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HomeMy WebLinkAbout020-638-10-4401-LUP-1994-498 Application for Land Use Permit . County of_ Sawyer y "� 0 Tlie undersigited hereby rnakes applicatiori Cor a Land Use Permit and a�r.ees th�t� 1 `,_ all_ work shall be done in compliance wi_th tl�e r.equirements ot the Sawyer County o Zoning Ordinance and the laws and regulati.ons of the State of Wisconsin. PRINT - USE BLACK INK OR PENCIL � � i� - ���..:��_..��,:. � � . e ,� : �: c� �� � , 1 �� � �� ��,� ���� Y,n � Owner Bui der L�_� �1 ��� a�r � r c� S �-� Mai i_ng AcIc�ess Mailing Address ��1,�� ! �J C-!_.,�C�. lr'���1 . ��5`� �Cr" � Ci.t�y, State , Zip City , State , 7ip r-, o 0 Buii ng Land Use Zone District ��.� � � � ( New ( ) Filling � �o ( ) Addition ( ) Dredging Lot size �' ,� ` ����,.c,'.:a� � '� ( ) Alteration ( ) Grading ( ) Moving On ( ) 1 -, � �, � Acres _-`",'� � � C�� ( ) �;��m � e.;� ( ) New Construction � Size ��_ ft wide ' wide ' wide Z Zr`��_ f t long ' long ' long � Floor area � � �� sq ft sq ft sq ft � � To tal hgt .� �' to peak ' hgt ' hgt x' Stories �' No , of Bedrooms �- rear lot line or-<wat���ne o C (year round) or (seasonal) G �* Type of Bldg , Addition, Use a o ( ) Dwelling �• �r ( ) Garage ( 1 ) (2) car � �• ( ) Storage �3uilding � ►-,• ( ) Boathouse � ° ( ) Livingroom � ( ) Bedroom ( ) Kitchen-Dining ( ) Porch (enclosed) (roo£ed) � ( ) Deck - open S � � z� 9(� ���oC� �ner� ,� �- e 3ti � � r�r . � ti�� �� Type of Construction � ;1�.� I � ��� ( ) rrame ( ) Iilocic n� �' f ! � � ( ) Log ( ) Concrete `' � Q ` r��• ( ) Pole ( ) Steel 'r�' ( ) (�{) Pole/Metal Q F U' � � � � Construction Cost $ 5����, �� Vol �� Pg �� of Deed �`' CS Vo 1 pg _..._..._ � y -,� _ .? � �� � ( o � �� � � Cer . Soil Test � ��Q �� � Sanitary Permit � �� -- � road ~ L -------------- � e � _..x �.,_i R r t.,„�:� • 7 o � Issued 09 November 1994 Denied _ F � � �^- 1 V v\f'�' ���4�1 \ "L �-1 r �}.JC.�{J\.J —/ Owner Zonin� A�minist ato-r J� , �, � �' � � /� i1/�' 1 . � ___.___ __--- 12�� � 9 _�.� .,� _ _ � , . •,o`, � \ • • , .-, . �---� �,, .�, / ��S � J ' �� �., �r � - � . , o� ,�•.. �I � � �� � ��' � � w � .. (a � �, -� � _ c- `�c e � . -'3-� -�' R , � � __-T---- _ " .�--.:^ -- —--- -- �" � , � v' �1 _— " - �,, - e� .-.. � � --. __ — "`_ _ ___--- f � � �� -� P � . --_. ^ �,� `� .� --�� 1�,,4`� ------ -- - - '� c, �-v 'i 1 C c �. C 1 � y � - � �, - - `—_�� �-, ' � - � . . �... �- � , � ti �, . r` ,.�� �_ �° 2� . O � — � 1, ' � . ..._ � �, �c� " �_ t� � � ' f • N :. �. __ � ' � l+ 0 � R �-- ___ "� , . --- � _.. � � � . � , � i � ; l� .. � � .. ; � �. ; --_ ._------ ,: �> .--. ._--. � i w ti �. ti � ;�' ��� k� ..��4'..�..�� . .i�:s..�.. � U � _ _ � _. � __ � . � � �r„ ��. _t . . � . � . ; � � � . , _ __ � . � .�tu = ,<ui ,�,v , � � � ��i,v '� .10.1 .q. l � —' .l4.( � .13.1 �,�- ;I � --- . � u ; u� �� � � ; � � � � -- - - � �a � =� �.� �(� l(�l/ . U(// � � ��� 1 �I(!/ � � 114/ � � ..._. � �U/ ��/// � � .l i.l ti1 L!%� .t 2.{ .t�.l .lb.t � � � � — � �t�ii ,11 �ii �� � �r/ . — �� � � �� 9 - /b l5 ` 15 �E F : 1} E R I A L f'H 0 TO t I 4 C �-5- Iq 10 ) SCALE: I INCH= 4 00 FEET FOR ASSESSMENT USE ONLY � i � c � c lA/ fA/ `TFC? t� >> eT1 � i4 � � 1 nROWN RY ' � M F ne^rr • � _�_ , e -, ,, �••-r�......_ �_ -- - ---- - - - - - - - - � � . s � P �� 6 7 State and County State Permit # 519� . . I � Permit Application County Permit # _ 9- 169 for Private Domestic Sewage Systems County SaWyeT ' ;DENOTES STATE APPROVAL REQUIRED CST 6- 190 Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: ��' y �� ���/�c ti/ /c, . _7�. 'l�����>,`} t� f ��,/�L , ����- f ;; `, >/ `� �'� B. LO ATION: _`�_Y4 .��„_Y4, Section �C:• , T���N, R1�_, E (or) W Lot# _ City Subdivision Name, nearest road, lake or landmark Blk# � Village Township �� ;--: `h;t �IY —c C. TYPE OF OCCUPANCY: Commercial "Industrial "Other (specify) *Variance Single family _Z� Duplex No. of Bedrooms =� No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms__ Automatic Washer YES IVO Other (specify) E. SEPTIC TANK CAPACITY j��� p� Total gallons No. of tanks / 'Holding tank capacity Tot21 gallons No. of tanks New Installation � Addition_ _ Replacement_ Prefab Concrete ________ ___ "Poured in Place Steel X Other (specify) �� - - F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)�2)�_3)�l, Total Absorb Area ,L� f�' sq. ft. New� Addition Replacement *Fill System ` Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length�_Width ��, , Depth �a" Tile Depth . ' " No. of Lines � Seepage Pit: Inside diameter Liquid Depth Tile Size �/`� Percent slope of land t` Distance from critical slope • > �' '� I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME Sctr�„ r S ��• :�r,�;,� C.S.T. # S.�=�/G�`� and other information obtained from � , � (owner/builder). Plumber's Signature ��;.,� _, i'�/ T;;,.. , S �•. - XI�(�¢I�►F(R�?GV# � S�.•� Phone #�'��f= ,1 � "`� � Plumber's Address /� %-���� • ;� r-•� �' c G. MPRSW PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). /� - ; . __ � ; , ;, . . _ � l_ , , _ �-- - �+ L[� �� � , .�� 'a � � � _ i I _ � � �(C ,.L � d/ � �-. � _ . . _._ � . _.r_ � t ,z , 'J __ _ _ . + t_ � �, ( i , , � � L�. ' � , ,, ; i � � f � � ,_. ...._... . .__.._ . a.. . . i G_ _._.. . _ � _ 1__ __ ,_ L � � , � , �-��� ' i 1 : ; ' � . . . .. .._ . {._..... Y . _:.. .. ....... ... 1 }� �..� .. . j .�...... '_.�....._.__.�. �......._.. i...... . . . ....' _.... _. . ._. ' . , t ' � ' � �\/ / \ / r ' ' � 1 ; � � � , :_ _ _ _ . _ _ . _ _. _ � � � �-�---� , ; � , � �_ � , � � , , ` , ' i , � I_. _� � ; _ � ; -� T_ __- - __ ; . --{ _- . _._�--_t _ ' � , ,, ' i o,cl 4 ( I ! ' + a -___. ; � � ; _.� i. � _�_ _ . . _a �___ � _1 _ � i , � ' '_ .�_�,��'� ' __ _i_ , i J �.___ , _.�___ . i . . f , �/ , , , ' ! , �i� T' i _'. i__�._ _ _ �. .. . . ` i 5 ' , i �,.� �� � � � i --_-�- --;-__; j-- f _`.. i.___ ;.__. ; � ; --' ! I f I i j �'i ��: � '..� ' � ' � � _ �. .--t-_._., L— L._.�.. -,.___, }..._— _. : . .__ I , {. _ i _ �---:. _ � ' i � ; , i ; � i I � � ..._--1— ._.�..._�. Ai.___ 1__...I.- �_---._._� �_._. y. -i.... .._.. .: __.'....—�----�1��--- +-----�.._ �_ _. . I .._ i_...._ _ . . , � � � I ' � i ' ' I , _..._•_--�---_t ._.,........ {. y_......__ '__.._ � _ j . -- — �— --..._ i_ �._ ... I i I i � i � i i i I h ! ; � i I � '. ` '_ , � I ' _ � .-�, .i--_ ;.. •----._.. . _.._ _ ;_ • — `--- -- --{-- - --- - � i, i i i � �! �_ 1 � \ I j � � ; ; i � i � ; : � : —y___ ... — - - , ..� c.. �_..._...— _w..... 1 - i--- ' -- -� . - ._}._ _ -f-_�� -!- , , ' ' � i � � � '� ' � � ' ' _ � �_-f_ _-�- ___ _ ,.._ w__+--+---. —,- � ---!-- - -�--- - ---- , i . ; ; ; ; , � � l. ' � i � � � ' .___.1.,__._...._..__ _'_'i.___ •" _� _ .__......._.— _i.......� __ ...... ._. ....._� . .._. .... ._. ...... _. . . 1 '� I � 1 . . . .� . � .....� _. . �.. , � � 1 -. � ' ..: , `� �, � , j i Do Not Write in Space Below - FOR DEPARTMENT USE ONLY Date of Application 9- 1 0- 7 9 Fees Paid: State 1 S fl flCounty ���� Date 10 S�t emb e r 19 7 9 Permit Issued/Rre�fe�t?�dc (date) 9-lOX- 79 _Issuing Agent Name F� ��np Nehrl i n� Inspection Yes�No Valid# Date Rec'd 1. county (white copy) 3, owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1/76 . Department of Z�nin� and Sanitation Sawyer County � � � Inspection Re�ort K OUaner Roy D. Thornton � Address 10578 DeWitt Road Belleville , MI 48111 d Name of busi_ness � � 0 Builder � � � Address ° � Plumber ponald Thompson Addreas Route 2 Box 102 Winter, WI 54896 Inspection r H O U (X) Pri��ate ( � Public Property x Sanitary •instal � � x Dwelling 3etback �- lake Vi.olat�_on Mobile Hm Setback - road ,.°.� Gara�e Setback-lot l�_ne ( � 3anitary ( ) Zoning Privy o �. �• � E � �' y�M- g0 !�cr,ES x ati� a��P�� ��.�a � �, 5�' � � � � Pc r�, � F-i � i�Q C.l. C� (D � sIT ~ qyo ri� TMC ��,�'�' � rn p1,ULLlING. ��~ Nc� tu��.� � � � � � � IJ' n I � � � ,�• o U ���,� � � i y � � : � � w I ou�r, RD SQci.� R�s Rp � Discussed with owner yes no � Discussed with Bu�_lder yes no Discussed with plumber )( yes no � D_iscussed with yes no D�,te bi s�I°.._79___---- �ETnature �f Officer � ' `�.�:��'r��_-------------------- . ,I DOCUMENT NO. II BTATE B` A!1tANTY LIilI9p FORM 2 j - ,� . �`. . 1^ I TN18 BPACE RESERVED FOR RECORDING OATA � ♦ . • r .i 1_� � . ' i . , I � -- ._. ._-- �� 't s.;lsf��2'�e b.'f;r.� t _ :::.:____=--_:--__:—__=_-_— — • :jrV/vBt'COlVliy � By Tl�is Deerl, ...._.....Ne11ie..K.._Schenlc.,_._a._widow_,...not._since f ' � • � .. -;•c1 (.�: r - ,I tho� _do ol � remarried '"� " p .................... �........ ........- ----..... ............. ..._.. ........ .._.........._.... � j� .._. K.•.. . � ' � i 7s at _� o�C:r.�^ 1 I I '— � .........................................................""'.._........................................................."'............_............ , . . . . �.r_l .i,�.__ZS7__ � ..................."".........'•"""""""""""""...."'._..............._........"'._._......."""""".................._............ `i r L Granror cAn�eys and warrants co...Roy..D....Thornton...and..Arlene._.G.____ ,__,__ ' �--- --z- --�-- � ........................Thornton. ..hu, b nd... n....wif.. • -- , :...�Z"�L�c..wc.-i �, _ J?-r a��� I .. . ,. ..� a.. . �..d . ...��...��...�.oix��_..t e.n����-�----- . . . . . ; ,. . �::;,::�,_ � .................................................................................................�-�---........----........----•-----...---........... ;; �. . ........................�---........................-�---........................................--�--�--.....----......---.....----•�-�------...---.. �. ...._..___..._....__ , '! Doputr I •-•.-•.......................................................•••••.._...................-••-••••••••••-•..._................, Grantee.....5., �; � for a ��aluablc consideration.................................................•••••..............._...................•••..._...... �i I_:_:-__-__— ........."'......................."'..."""'...........""............................."'...._.......... ��RE7URN TO .............................""...... . . the following described real estate in.•••••••-•..._ 3lc[}LEI:......••••••-••-•••-•.................... County, • ,�� � State of Wisconsin: I Ku"'`A"y �� %�``�s`�S i �-----_ -- 1'ax Key #._.........•••................................ This is X10S1_......... homestead property, T}ie �ast One—half of the Southeast Quarter (E�/2—SE'/4) , of Section Ten (10) , Township Thirty— � eight (38) North, Range Six (6) West. I �'RANSFER �; 7.Q° . �sa?~ E . � Exception to warrantier. � I I Execuced ac........WinteT,�_..Wiaconsin 22nd Janu I . ..•••••-••••--•••••••-•••..._. this............. .......... day of..............•.•---a�................•••..., 19.7.r�..•--, SIONED AND SEALED IN PRE3ENCE OF ��� �C1L^L..Y� I` • � L � I-�I - ' .__.(SEAL) �...............�:..---.......----._............:�.._:��..--�--c..�:........ Nellie K. Schenk ...................�---..........................._..._....._.................._........-----..._....._.... • ......•-•••••••..........-•••••-••--••••••••-••-•....•--••-••••--•....-•...............•-•--..(SEAL) � ...............................•-•--•......._................_..............................--�SEA L) .....••••••-••••••.........••--•••--•••--••••...........•••••--•-••••••••••••••••••••-•.......(SEA L) � Signaturesof ..................................:...••••..............._......................................................................................-•••....................._..._........._...... authenticatedthis...................•••••••.................._... day of.................................................................., 19........... ..........:...�....�..�...�...�....�._...............�..�.�..�..'.......... I Title: D(ember Stnte Bar of Wiscnnsin or Other Party� Authorized under Sec. 70<.06 viz. ...................................................... STATT: Or WISCONSIN ss. j RuBk .County. ..................................... ........................... Personally came before me, this....................22T1d......................... day of..............TaT1L1s2'3!............................--•--........, 19......75 i theab�i�•e named.......,._....•••••.....N.e�.1.7:G'..K.*...SCY�en�............................................................................................................................... � . .. ............. ..........................•••...........................................................•••--..................................................................... •,�.., to me knnwn tn he the person........ who exccuted the``C�,�:�+i�G instr�ment and acknuwledged the samc. . � '•• .��;:�•...,��' �r'•, ` . ., //�� .� ..., I / THIS INSTRUMENT WAS DRAFTED 8Y .� �;� ` ...�L�'1...�....... ...�-f"[. „ ...,(..1.�.....�L,•",f..—{„�/.......... i I �`' ti� `' Philip M._Kaiser __ i • • • - -. ---- --- -- oh .....Kaiser.,...Realtnr..................�--....._.......:t.. o e_ �? ' �:: w �' I :•,� The use of witnesses is optional. . ��'• '�J No!aty•Public; ......... RUB�C..._ _. ............... ............. County, \�Vis. '' ���h���'�� O � I ���'•��� s7'j,��eix,.e�immission (�ri•��u� pmt ..January..1,...19.78................ _ ._..�. .. �---------.-�.-. :c-_.. ���N11111t11���, .. � ---..._. .__ . _ _ ..-�-_-�__--- /� Namrs u( �crsuns si�;nin�; in any capacity shnuld hc typcd nr �ri����•d hcl��w thcir si�n:itures. \/O�• a �� �� ,f J� Y [.. �Y rr