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HomeMy WebLinkAbout010-171-00-2902-SAN-2023-150 SAWYER COUNTY ZONING & CONSERVATION ADMINISTRATION � 10610 Main Street, Suite 49 � Hayward, Wisconsin 54843 � (715) 634-8288 9.� sanitarian(d.sawvcrcountvgov.orE u1 t COUNTY SANITARY PERMIT APPLICATION � In accord with Chapter DSPS 383,Wis.Adm. Code and Sawyer County Private Sewage System Ordinance APPLICATION INFORMATION—TYPE OR PRINT PropeRy Owner's Name PropeRy Legal Description �J t.l-� l,t' �� {�'b�CC,i-l �(U�/� �4�lS t GL � '/< '/a, Sec. Z�,Twp. ��( N,Range � _W Property Owner's Mailing Address Lot Number Block I`umber i?���SO �.t1`, lltStG�'1 ��;a� P+ �-�� City,State Zip Code Phone Number Subdivision hame or CSM/�Number ���� ��� �� J 7 � ���� � �'_��� LI.0 7 ���Z.r��� ��C ICZ� TYPE OF BUILDING: (Check one) ❑ State Owned ❑���' Nearest Road Public 1 or 2 Famil Dwellin No. of bedrooms 3 ❑vivage ����1����� �� � � y g �Town of ��-��(�(,'�C 1� Fire Number !C 7��� PUBLIC BUILDING/LAND USE: [Explain the use/purpose for this Parcel Tax Number: (12 digit legacy number) permit,(i.e.,campground,festival,recreation/enteRainment event etc.)] � , �_� �7 r -� C�-�-� o � TYPE OF PERMIT: Additional Information: ❑ POWTS Reconnection(SAN#_-_) �POWTS Connection (SAN# OI - Z�) *Attach a Plot Plan with all required information per SPS 383.21 POWTS Revision(SAN#_-_� ❑ POWTS Repair(SAN#_- ) *Soil Test Information(CST# �( - (�3 � ❑Other: *Gallons per day 4�SZ� RESPONSIBILITY STATEMENT: I,the undersigned,assume responsibility for the installation of the POWTS activity for which this permit is issued. Plumber's Name:(Print) Plumber's Signatu MP/A4PRSW No: Business Phone Number: S'czs��, Ku�+-fe.l �7s-�s� ( �rs)�y� -3�.s��_ Plumber's Address(Street,City State,Zip Code): �, o. G� K �� �'��/E� <<�.r s��zi OFFICE US ONLY: ❑Disapproved Revi w Da e: Pertnit Fee: Date Issued: Issuing Agen[Signature �A ved ❑Owner Given Reason for + �/ / � ' pP Denial � �I � ���� � I��� I�S '�Y ./�c�(/��Q 2 '✓cCc=`- COMMENTS: **Expires 2 years from date of issue** Expiration date: )__� -� ��_`T� CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: � J}` � � D � �� �.; � �, � ..�:. Y__.�.�-_t..�.._.--�-�--_.,� . o�' � . �y .�,_ 2 0 2023 � G I��, � � � hk#__._l��► �U _ a3c.�� ____ _ sAvvYEi� .r.r -- Rev.04/21/15 - " � �" � � I 0�"�1 % NO R�FUtv�a AFTER I�SUE OF P'ER�Ut1T _ Ju.f i e S: �lbla.,� • ADDITIONAL COMMENTS AND SKETCH G--tVi/l,! ��(�'b�s'f"' SANITARYPERMITNUMBER: OI - oZ00 ,_ ( 3C{$d \,�,"il�(S�eN �(X ' _ _ � _ _l�lrc.�le�_��c- _ 3�/L� ' I ' . __ . __. . 1 � � '{_ __' � 1 � i ' i � ' � i - � . . . _ . . . . � I � .. � � � . .. ...' . .; . _ _. _. , , � _ , � _ r � � .�_ � � ' ' _ ( , _, � , , . -- - �--� _ ^- � -} r-_ -- _� --�--I — _ -- `�`' ,� � � 1. . ' ' _ , _� I - --- - - -- _ _ - __ _ _ -- S e � ,�� ._ , _.--`_ � � � � ; , � � , I -i I - � � � -�--j---'� - - - - - -�-=-- _ , _ ---- - ' �- �� � T I _ � ' ._. _�_ " ' --' -- � ' . ' . . , r. ___. - .,. . . 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DeparlmontolCommcrco CS7 01 —193 x$&&i1�� 534317 � __ _ � --- --- — — __ _ _ — --- ) Stalc'Pransactiun Numhn� - _ _ � Sanitnry 1 crmit Applicntion N � In xccoWance��ith> Conun tii:I121.14is.Adm Code.suFmis�fnn of�his fonn�,�Ih�appropriatc grntmmental W unit �s ¢quircJ pnor Iu uhlaming a s:�iilan- p<nn:� ":rlc :\pplr.atirn I„nn. I„i .Iarc.��rncJ 1'ON7S arc Pru e.l. dJrus(if di1[emnl Ih,t�mail� adJr`as) �uhmltkJ �n 1hc Ikpan�n<ni o( ('nmmcrcc 1'er�un:il mli�mta�ion �ou pru�iJc m:�y hc uscd Ii>r sc.nnd:�ry l O��J�N PC[11i7SU 1 ii �Oda ur ses in a:iordsi.<xrth�hc P�i�:x¢La�e,t. IS WI UI��O.Slals. 1. :�pplication Infnrmation-Plcase Frint All Informa�ion Prvpc1tlyOnnrr'sNamc "--_ _' __ ._.— _" 1':ucdq n —1 1 v ; , 10. 010-171-00—'L902 � Propen}�O�cner's�failing.Wdrcss Propcm�Lcxalion ry � � �' I -7 V � � _.1 '� �.� l. (i���l Int / OV, l'in� ti�atc � l.ipQdc PhoncKumhc� ' ' 9 � {.� '�, ' ticiiiuo.�� .� �4°r '0./1.� n �� ' \� �J � � lurdoonc) l r I'ypc nf Itwldm„(clicck all lhal appl}'1 �-� I.rn N � - ------ .. . . T. y�__.N. k 4 . ._ IS or\C l! ��or2PamilyU�cclting-Numbcrofliedramu� _ �rL 29 tinhJivisionNamc . ....-- - ... . _- � � V �,�,K���- -- ��,,., � Lul�� L'1�-% ✓ � �I'uhlidCummrr.i�i I lc�aihc I�ai•___ _ �)Ci1v oi ___. ' . _ .. . . _ . ..._ . . ntitatcfhm:d-Dcscritml�u CS\I\umt+cr ❑ Villagcof _ ___—. . . _ _.__.— . E�Tmv�o( I�Gi., W..�k . 111.Type of Permih (Check only one box on line A. Complete line fi if applicable) - n. ❑Ncw Syslrn� C� Rcplac<mrnt Syskm ❑TrcalmcnVFtnlding'Rmk Rephttmrnt Only '�S Ulhcr Modific:uioIn Io Gxisting Syslcm(ezplain) co:�.�t 'f� Q• ❑ Permit Rrnewal ❑ Prnnit Rcvisiun ❑Chan e of Plumbcr Lisl Precious Fcrmit Numlxr onJ Dye Issued g ❑Pcrmit Ttansftt to Ncx� Rcfnrc Expiralion (Tmcr �7� _ r,�v IV."f��pe of PO�YTS SysteMCom onent/Devicr. Check all�hst a I � �-'Non•Pressuriud In-Ground ❑Prcssuriud In-GrounJ ❑AI-Grade ❑ �liwnd>2d in.of suitable soil ❑ptound<:;in.ofsuitaMc soil ❑ ilolJingl�ank ❑OthcrUispersalComMmcnticxplain)_ ___._ . ._ ❑PrclrcalmcnlDcvitt(cxplain) __ __ \'.Dis�ersaVl'realmenl Area Informalion: �- Iksign Pbw(rpd) Iksign Soil Applicstion Rah(gpdsQ �ispersal Arca Rcquircd(sQ Dispertal Arca Prn�scd(sQ Sysicm Blcvatinn LS�"� - — —_ -- \'1.'fnnk Info Cap�.iry in �Ib�al a n( \1:mufaaumr Gallons Gallons Umcs = U � u Ncx Tenks Eri.��nY.TarJs L � - � � o � Z � s `� eV•� :_ U v. �., n i= J 3rpbc ar IIoIJ�n;;TonA � �---""- �-- ^ _. .___ _._ _ -_ _ _' — _-'- _ c.'L' IU�L' / S,< ✓ � kning l'Ir.�mhcr -- — — -- —_. ._—___. _.'"' __' "_. .. - . _ _ _— __ _.__ ._"_' -. ._. . _�__- _ VII.Respmisib�lil) �Intemenl- I.t6r undeng nrJ,atum¢rnpmisiLil�h fur'ulall il�m uf ILe PO\\ I ti ehm�n nn Ihe a11�tI�cJ pl m� . ...'--� � I'Iwubcr'>Nan:t II rintl I lun�f'�li�n�lurrt , �— 1�11'i\II'RS NumFcr Husin w P6nnc\umber -..._ S� �:+-��� ���, ���,_�, �r� l >>� � L _-n�,�,, �., �� y v���1 - - -- -- --- _ __ _ -_. I'lun�hcr's dddrcsc�Str�u.('ily.S�atc.%ip Co.lcl. �lr•'- z +n1 C�v,�����_1,-' - ____ — — --- VIIL(ountv/Dep�rlmrnt Use Iv � ,�A _— .___ _-- -- -- � --- —. ___--'_ ..- ---_. . IJy. prorcJ [� UisapprottJ IS'cnutl I�tt� I (-- 1)il<Is.ucJ I.suun A�ccm Signalwc \ .. . ❑Oi�ncr<iivcnRcuonlorUcnni U�i J..' 12 9 �9 - � _- {'U� IX.Cnndilinns of,\ppruraVReasons for Disapproral �- IMI'Ok'1'AN'1' NOTICE: Wisconsin SCate Slatuce , , iapter 145 . '245 (3) , states you are required to have your septic tank pumped/ inspected aC least once every 3 years . Allarh 1�compkle plans far Ihr e�Urm anJ submit Io�he<benly only an paper nol ln�tban 111n:11 inchn io�irc V({�).Li7R I�Z.02�09��'B�Id IhN 0�.��� 7/21123, 10:21 AM Real Property Listing Page Real Estate Sawyer County Property Listing Property5tatus: Current Today's Date: 7/21/2023 Created On: 2/6/2007 7:55:18 AM �Description Upda[ed: 12/18/2019 '� Ownership Updated: 12/18/2019 . ..___ ___ .._ _ ..._... __._ _. .... .. .. . ... .. . . ..._.. __... ._._.__......... 7ax ID: 10013 JULIE J ABLAN LIVING TRUS7 NAPLES Fl PIN: 57-010-2-91-08-23-5 15-112-002902 Legacy PIN: 030171002902 Billing Address: Mailing Address: Map ID: -4.29.Z )ULIE J ABLAN LIVING TRUST IULIE J ABLAN LIVING TRUST Municipality: (O10)TOWN OF HAYWARD 13950 WIlLISTON WAY 13950 WILLISTON WAY STR: 523 T41N R08W NAPLES FL 34119 NAPLES FL 34119 Description; ROUND LAKE PARK PRT LOT 29 u1 Recorded Acres: 0390 r Site Address * indicates Private Road . .._- .. _.__. ._ __. Calculated Acres: 0.570 10794N PEN[NSULA RD HAYVJARD 54843 Lottery Claims: 0 First Dollar; Yes �..� property Assessment Updated: 11/9/2015 Waterbody: Round Lake ZpZ3 Assessment Detail � � �� �� Zoning: (RRl) Residential/Recreational One Code Acres Land Imp. ESN: 444 61-RESIDENTIAL 0.390 335,500 212,500 �� Tax Districtr Updated: 2/6/2007 Z-year Comparison 2022 2023 Change 1 � � � � � �State of Wisconsin Land: 335,500 335,500 0.0% 57 Sawyer County Improved: 212,500 212,500 0.0% O10 Town of Hayward 7otal: 548,000 548,000 0.0% 572478 Hayward Community School District 001700 Technical College �Property History . Recorded Documentr Updated: 12/18/2019 N/A � � � � �� � QUIT CLAIM DEED Date Recorded: 9/5/2006 341310 WARRANTY DEED Date Recorded: B/22/2000 286027 714/SOS https:lllas.sawyercountygov.orglsystem/frames.asp?uname=Eric+Wellauer 1/1