HomeMy WebLinkAbout014-941-05-3304-LUP-1992-293Application for Land Use Permit
County of Sawyer 0
The undersigned hereby makes application for a Land Use Permit and
agrees that all work shall be done in compliance with the require- 0�
ments of the Sawyer County Zoning Ordinance and the laws and regu-
lations of the State of Wisconsin.
PRINT - USE BLACK INK OR PENCIL
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Owner Build r
k-T 16 &L_-� x4 (
Mailing Address Mailing Address
14 5A 8�1 G
City State, Zip City, State, Zip
Building Land Use Zone District o 0
New ( ) Fillingrt
Addition ( ) Dredging Lot size 1
Alteration ( ) Grading
( ) Moving On ( ) Acres . co
New Construction 5
Size ft wide �� ft wide
_z-4' ft long ft long
Floor area ���1 sq ft_, sq ft
� r
Total htg i�`�" to peak $ _ �e-e}c�'�-
Stories Stories I�
No. of Bedrooms - - - rear lot line or waterline c�
0
14
(year round or (seasonal) r G rt
Type of Bldg or Addition ' a o
Dwellingj�"� �4' '
( ) Garage (1) (2) car
( ) Storage Building
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( ) Boathouse �- o
I o
( ) Livingroom '
I
( ) BedroomC
Kitchen -Dining
( ) Porch - enclosed/roofed ` c
{ Deck - open jgpq-IP
f i
Aa
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Type of Construction
"C>< Frame ( ) Block
( ) Log ( ) Concrete
( ) Pole ( ) Steel Metal �_ �. �x l�,t m
( ) ( ) � ._ � N
Construction Cost $ / ,t9Dd`'�
.72
t3.3
.10.2 .9.1 .14.1 .13.1 13.2 14
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6 .11.3 12. STATE HWY.77 I5. q
7 8 �
REF. : AERIAL PHOTO 84 SCALE: I IN. = 400 FT.8 �
U.S.G.S. STANBERRY EAST DUAD. KM 8-3-77
SAWYER GO. DEED RECORDS
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� � DOCUMENT NO. SraTE BAR OF WISCONSIN — FORM 2 �
WARRANTY DSSD
' THIS 6PACE RE6ERVED fOR RECORDINO DATAI
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' -- -- - - ---- -�
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�eqiu�nr n 'J�hce l
Michael Vanacker and Mar1orie _ Vanacker , his wife , i SewyCr ��;,nty f ' � / �
•------ -- --- •------•-----------------------------
•---�s --1oint__tenants.--•---•-----•------------------------•--------•----------..._........__._._. i Recei�ed for record t�� dap ol �
-- ----- - -- •--- --------------•------•---........_ � r� �t A D 1� 7�y'�_ o�cloak �
---------------------'------'---._._..........---'-•---------------------------'--'--•._..._.. - '----....------- I� � M au� rErnrds• i Ir� v��L o�c � I
conveys &IId warrants to _....��4c� ie__G:_. Chambers_,._ an . adult_. man ._.___ i� 0( Record � � n F,,�, �,. S�: �
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•---••-•-•---•----••-•---------------------•-----•--------........_...-----------------------•----....----------- Reqistet
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- - •----•---------•--------•--••-•--••-•••-•-••-------------•----......_.._......•--------•------._...._.. ' �
-•---- - • DePa
,___For..a__valuable . consideration__of_. one_ dollar and other I._—=____— - - h -
- ---------------------------
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_____v_�� luable consideration _ _ _ _ _ ___ __ nRfiTURN To. . '
---•••---------------------•--•--......_..-------•----•--------------• /� / C' �' �� ,� � G�� 2 ��Qrc�!td.� '
•--•-----•---•--•--•------------------------------••---------------•------------ -----•-..
the following described real estate in __..______Sa��!�.�.... ......... ...........County, I � U , 4 o x (� � �'� � !
State of Wisconsin : , I i
Tax Key No- ------------------•-----•--•-• ; �
` That part of the SW�SW� , Section Five ( 5 ) , Township """"
` Forty-one ( 41 ) North , Range Nine ( 9 ) West , described as follows : Commencing at
the intersection of the east right of way line of the town road , lying on the west
line of said SW�SW� , with the south line of said SW'�SW� , the center line of State
Trunk Highway # 77 ; thence running north , along said east right of way line of the
town road , 318 feet to the point of be� inning ; thence continuing north , along said
east right oF way line , 209 feet ; thence running east , parallel with the south line
o [ said SW�SW'� , 209 feet ; thence running south , parallel with the west line of
said SW�SW'� , 209 feet ; thence running west , parallel with said south line , 209
feet , to the point of beginning .
Subject to all easements , exceptions and reservations of record .
,
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F�E
��s � �
,F;1 ,�P�T'
is not ,
This ____________________________ homestead property. � ` �
(is) (is not)
Exception to warranties : i
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21St AU USt 7 $ '
Dated this ---------•--------------•---.._..._..------. day of --------------------g--------------------------•---------.., 19---•----•
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• -------------- (SEAL) .!/_ .f�L�`�_!�__--c- ----GZ���Gl�__ `�C SEAL)
•----•-----•---------------•----------•-----•-------- - �
« . Mic Vanacker
•--••-----------------•---------•-----------...
---------------•--- . - -------;-----------•-- ---• ----- -•------•• -
�-- � -----------------------------•--•---••-------------.... .--•----._ (SEAL) -- --- ---- -- ----,-- ---- --- - -- --- - AL) �
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A �0� �11Cha2 T ��cker �'� t% gNOWLED (� MENT
Signatur a . a thenticated e __________________ daq of STATE OF WISCONSIN
---�u-gus- -•- - -- •-------- ------- 19_._ 78
�� es.
� � � Saw�er _ County.
---- ---- ------------------------• --
I ------ -- -- ------------ ---- - --------------------------------------------- 21st y
" Peraonally cnme before me, thie __________________da of
ow rd . anson _.____August, _ _1978___________________ the above named
- --------- --- -- - - -------------••---- . . . _
- - -
-
i'iTL� : ME ft STATE BAR OF WISCONSIN _._.�X�Xb�4��c���� Maraorie Vanacker
(If n � --------•--------------•--•---------s•----------------------
---------------------•------•------------------------•--------•-------------••--
au rized by § 706.OG, Wis. Stats.)
�. -•----•------------------ -------------•---------------•------------------------
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P . . , . . . ,� �:--- --------------- -�--�---- ------ --- ---------------------------.. ._
THIS INSTRUMENT WAB DRAFTED BY _\ '
J_ � ' •. �tr � e kno e�per ____�___._ who executed the
Thomas E . Van Ro � �i ent a nowledge the eame. '
y z � OTAR ��.
.
.
----- _- --------------------�----------------- •
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.. ._. .. ._ -- . -.-��-� ---- ----- ------------------ - �
------------------ . _.. .----.-..--..-----._._... .
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N �, �(� (jl\G :' � ard . __ Hanson
•t - --- ---------- ------------------------------
(SignAtures may be authenticated or ackno '��d, Both ;�, SaW
are not necessAry.) r, �. ' • • . . . . . Y Public ----------------- ---�-�z'----•-----••---County, Wie,.
�!j, ommis on is permunent. (If not, etate expiratioii
�F v '� date :
- ------------- --------------- -----------••----------•--� 19----•-� -�) �
•Namee of pereons eignlnq ln any capecity ehould be tyDed or printed below their ef¢nat�� I ' � e] � [] �. C � � I
V L 7 � �
� WARRANTY DI:�D STATT AAR OF WISCONSIP' �
." -' - . __. . n Niycnnvin I,r�;nl I?Inuk Cu. In�'.
State Permit # 14947 �
� �� � � State and County 8 -�—,
� • Permit Application County Permit # --
for Private Domestic Sewage Systems County S�r
CST 8-211
"DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
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/Y��r� S 'c�'o �.� r
. OCQ�IQ� ..,�'-�4_'/4�I.�7 Y4, Section_�, T�! N, R� / (or) W Lot# City_
l /S
Su6division Name, nearest road, lake or landmark Bik# Village
��� , � � Township • ,: L9�
C. TYPE OF OCCUPAN . Commercial *In strial *Other (specify) *Vanance
Singie family _� Duplex No. of Bedrooms_� No. of Persons_�
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder�lC��f�l4_NO # of Bathrooms _
Automatic Washer�'�£'$ IVO Other (specify)
E. SEPTIC TANK CAPACITY - Total gallons No. of tanks _�_
*Holding tank capacity Total gallons No. of tanks
New Installation Addition_ Replacement_ Prefab Concrete
`Poured in Place Steel Other (specify) —
F. EFFLUENT DISPOSAL SYSTEM: Perco tion Rate 1) � 2)1_� 3)�_�Total Absorb Area_ �.'�L.> sq. ft.
New � Addition Repiacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length l�l�Width�_Depth _�Tile Depth�_No. of Lines _�__
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land 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, i � ,�' f f
NAME � .�� ��`.��C.� ��/� ��L �'_�L.l�' C.S.T. # '`i � / and other information
obtained from _ / (owner/builder). / �
Plumber's Si nature /,��: �„l '� , "-.��:--, � �� Phone # � /�� � � '7' �
g �`'�, ;; MP/A�4?�R9ifU# ��� ,
Plumber's Address�L��1�� ' 1�' % , � .� � Y � l �
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20 i clud' c� well). �'
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Do Not Write in Space Below - FOR DEPARTMENT USE ONLY � /
�ate of Applicatio 9'06'78 Fees Paid: State 10.00 County 15.00 Date 6 September 1978 v
Permit Issued (date) _Issuing Agent Name�]'a i�n�M, N _h� rl i.�cs
nspection Yes No Valid# Date Rec'd
I. county (white cp�y} 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 Zoning and Sanitation o
Sawyer County �
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Inspection Report
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Owner Rickie G. Chambers x
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Address fD
P.O. Box 422 Ha,yward Wisconsin 54643 �
Name of busine�s
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Builder a
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Address fD
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Plumber LaVern Dennis
Address Winter, Wisconsin 54896
H
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Inspection �
�() Private ( ) Public Property Sanitary-instal ,°.,�
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Dwelling 5etback - lake
Violation Mobile Hm Setback - road
Garage Setback-lot line r
( ) Sanitary ( ) Zoning Privy �
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.�et� �a mod:-�.��. �,�1�
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d�,,,cv�s�or d�c..r . m �n
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60 �o�� �
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Se`�''g
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9'fOJn.� WaW�^ LttPaO�[ O LCrJs.� Zau �G I• 1'�'l�t/p�. ;J �
cNcT{'�oh Par� a'�. 6�7q �er'�� clasS ~
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38hG, 2M} Siud -�'e�d �,�' class 3 Pt�'f'� 375 S�,�F � �YK'1, �'
Discussed with owner ) yes no �
Discussed with builder yes no
Discussed with plumber yes no �
Disc�zssed with yes no
Date q-g-7$
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Signature of Officer