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HomeMy WebLinkAbout002-940-25-5308-SAN-2023-058 � SAWYER COUNTY ZONING & CONSERVATION ADMINISTRATION � 10610 Main Street, Suite 49 Hayward, Wisconsin 54843 � (715) 634-8288 W sanitarian(a sa�s�•ercount���o��.or� � � COUNTY SANITARY PERMIT APPLICATION «-; In accord with Chaptcr DSPS 383,Wis.Adm.Code and Sawyer County Privatc Sewage System Ordinance APPLICATION INFORMATION—TYPE OR PRINT Property Owncr's Namc Property Lcgal Dcscription Jc�,tr2s r1 � Jc55�e L ��lC��f(5 TfusT GL'Qtt 3 {5�, (Y� Sec. 25 ,Twp. 40 N,Range pq W Property Owncr's Mailing Address Lot Numbcr � Block Numbcr � 82q Checver Avu,�e, City,Statc Zip Codc P��Nu�������� Subdivision Namc or CSM Numbcr C-t�e,� i� l�0134 ��30 >z3a-�a�3 ��K� �`1 t TYPE OF BUILDING: (Check one) ❑ State Owned ❑��ry N�ar�si Road M��d ❑Public � 1 or 2 Family Dwelling—No.of bedrooms ❑v�uaec Firc Numbcr � �l'own of �`� �G•�2 141�1UuJ 1vlQ,�Jald � PUBLIC BUILDING/LAND USE: [Explain thc usc/purposc for this Parcel Tax Number: (12 digit legacy number) permit,(i.c.,campground,Ccstival,rccrcation/cntcrtaimncnt cvcnt ctc.)] � ,� � 4 � � � � 3 � p, � - - - -- - - - -- u TYPE OF PERMIT: Additional Information: �POWTS Reconnection(SAN#��1 - OS1 ) ❑POWTS Connection (SAN#_- ) *Attach a Plot Plan with all required information per SPS 383.21 ❑POWTS Revision(SAN#_- ) ❑POWTS Repair(SAN#_- ) *Soil Test Information(CST� �q.. (,�� ❑Other: *Gallons per day (00� RESPO:vSIBILITY STATEMENT: I,the undersigned,assume responsibility for the installation of the POWTS activity for which this permit is issued. Plumbcr's Namc: nnt) P]y gnaturc MP/MPRSW No: Busincss Phonc Numbcr: � �.4�AR.�ti �ie ` � ( /s)�'19- 3� Plumbcr's Address(Strcct,City Statc,Zip Codc): S/S�v �f o 7 7 OFFICE USE ONLY: ❑Disapprovcd Rc��icw Datc: Pcrniit Fcc: Datc Issucd: Issuing Agcnt Signamrc �Ap rovcd ❑Owncr Givcn Rcason for �I`��a3 � `�� � ( �-�I �-� 7'l/]�_ J, „�� 1_��w� Dcnial � . . 1����� ")� COMMENTS: **Expires 2 y�ears from date of issae** Expiration date: S��3� 3-v-?S CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: � � � -� � � • � i�s?'��S �� � � ,�.-� � d� �`��-� -h��r 5�3H �_ _ ��-1��t _ ��. ,---��--, ��,- r r,� Rev.04/21/15 �� r'�1 4+ � � :�' �'''.� � ---- � �__, i�C R�F�JNDS AFTER ` ; i-=- � . ��� i 1 E F '�,1lll-t � � � --fi�ln�7 ssu o � :�� MAY i 6 2023 S-�'JVYER CuL�i��' ZONIf�1G ADMiNISTRPriJN �wr��rs : �'a��t�� N• C (����:-�>Trus � L� (: n _ ! �4. s4'�J�2�'C..�J. l,���C�i,�C-��'t.0}7. „-_'_ � � Sess'�e L . « t� PrrJ: ooz-9�o—zS_ s3a8 SZ9 c�ee�er Av�. 1S` zs �- '�t�,`,i 2 vqw G�e►rtevc�.� TL, ���3Y-z�1ZS Lo� � C'S1--1 S � l`�� 4r 3 . _ s;��e- : _!4�7 p rYl�.l l a+-�. 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"-�� S�� Madison,WI 53707-7182 - ���- �a-oa� 61 I Doo Sanitary Permit Application ��:��������,.,����,��^���„h« - In accordancc wilh SPS 783211-').�I'is.Adm.CoJc.suhini.siun uf�his li�rm to Ihc appn+prialc po�-crnmcnlal unil . is rcquircJ prinr lo oMnining i�snnilnq�permil Nntc�.Applir.niun tixms fnr st:uc�n�ncd P()1V'I�ti nre submiltcJ lu - Ihc Ucp:�nmmu of S:i(cly anJ Prolcssiunnl ticrviccs. Pcnun:il iiKnmiatiun yuu pruriJc may M1c u.cJ lix�ecnnJan. Pru�cci AJdre.s lil diflcrcnl Ih:m mailing;iJAressl u uscs in nccorJ:wtt�rilh Ihc Privncv I.aa.s.I S.U4 I)Iml.Stati. 1 i7701V MaII:uJ I.mic Ha��carJ.W I S;H.13 i. A licationlnformation-PlcnscPrintAlllnformation `,, Prnpcny O�cncr's Kamc I I'arccl 4 � 1:imcs N Chnkires'fmst-Jcsstc L Chnkires Trus� �� U02940255309 Propcny Owncr's A1niling AJdress Pruper�y LncnGun i %?9 Ch Yvcr Ave. (� aort Lol 3 � Ciq�.Slale Y.ip Gxlc Phonc\umhcr . '4.Scctirni�5 Q Cicnc�'a.11. fi11134 t�ill?$RG?4(� 1!' 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Com lete line 13 if a licnblc :\. ❑Nc�c tivslcm �IteplattmcN Syslcm ❑TrcaunenVllulJmg L�nk Rcpl;iccmcnt Unh� ❑Othcr MrnlilicaUnn In licisling ti��slcm I��plain) Il. ❑I'cnnil Rcncwal ❑I'crmil Rcvision ❑Clumgc uf ❑I'crnw�1-r.mslcr to Ncw List Prcvious P<nnil Nunihe/r an U:tic Is�ucd Bcfttclizpimtinn I'Iwnbcr U��ncr '�Cr-C.���' (0�6 �� IV.T e of PO�VTS S�stcm/Com onenVDcvim: Check all th�u a 1� �Non-Pressuri[cd ImGrounJ ❑Pressurircd 6�.GrumiJ ❑M-(iraJc ❑S1uunJ>2q m ol suil:iblc>nil ❑�1nunJ<24 in.of suitnhlc>uil ❑Iioldin@'f:mk ❑Uihcr Dapers:J Component lczplain)Lill�n Gnrcilp ❑Prcvcauncni Duvicc(cspinin) V.Dis crsnllTrentment Are7 Informntion: - n�s� ri�,,,irrai Ihsign tiu�l n��i��,uon rn,��•�,;�i:��,•;�ic�•�i���«•a un i u„��„i,�«•:�r��,��,.�a un s>,��•���i:i<�.��„ ._P;.�. �p d re���itir�+n i.cw izoo qt ao ('^'— ,,,,,1 �., � s�l VI.Tnnk Info Cnpnciq�in Galluns = c c • . �fulnl B uf U V _ y � (iallom Uniu M17anul'aclurcr � � , Nc..�i'nii�a I:�i.im�Tauls �� __ �=y = �' r. � _ ticpiicorHolJui�'1'nnk I?GO I?60 I itasnnuscn �i __ N � _�___� Dn>ingChnmhcr 7(ill 7G11 I Rasmusxn VI1,Res onsibilit Statement-I,Ihr unJerai�nrd,nssumc respmivlblliW for inslnl6�tlon nf Ihr PO�YTti shnw�n an Iht nitnnc�A pinm. 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't'��� i)a :'i%�J' � r� L�T�f _,�r! � S117123,2:06 PM Real Property Listing Page Redl EStdte Sawyer County Property Listing PropertySWtus: Current Today's Date: 5/17/2023 Created On: 2/6/2007 7:55:08 AM �Description Updated: 1/14/2014 � Ownership Updated: 1/14/2014 _ Tax ID: 3667 � �� ]AMES N CHAKIRES TRUST GENEVA IL PIN: 57-002-2-40-09-25-5 OS-003-000080 JESSIE L CHAKIRES TRUST GENEVA IL Legacy PIN: 002940255308 Map ID: :3.8 Billing Address: Mailing Address: Municipality: (002)TOWN OF BASS LAKE ]AMES N CHAKIRES TRUST ]AMES N CHAKIRES TRUST STR: 525 T40N R09W 829 CHEEVER AVE 829 CHEEVER AVE Destription: PRT GOVT LOT 3 LOT 7 CSM 5/47 #913 GENEVA IL 60134-2925 GENEVA IL 60134-2925 Recorded Acres: 1.560 Calculated Acres: 1.490 w Site Address * indicates Private Road Lottery Claims: 0 14770W MALLARD LN * HAYWARD 54843 First Dollar: Yes Waterbody: Grindstone Lake i..� Proper[y Assessment Updated: 9/13/2012 Zoning: (RRl) Residential/Recreational One Z023 Assessment Detail ESN: 406 Code Acres Land Imp. G1-RESIDENTIAL 1.560 292,300 73,400 � Tax Distric[s Updated: 2/6/2007 1 State of Wisconsin 2-Year Comparison 2022 2023 Change 57 Sawyer County Land: 292,30� 292,300 0.0°/a 002 Town of Bass Lake Improved: 73,400 73,400 0.0% 572476 Hayward Communiry School District Total: 365,700 365,700 0.0% 001700 Technical College • Rewrded Documentr Updated: 1/14/2014 �L'�4 property History WARRANTY DEED N�q Date Recorded: 12/17/2013 388724 WARRANTY DEED Date Recorded: 2/7/2012 377041 https:lltassawyercountygov.orgl/systemlframes.asp?uname=Eric+N/ellauer 1l1