HomeMy WebLinkAbout010-941-33-4211-PVY-2023-003 SAWYER COUNTY ZONING&CONSERVATION ADMIN ���,�
10610 Main Street,Suite 49 1:;J
Hayward,Wiscoosio 54843-0676 MAY 1 0 2023
(715)634-8288
www.sawvercountveov.ore SAWYER Cut�ivTY
ZONING ADMINiSTRFI"ION !
NON-PLUMBING SANITARY PERMIT APPLICATION �
In accordance with Chapter DSPS 391,Wis.Adm.Code and
��.i Sawyer Counry Private Sewage System Ordinance �
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�-\ APPLICATION INFORMATION-TYPE OR PRINT PAGE: af
y �Y Propaly I.cgW Ducriplion Q
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Propeny ONncr i Maiiing Address Lot Numbn Blodc Number
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65� ��c��- / ,Lo; / _.--.
Ciry.Stote / � Zip Code Phono Numbcrc�.3�—y3�U Subdivition Name CSM Num6a
�O���-�i �/n2*-�� UU,i:� �"�]/I� � % ''�`�v/
TYPE OF BUILDINC:(Check one) State Owned ��ry Nea�w
❑Public �i or 2 Family Dwellint—No.of 6edrooms.� D vivage �'f�����- f ��
— �Town of�/�L�12�.�G/� Firc Number'� ��'�
PUBLIC BUILDING/LAND USE:[szplain the u,dpwpcnc for tAis Parcel Tax Number:(12 digit legacy number) �
permil,(i.e..eempgmund,fmival.rtaeatioNrn�crtainmrnl event dc.11
i�1 o-1�L-.��-��Li
TYPE OF PERMIT: TYPE OF NON-PLUMBING DEVICFJSYSTEM/I'OILETNNIT:
❑Privy-Pit Toilet(CST# )
�Non-Plumbing(Privy,Talet,Restroom,Etc.) ❑Privy-Vault Toilet(200 gal. min.capacity required)
(Vault siu:_gallons or cubic yards
❑Other. Vauh Privy Type:OConcrete�Steel QPolyethylene❑Other
❑Composting Toilet System ❑I�inerating Toitet Device
$�Portable Restroom Unit ❑Other
RESPONSIBILITY STATEMENT:
I,the undersibmed,assumc rcsponsibility for thc installetion of the non-pWmbing mnitary rystcm for which this pertni�is issued. 1 funha agree thu
any dwelting in rnnjunc�ion with Ihis permit x�ill not be provided with indoor plumbi�g and/or waltt hookup. I will usc thc non-plumbing syslem
indiated as a means of wavtc disposal,end 1 will wrty water lo und from the swcture. 1 unders�and that bcforc indoor plumbing and waler hook ups
arc inuullcd,thc proper Siete and County I'crmits wil!bc applicd for. 1 fuhher understend that any dcviatians from the above will constitutc a
violution of Sawycr County Otdinences und would subject mi:�o the penalties of lhe Ordinunas. Uy signing Ihis opplication,I am also yanting
pertnission�o�hc zoning dcpartment pe�wnncl m rnter my property et any ressonable time for thc purposr of' ian w assure compliance with
thc zoning and seniWion laws rele' �he issuance of ihis permit.
Oxner's Name; Oaner's Si�mure:
!1 i S -
OFFICE USE ONLY:
Disepproved Prnnil Fa: CST No. Duc Issced Issui�Agan Signxurc
�Approvcd ❑owna Givcn Initid S I50.00 �?—0,2b 5�I� ��3 ��K�-�u.f.C��=
Advcrse Delaminalion
COMMENTS:
`Expires 2 yean from date ot issue
•NO REFUNDS AFTER ISSUE OF PERMIT
SHORELINE pROPERTY:0 YES NO If"Yes,"Name of the body of water:
COIVDITIONS OF APPROVAUREASONS EOR DISAPPROVAL:
�r�GI��L ,;��
s�,�, a3 __
Rev.04R9/I6 NO R�FUNDS AFTER � z S lv
ISSUEOFPERUIIT ;c t# ���3� A
P �,��F+
NON-PLUMBING SANITARY PERMIT APPLICATION
PAGE:� of 3
Privy Plot Plsn
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Please include thc following information wit6 distances on the ebove plot plan:
, �-;-: ,
;. .ti :a ��. _� �. � `�
❑ North Arrow l ---� y
❑ Neaz�est Road \ 9�3� i(/ �cv 27
❑ Site Address % �'�`��"'4�`� ���
❑ Structures ����3
o weu �-3� Ty//.z�')
❑ Property Lines
❑ Lake, River and/or Stream C o r/ y� t��� �
o Wetlands
Minimum Setback Requirements: �
• 10' from any slab conswcted accessory building
• 25' from any habitable building
• 45' from any property line
• 50' &om 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.0424/16
� - .
NON-PLUMBING SAMTARY PERMIT APPLICATION
PAGE:} of�
General Requirements,Recommendations and Standards:
1) The privy structure should be insect and vermin proof.
2) All windows,ventilators and other openings should be screened with#16 mesh to prevent entrance
ofinsects.
3) The privy structure should be provided with cross ventilation of 2 square feet of screened opening
for each seat.
4) Privy doors should swing and be self-closing.
5) Privy seats should be provided with hinged covers.
6) The entire installation should be kept clean and sanitary.
7) Freshly slaked lime or other equally effective disinfectants should be used at fcequent intervals for
odor controi.
8) Floors, walls,seats and urinals should be scrubbed as often as possible.
9) The outer base of the privy should be banked with earth.
10)Concrete,cement block or metal flashing should extend 6"above the ground and 12"below the
ground to prevent entrance by insects and vermin.
1 I)The footprint of any priry structure shalt not exceed 40 square feet and not be used for storege.
l2)Maximum height of any privy structure is limited to 10'.
l3)Privies for public buildings shall comply with SPS 353.63
14)For open pit privies the bottom of the pit shall be a minimum of 36"above any restriciive factor
(ground water, saturated soils, bedrcek,etc.).
15)A certified soil test is required for open ptt privies and must be filed in the zoning office before
permits will be issued.
16)A certified soil test is not required for a sealed vault privy.
17)Sealed vault privies shall have a water tight vault made of materials approved by the Department of
Safety and Professional Services(DSPS).
18)Sealed vault privies should be ventilated with a pipe of at least 3"in diameter which terminates at
least 1' above the roof of the privy and in accordance with s. SPS 382.31 (16)(a)to(�.
19)The sealed vault privy should be putnped out when nearly full by a licensed septic hauledpumper in
accordance with ch. NR 113.
20)According to DSPS 391.12, the storage chamber of a sealed vault privy shall have a minimum
stora�e capacity of 200 gallons or one cubic yazd.
21)The storage chamber of a sealed vault privy shatl conform with the requirements of DSPS 384.25
relating to holding tanks.
Rev.04/29!16
5/10/23,3:02 PM Novus-Wisconsin Access rev. 13.1108
Real Estate Sawyer County Property Listing Property 5tatus:current
7oday's Da[e:5/10/2023 Created On: 2/6/2007 7:55:23 AM
_�Description Updated:4/2/2018 '� Ownership Updated: 5/23/2022
7ax ID: 13295 ]AMES BRAZINSKY LOVELAND CO
PIN: 57-010-Z-41-09-33-4 02-000-000110 KAREN BERNER LOVELAND CO
Lega�y PtN: 010941334211
Map ID: .14.11 Billing Address: Mailing Address:
Municipaliry: (O10)TOWN OF HAVWARD 7AME5 BRAZINSKY ]AMES BRA2INSKY
STR: 533 T41N R09W 9056 BOXELDER DR 4056 BOXELDER DR
Destrip[ion: PRT NWSE PRT LOT 1 GSM 4/1 #661 LOVELAND CO 80538 �OVELAND CO 80536
Recorded Acres: 1.580 te
Lottery Qaims: 0 r Site Address `indicates Prlvate Road
First Dollar. No 9836N STATE HWY 27 HAYWARD 54843
Zoning: (R-1)Residential One
ESN: 444
J Property Assessment Updated: 11/9/2015
2023 Assessment Detail
� Tax Distric[s Updated: 2/6/2007 �ode Acres Land Imp.
1 State of Wisconsin Gl-RE9DENTIAL 1.580 23,500 0
57 Sawyer County
O10 Town of Hayward Z_Year Camparison 2022 2023 Change
572478 Hayward Community School District �and: 23,500 23,500 0.0°/
001700 TechnicalCollege Improved: 0 0 0.0%
TOWI: 23,500 23,500 0.0°/
•� Remrded Documents Updated:4/10/2014
� WARRANTY DEED
Date Recorded 5/9/2022 439020 �property History
O WARRANTV DEED ry�q
Date Remrded:7/26R004 323534
O CERTIFIED SURVEY MAP
Date Recorded:6/30/1975 151768
https:l/las.sawyercountygov.org/IAccess/master.asp ���