J, Dufry -ose Anne Jerrp �
Luura C, tAcLas; n (SEaL)
'� Walter J, I�xffy
� S'fA17s UI� �V1S(:ONSIN, (SEAL)
,53w�JE I• ss.
Couarv. (SEAL)
Personally came before mo,thls �th
� day oi DecemtEr �,ll.,19 ���
tlio above numed ;ose Nt:nE Jg7-ry '
to me known to be t2io parson who axecuted the toregoing lnstrumont azid ncknowledgod the saina.
Recefvod for Record this ?th day of
IauraC. i•icLu�;E'an
Decemt;t-i• 5" 11;?0 Lnuru C, A?cLa;r;:�n
A.D„19,% ,at o'ciock A M, Of�1Cia1
Seal Afi'ixe ��eKister o�' llFt�s
7k.w•.i C. A1cLap��;;un �LoEaig;P,a�,itr, �w���i•
Registor of Deeds. County,N�(s.
mE,I.m
M9�21�sTdt3tesplres ls t 1,?np �
Deputy. °� • ,9.ll.,1�J i5
1VA/iHAN'I'Y DIED. STATE OF WISCONSIN—FORhi No. 9
----- - _
- :'-= _,_
_ _ _ ,
NU;VUER This Indenture, uadeby it. V, `I�1Cker, single
r����- qrantor ,oi
�tsw�er
Oounty,W�sconsln,horebp conveys an 1 warrants to
Lester Lepke
thoswnol One Uollar tind ot,i:er • ; 6runteo ,ot �a�:!yr'r
: .u�ible 6 County,V✓Iscou,in,for
Clio following truct of Innd In S;iwyer County,State of Wlsconsin:
'1'lie We.,t half nt the Southeast Qua te�• (W� Sr^.r�) �r Section One (1), `I'o�,�r.�hin 1'P:ir•��-seyFr, ('�i)
iVo�•t,h of :��nge Tli�ee (3) ti9�st.
5'�y� I'ever.ue 5t�ir�us attached anci �.rviceflFd.
Sub,j.�ct to an; z�nd all reservr�tio:�s oi' record,
il't�is deed i� ir,��ed in fuliillmerit of the �erms of' a certain 1a.nd cent_;
�rrantor �:n�i tt,r �;rantee and �•ecorded in Yo2. 53 of lleeds "act �ritere�i into �rrti,�r,��ri tt:e
, _oz�ge 520.
IN �VI'fNESS �ViIGREOP,the sald grantor ha g hereunto sot hi s liand and sesl thls 15 th
Api•i 1 ,A.D.,19 4(
• day of
Sigued and Seale3 In Prasonce ot
�• V. `ilicke:
�>• .:. Pl:il]ifs II. J, Fhii'.ips (SEAL)
�%. �. Fhillip;� FI. J, PhS�llipe
(SEAL)
S"1'.1'1'1?<)1� �VISCONSIN, (SEAL)
Saw��Fr }ss.
COUN'1'Y.
Fursonal�y cnmo bafore me,this �5 th �SEAL)
day of Ap ri 1
tl�e above nnmed 1 ���•D.,19�'6
�• �• �CSCBT' '
to me knowu to be thc�person who esecuto:i t}le foregofng lnstrument und nckuowledgc�d the seme.
Itoccived for Hecord thls 7th
day of (l. j
. rr����in�
;)ecember A.n.,1059 ,et j;45 o•clock P ��• %. }�hi i"I ips
M. Notarirxl
�,,, 5ea1
"�"�u`��`^ �• �La<",:"an Reglster of Deeda, A7�fixed NOt�Public, �a!��per
County, Wls.
J (�� �, ^�� DeDuty. �
MY Qoznmisslon ezplros 1-7�-50
r h n� ,n.n..�a
s;i:
AFFIDAVIT .
29��03 �XISTING SGPTIC SYSTEM •
ONE AND TWO PAMILY Registers Otfice �SS
Documcnl Number Sawyer County
Received for record this �� day of
: �A D 20�at o'clock
IF TH8 EXISTING SOIL AF3SORPTION AREA DOGS MGG"i'THG� M andrecordedasvol.�
MINIMUM REQUIREMENTS FOR GROUND WA"iER AND BEDROCK ecordsonpage_,�47
DEPTHS AND IF IT IS EUNCTIONINC,AN ADDITION TO OR
REPLACEMENT OF A HABITAE3LE STRUCTURE CAN IIG MADE IN Register
MOST INSTANCES WITHOUT UPDATING THE SOIL ABSORPTION
AREA. IF THE EXISTING SOIL ABSORPTION AREA 1S CiT]LIZED FOR D9P�ry
THE ADDITION,EVERY ATTEMPT SHOULD 6E MADE TO LOCATG
AND RESERVE AN AREA WHICH IS SUITABLE FOR A CODE
COMPLYfNG REPLACEMENT AREA FOR WHBN THE SYSTGM EAILS.
IF THH ADDITION WILL SUBSTANTIALLY INCREASE THE
WASTEWATER DISCHARGE,THE EXISTING SYSTEM WILL BE
REPLACED WITH A CODE COMPLYING PRIVATE SEWAGE DISPOSAL
SYSTEM.
RHTURN TO:
Sawycr County Zoning Administration
030-737-13-2301 P. O.Boz G68
Parcel Identification Number Ha ward Wl 54843
Owncr(s): Steven and Donna Jerry
Mailing Address: 1530 N Blomberg Road Exeland, WI 54835
Propertydcscription: SW4 NWy Section 13, �Fap 37N, R7W Town of Weirgor,
Sawyer County, Wisconsin
����W�� Steven and Donna Jerry plan to
(�) Add�_bedrooms on to an existing dwelling; O Add bedrooms on to an czisting mobile home
O Replace an ezisting dwclling with a new dwelling/mobile home conlaining bedrooms
O Replace an ezisting mobile home with a new dwclling/mobile home containing bedrooms
The present private sewagc has bcen working satisfactorily as Car as disposing oC wastes. If the present private sewage systcm docs
fail,it will be replaced with one that is code complying.
,.Date
.i
�- .5' i Ci d
Date
1 have inspected the cxisting private sewage system tank(s)and I have determincd that iUthcy mec[the requirements o(ILHR
83.055(3)(g)"De�ermination on tanks"(i.c.,leakage,condition o(ba(flcs,tank cover,and tank capacity). 1 have also determined
that ihe capaci�y o(thc cxisting tank(s)is ��000 gallons and is/are sized for a 3 bedroom d�vclling per current
ILHR 83 requirements.
F-'1-Q.��'.P. �-v.F-�«.Q�: PowTS'CS i� ZZ�c(b� S-(S'-Y� I
Master Plumbcr,Mastcr Plumber Rcstrictcd Sewer,Scptag P iper License Numbcr Date
Personally came before�q�thim��F:;,..
�,� �.��o.�v.ucr�:��,,,
I ��'��;, ��DQ I
���z���-
— Notary!'ublic
�c��' �-e3�•�1���'t��'�unty,Wisconsin
My Commission expires�0(^p�(1�a�`1g��`�� ��
Existing scptic system-Sanitary Pcrmit 99 —3'7U � CS T 4�—VO 1
Dare sysiem installcd 10 —$—�q
I�-t w ►��...Q� � ..�:�.�.�
s-�s- of
d,«
This instrument was drafted by:
s�� ����, UOL 7 4 2 PG 2 4�