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Application 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 requirements of the Sawyer County o
Zoning Ordinance and the laws and regulations of the State of Wisconsin. �
PRINT - USE BLACK INK OR PENCIL �'�
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Mailing Address � Mailing Address
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City, State , Zip � City, State , Zip
, r �Building Land Use Zone District I�:., �C —1- �
(7�--New ( ) Filling � �
( ) Addition ( ) Dredging Lot size _�� ��'x Zy/, �:� %;_ � -� ,�
( ) Alteration ( ) Grading `- ' .
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( ) Moving On ( ) Acres o �O �= : �1, �1 � ; ,
( ) ( ) 1� -�
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New Construction � �,, �;;, `._ %
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Size =' , ft wide �'' ' �wide ' wide
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j. f t long '' =�' ' long ' long
Floor area � - _ _ _ sq ft �"��_ sq ft sq ft � ,
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Total hgt /�� . to peak i � ' hgt ' hgt x'
Stories �
No . of Bedrooms => ____ �-_-----��_��� ;r waterline o
(year round) or (seasonal) 1�lelsby ake- G rt
Type of Bldg, Addition, Use ' , a o
(�) Dwellin r ��,/
g ��_ /��,4C��!L_' _ ! C• rt
( � Garage (1) (�2) car ' �•
( ) Storage BuiIding `�
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( ) Boathouse °
( ) Livingroom �
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( ) Bedroom
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( ) Kitchen-Dining �
( ) Porch (enclosed) (roofed) � , �+`,.
(�') Deck - open:% - '
( ) �. r�r
( )
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Type of Construction � �.��
(>� Frame ( ) Block ?; •
( ) Log ( ) Concrete '�. F�
( ) Pole ( ) Steel
( ) ( ) Pole/Metal �
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Construction Cost $ / ,�,- �
Vol '�`!^ Pg -'" ' of Deed �
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Cer . Soil Test �c(-Z.2% �
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Sanitary Permit �c./_y� C 0'r'� t�•�d• ~ ��
---------- L road --�Q`�--- --- z � �
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Issued 2�,Y December 1994 Denied �
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',�wi=�� Zoning Administrator
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SAFETY&BUILDINGS DIVISION
201 E.Washington Avenue '
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
November 1 , 1994 209 West First Street
Route 8, Box 8072
Hayward WI 54843
HOFF �T
RaGII� HOFF
RT 3 BOX 3108
HAYWARD WI 54843
RE: PT�AN 594-21195 FEE RDC�IVID: 200.00
KI�C�S'I'E�2, VE�2NON
SE,NW,34,42,9W
'I'OWN OF LII�OOT CJOi71�Y OF SAWYER
PETITION FOR VARIANCE 'PO CODE SF7CI'ION(S) : IL,F3R 83.10 (1 ) .
The Department has reviewed the above-referenced submittal.
All of the statements and supporting documentation included with the petition
were considered. Since your request is similar to other petitions approved by
the Department (e.g.S93-20340) , the petition is conditionally approved.
The conditions are:
1 . That the system be installed using a system elevation of 97.65' . ;
2. That the system not be installed any closer than 10 feet to the
crown of the critical slope and not closer than 20 feet to the
proposed below ground foundation of the structure. ;
3. That the basement foundation walls be coated with a proper
waterproof sealer and then covered with a plastic film not less
than 4 mil in thickness. This plastic shall extend from just
below grade to the bottom of the footer. ;
4. At any sign of seepage of the effluent from the critical slope the
use of the system is to be immediately halted and this office
contacted so that an evaluation of the system can be made. ; and
5. The plans for this project must be submitted to the Sawyer County
Zoning Office prior to issuance of the sanitary permit.
This petition approval is granted conditionally with the understanding that
all of the petitioner's statements included on the variance application form
and any other documents submitted to the Department will be carried out. This
variance is specific to the subject petition and cannot be used for any
additional modifications.
SBD-8928(R.O1/B1)
� - .
SAFETY&BUILDINGS DI VISION
201 E.Washington Avenue
P.O.Box 7968
Madison,Wisconein 63707
State of Wisconsin
Department of Industry, Labor and Human Relations
Hoff Construction
Page 2
November 1 , 1994
Petition #594-21195
Al1 permits required by the city, village, township or county shall be
obtained prior to installation.
The petitioner has requested a variance which would permit the installation of
a conventional soil absorption bed which will be placed 20 feet from a below
grade foundation and 10 feet from the crown of a critical land slope.
Inquiries should be directed to me at the rnunber listed below. Please refer
to the plan number shown above.
Sincerely,
c���'�
i��
Carl Lippert
Wastewater Specialist Sr.
Section of Private Sewage
(715) 634-3484 Nbndays
6540L/ 1
SBD-8928(R.Ol/9l)
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