HomeMy WebLinkAbout010-145-00-0402-LUP-1998-693 Application for Land Use Permit �, y �
County of Sawyer w � /�
PO Box 668 -Haywazd WI 54843 W
715/634-8288 Z (
The undersigned hereby makes application for a Land Use Pemut and agtees that all work �' �
shall be done in compliance with the requirements of the Sawyer County Zoning Otdinance r
and the laws and regulations of the State of Wisconsin. S
PRINT-USE BLACK INK OR PENCIL �
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Mailing Address � Mailing Address - �
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City,State,Zip City, e,Zip
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Daytim�one Daytime Phone �
Building Land Use T
64 New O Filling Zone District r��-�( =a--
( )Addition ( )Dredging
( )Alteration ( )Grading Lot Size
( )Moving On ( ) � �
( ) ( ) Acres , �� � =-
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Primary Shvcture Accessory Building Addition ' 7�
{�Dwelling QQ Gazage�attach�e,�detached O Deck �, s
�Q Yeaz round (�#of car sTalls ( )Porch � o
( )Seasonal ( )Storage Building ( )Enclosed � �
(�Frame built on site ( )Screenhouse ( )Living room
( )Modular/manufactured ( )Greenhouse ( )Kitchen U'
( )Mobile/manufaccured ( )Other ( )Bedroom o I
( )Other primary structure ( ) ( )Relocate/enlazge
O O O#ofnew �
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Type of Construction -�
¢a Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � :
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( )Other �
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Construction Cost$ ��p� /iG r . °` �
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Vol�.�i l Pg�of Deed Certified Soil Test# 9�$-d 9�� � �
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CSM Vol � Pg F--X 7 Sanitary Permit# 9�i- ��
Plat Envelope Or: N z
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Condo Vol Pg Yeaz Installed
Af�'of ex septic V P Owner When Installed:
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Application for Land Use Pemrit — Page 2 �
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. N«�, #2. � #3. /- � � � #4.
Size�� ft. wide � ft. wide � ft. wide �__ ft. wide
� ft. long '� ft. long �2 G ft. long � ft. long
Floor area / 7YD sq. fr. s 7�e sq. ft. � 5 ' sq. ft. sq. ft.
Hgt from grade� to peak �� ft. hgt. ft. hgt. ft. hgt.
Stories .+ �� t.���R` ' `"' +� stories stories stories
„
# of bedrooms �� �
rear lot line or waterline of fS�: .-' • , � lake/river
In the box sketch in: f
Location and size of all �
existing and proposed structures. � �
Location of septic system. Y/
,� � ;. � ..
Indicate distance to: `� - �'�^ 1
Waterline � �
, j as � 3 � _ �
Road /'�-� �/ DIwSj-
Lot lines i �
Septic system �
Distance between structures. � r !
Indicate North. 7. y
IGA'w�-
Fire Number. t • , �
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Si ture of Owner y� �
The above certifies �hat the listed �-Y ,
inCormation and intentions aze true and ' �
wrrect. The above person/s/hereby
give permission fa access to the
property for onsite inspection. ------- cen[erGne of ,� ,-r ^ �! ij road-------
�1,��"� �E � i��b c�c� _ +y�� ,,�,rk . i2-p_ 4 8 7 5'�n i,�,i �cF.: Br2��ws Fo2 �u�til%cLn u�'z.'
R-� y R'1.�,.., ti 1� �bnrka �.��ae vx.��"
IssueDate December 2 , 1998 ExpireDate Decem er 2 , 1999
Office Comments: ���'�""""' � l��vh'��
Signature of Zoning Administrator
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Document Number: '
SEPTIC TANK MAINTENANCE AFFIDAVIT
This affidavit made and entered into this day of
, 19 , by
known as owner(s) of property identitied by Pazcel Identification
Number(s):
WHEREAS, application has been made for a sanitary permit on the
following described parce►,to wit: R��.l,o
LAND DESCRIPTION Sewyer County Zoning&Sanitution
PO Box 668
Haywerd,WI 54843-0668
AS OWNER(S; of the property described above, I (we) agree to submit to the County of Sawyer a
certification form (to be provided by the County), at my(our) expense, every three years and signed by a
licensed Master Plumber, Master Plumber Restricted Sewer, a licensed sep[age hauler or licensed plumbing
inspector. The form shall state and certify the following:
1) The current operating condition of the private sewage system,and
2) That the septic tank was recen[ly pumped by a licensed septic tank pumper or it was inspected and is less
than one-third full of sludge and scum.
I(we),the undersigned,have read the above requirements and agree to maintain the private sewage system in
accordance with applicable state standards.
This AFFIDAVIT is to run as a covenant with the deed and shall be so recorded at the expense of the owner(s)
and be binding on all successors and assigns of said parcel of land.
OWNER(S)
Date:
Date:
STATE OF WISCONSIN:
Personally came before me this day of , 19 the above
named person(s)who executed the foregoing instrument and acknowledge the same.
Notary Public,State of Wisconsin
My commission exp�res
7his inswment was drafted by:
w �7 � � � � STATE BAR OF WISCONSIN FORM 2 - 1982
WARRANTY DEED
DOCUMENT NO. Rbpiner's Offlce `� .
_ _ _ _ _ - - -- - --- -- Sawy�r County f
-- _ - _ _ _ . _--- --- --- — — -- — . .
INor.�ived for rucord tt�is �� day of -
Russell D. Clagett, aka Russell D. Clagget and �"i4'T � AU ,y .�� a, �� �•�:,o�K
Barbara Clagett aka Barbara L. Clagett, aka Barbara _�_ M a�a f2�GfdEd �5 �oi. �y'��_
L C1agaEtL his wife and in her own riqht, . �� s ,on uage � � -
,< <c . c2�x.�-x�
conveys and warrants to .781f�S E. Wolff and RoGerta M. WOlff, �'�;`r
his wife, as ioint tenants
Deputy
THIS SPACE RESEfiVEO FOR RECORDING DATA
NAME AND RETURN ADDRESS
the ioUowing described real estate in $aY►'y�r County,
State of Wisconsin: P@QP1eS NdtlOnd 1 BaRk
That part of Lot Four (4 ) , Linden Subdivisior, �escribe�
as Lot TwQ (2) , recar�E�d in Volume Ninetee:n (1g) of , ,
Certified Survey Maps , PagE• 287 , Surv�y No. 5711 . .�� � �
--- -----_ :_ _ _
Grartees are non-resi�er.�ts of the� State c�f Wiscc�snin . ��
010-145-00-0402
PARCEL IDENTIFICATION NUMBER
Grantors , for thErr�selves , the•ir heirs , successars a�,�
assigns , here���y re�serve� the usE af existing driveway arez describe�� as folloM�s :
ii Commencing at tt�E• �Iorthwesterly corner of said Lat 2 of Certified Survey Map �
� as recorded in Volume 19 of CShf, Page 287 , Survey Na. 5711 , said cornEr being ��
the pc�int of beginn�ing ; thence North 71a57 ' 46" East , along the Southwesterly ;
I right-of-way- lir�e� of Linden Road, a distance of 13.0 feE•t ; thE�nce in a southerly ;
! dirE�ction in a straight line to a point or� the westerly pro��E�rty line� of said Lot 2 !'
of said CSM that is Sauth 1b°53 ' 17" East of and 162 .0 fee�t from the poi�t of �i
� beginning ; th�r�c.E� North 17 53 ' 17" West a distar�ce� of 162 fe�t to the point of
beginn.ing. Exact rights an� du�tie� regarding this re�servation are more particularly ji
se�t forth in separate agreement bearing ev�n date herewith. ;�
TRANSFER
� </l5, � �
FEE '
This 1 S nQt homestead properry. ��
(is) (is no[)
�, Exception to warranties ��
Sub�ect to reservations , easerr,�nts an� exceptions af recor� an� Sawyer County ��
Floo� Plain Ordinar�ce�. �
Ij
�� !I
Dated this 1 \ — day of September , A.D., 19 S8 �;�j
� '''
� �CL�(,-G � � CC (SEAL) � '� (SEAL) ��
�
. Barbara Clage t , aka . Russell D. Clagett , a a ��
Bar ara L. agett, a a usse . agge 'I;
Q9MF19M'.l � , rT�.��a+ (SEAL) (SEAL)
i y
AUTHENTICATION ACKNOWLEDGMENT
I
State of Wisconsin, i
Signature(s) �
ss. II
y �
aw er co��,�v '
aut}ienticated this day o( Personally came before me this �day o[ I'
September , 19 98 , the abuve named
� ,, :•� ' �.:� �.ti Russell D. Gla�ett , aka Russell D. Clagget
� . �� ;'-•�� ° ' ': ar�d Barbara Clage�tt , aka Barbara L . ;
;; Z�n��E: n�Eti1B�Rsr�lEs.aaorwiscoNsi j► '•; Clagett , aka Barbara L . Clagget , his w fe , I
, ;y, ����. . ;,li,
��� Qf not, � � ,.::; -- ��
; authorized by §706.06, Wis. Stats.) ti ��`�G ;t, �� me kno e erson S whu e � ed the fureguing ;
. : �
�,; �; �,; 4 instr n ow sa �
i� THIS INSTRUMENT WAS DRAFTED BY ��""���� �
" Hor►�ard E . Na�sG�u , Attorney ,
�I a d E . Hans�or
�il Notary Public, County, Wis
(Signatures may be authenticated or acknowledged. Both ar My commission is manent. �E�Qg�.X�.y�g��p�iR�i�pg��j� '
�i 'I
necessaiy.) ,�}i ) j�,
_ - -- - --- - -- -- --._ _ . _ �
- _ - - __ -- - - - --i��L -
. �
• Namr�u( Exiwns sigmng in any capachy should by typed or printed below their signawres. � 4 � �r�] � I
STATE BAR OF WISCONSIN " � w�scons�n L al F3�aruc Co . Inc
�� WARItAN7Y DLL'll Form No. 2 — 1982 Mqwa�icee, W�s �
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