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HomeMy WebLinkAbout236-941-22-4467-INS-1999-045 Sawyer County Zoning Administration o n O � Inspection Report � �, Owner(s) Hayward Family Dentistry SC x D .,s� Address P.O.Box 1220 Hayward Wisconsin 54843-1220 � '--� AgenUPurchaser � � C7 Address � -n a Bldr/Plber/CST � c� Address `< t7 Inspection � Private � Public Violation � Zoning � Sanitation z -� � Dwelling � Mobile Home � Commercial � Garage � Addition � � Q Setback-Lake � Setback-Road � Setback-Lot Line � Soils Verification � ,.� <' ,� y O WD Vol 540 page 470 Acr s:0.860 G1 #10541 N Ranch Road Lot 2 CSM Vol 8 page 30 °� � 0 / D �� �; G U r'� � ' .� c� � �� / _�� �� a � N V � � � o ^ ; �� � N I� - �`� � ,_. v �`�'0y � - ' '�-{ � o �' � ' s �� � r � a o a � � � \ � �� � � .�. �� `'' � � r � �� � ��� � o I� ° � � 1�1� � u m ��� � � \ N N I� A A � �\ o N m l� \ A �r � \� v� � �\ I � N R-�-W N � �_ � � z w � 'I�ft�iC� Roi4D l �, � N I� Discussed with Dr.Patrick Duffy � Date&Time June 7, 1999 9:00 A.M. =uN� �g„�q 9q. �?;Lf 5 p,„/�, Signature oflnspector �9y., yN�o'tv Town of Hayward County of Sawyer 23 June, 1999 Date SUBJECT: Variance Applica[ion To: Sawyer County Zoning Administration P. O. Box 668 Hayward, Wisconsin 54843-0668 Owner: Hayward Family Dentistry, SC 634-2011 Address: P.O. Box 1220 Hayward Wisconsin 54843 Property description: Parcel in part of the SE 1/4 of the SE I/4, S 22, T 41N, R 09W 010-941-22-4442, Parcel .16.42 Lot 2 CSM Volume 8 page 30 #10541N Ranch Road Volume and page no. of deed: WD Volume 540 Records page 470 Acreage and lot size: 0.86 acres Zone district: Commercial One (C-1) Application is for: the construction of a 28' x 41' addition onto an existing office building at a setback of 109.5 from the centerline of State Highway 77. Variance is requested as: Section 421(1), Sawyer County Zoniog Ordinance, would require a setback of 130' from the centerline of a State highway. Name and address of agent: Signatures of property owner and agent and/or purchaser. The above hereby make application for a variance. The above certify that the listed information and intentions are true and correct. The above person/s/ hereby give permission for access to the property for onsite inspections. _- COMPUTER N0 . PARCEL NUMBER --------- VALUATIONS --------- NAME AN� CODE/ADDRESS OF OWNER LEGAL DESCRIPTION CODE ACRES LAND IMPROVE �__ PROPERTY ADDRESS 10-941 -22 4439/2-41-09-22-4 . 16 . 39 SEC/TN/RNG ZBMp SCHOOL ACRES PT . SESE 62 . 950 13,500 60, 800 �___ 6IDLEY, CAREY GIPL01 22/41 /09W 2478 . 950 L 2 CSM 4/263 7/13 PLUMBING HEATIN6 6 EXCV ---------- HISTORY ---------- 10585N RANCH ROAD 507/303 _ HAYWARD WI 54843 CHG : 1/O1 /98 CHV : 1 /O1 /94 HO 105$SN RANCH RD HAYWARD 54843 _10-941 -22 4440/2-41-�9-22-4 . 16 . 40 SEC/TN/RN6 ZNMN SCHOOL ACRES PT . SESE G2 1 .580 10 , 600 11 , 100 FRED C 6 ROBERT J SCFR03 22/41 /09W 2478 1 .580 LOT 1 CSM 72/75 SCHEER ---------- HISTORY ---------- __ PO BOX 221 497/101 HAYWARD WI 54843-0221 CHG : i/22/94 CHV : 1l01 /94 HO 15544W STATE ROAD 77 HAYWARD 54843 10-941 -22 4441 /2-41 -09-22-4 . 16 . 41 SEC/TN/RNG Z#MN SCH00� ACRES PRT . SE3E G2 . 700 10 , 000 6ERALD L TUGE02 22/41 /09W 2478 .700 LOT t CSM 8/30 ___- TUTTLE ---------- HISTORY ---------- PO BOX 1137 566/84 HAYWARD WI 54843-1137 CHG : 1/01 /96 CHV : 1 /O1 /94 HO 10-941 -22 4442/2-41 -09-22-4 . 16 . 42 SEC/TN/RNG ZNM# SCHOOL ACRES PRT . SESE G2 . 860 13,500 134, 200 -_ HAYWARD FAMILY DENTISTRY HASCOS 22/41 /09W 2478 .860 L 2 CSM 8/30 S C ---------- HISTORY ---------- PO BOX 1220 540/4T0 --- FIAYWARD WI 54843-1220 CHG : 1/06/96 CHV: 1 /06/96 HO - -------_-___ 10541N RANCH RD HAYWARD 54843 --ID-941 -22 4443/2-41-09-22-4 . 16 . 43 SEC/TN/RNG ZNM# SCHOOL ACRES PT. SESE 62 1 . 750 20, OOQ __ __ _ NORTHWOODS PHYSICAL NOTH01 22/41 /09W 2478 1 .750 LOTS 1 � 2 CSM 15/146 THERAPY 6 FITNESS CTR ---------- HISTORY ---------- -- 600 SHELL CREEK RD ST 2 _ -- 518/6-__ _. -- --_ -- -- --__. _ MINONG WI 54859 CHG � 1/O1 /97 CHV : 1 /O1/94 HO �'_- _ _ _ _ -- 10-941 -22 4444/2-41 -09-22-4 . 16 . 44 SEC/TN/RNG ZNMN SCHOOL ACRES PT . SESE G2 1 . 150 13,500 52, 200 ROBERT C � JEANNE K HOR011 Z2/41 /09W 2478 1 . 150 LOT 3 6 OUTLOT 2 CSM 15/146 - -- HORNAK_. _. _ . _ _ _ _ __ _--- ---------_ HISTORY ---------- _ _ - ---- _-__ . __ . _ _ _.___ -- --- PO BOX 719 518/5 HAYWARD WI 54843-0719 CHG : 1/01l96 CHV : 1 /03/95 HO -�_ __ --___ i ' DOcun4EN7 No. S :E BAR OF WISCON3IN FORM 1-1982 TNIB BPAC¢ RESEflVEO FOP PECOROIN4 DATA ���� � 2 WARRANTY DEED --— -- --— --- ---- --- -- --- --_ __._. - hiyiir�dUo� � This Deed, made between GERALD L. TUTTLE and (��p�� - -� - — -- --- - .. .- __JEROME._E.__GAWLIK,..an _undiyided one-half interest to reoord �6e ds� �1 . each as t�AaAtS in._�.o[mnon .. _ _ _. ._ .. ___. � A D 19 et o'dool I M and tecorded In �oL 'S --- -"- --- -' --- --- - Grantor� � and ..._ -HAYWARD .EAMZI,X .D$NxZS2AY� S,.0 � _1_WiScon�in_. _ d Re�ci� an � �17 - �orporatinn - - - -- - - ------ - -- -�- -�--._........ � -�--------------------�----------�-----------�---�-----------------------�-----..._, Grantee, � � ......_..-----�---------------...-'------...-'--------------------------...------ ' Witnesseth, That the said Grantor, for a valuable consideration...__. _._.Df..Dne_�o1Lar..and.o.ther..valuable._.cons.i.d_ex�t�ons--- = L ,-��_ -_ = � HETURN TO � ,/ conveys to Grantee the following described real estate in _.-SdFIy�[ ... ... 9 aQ�iK OF h�Jqyuprd f}ef,tR t County, State of Wisconein: Taz Percel No: --------------------•----------••_ i That part of the Southeast Quarter of the Southeast Quarter (SEZSEZ) , Section Twenty-Two (22) , Township Forty-one (41) North, Range Nine (9) West, described as Lot 1t�o (2) , recorded in Volume Eight (8) of Certified Survey Maps, pages 30-31 Survey No. 1582. Description obtained from Abstract No. 22190 prepared by Hayward Land Title Co. ����� � � FEE , This 1s not________ homestead property. '-..----'-----. . (is) (is not) Together with all and aingular the hereditamente and appurtenances thereunto belonging; And-----grantors...------- �- -.. .... . . . ..--------"--�----..---------------._...........---................_._.------.-.-..... warrants that the title is good, indefeasible in Yee eimple and free end clear of encumbrancea except all easements, exceptions, and reservations of record and will warrant and defend the aptpe. _f-) Dated this ..--------------��-'------ -----...... day of ---�.4--�-.. .. . .._�---................-------------_, 19.9,`/... �--�-�--�---------�--��--�-��-----------------------..(SEAL) 1"c%�5\\.—`-._'_`_�_'�--.�.`��_--.._(SEAL) . Ge ald L. Tuttle ` -� -�--� - � ------ -...-- - .........-- - ...- - -- - ---- - - i ' "_ ' "'"_ "_-'" .....---...-�-----(SEAL) `� . .___..._........--- - - -��- --- --....I----. .(SEAL) . . __..Jerome_.E. Gawlik --- - ..... - - -. - - - -. ............. .. -._. . .... - - - - -- --...._. AUTHENTICATION ACHNOWLEDCiMENT Signature(e) --------------------------------------�---------------- STATE OF WISCONSIN � es. -----------------------------------'---------'-------'---------------------- -�'-' '-"— ��---"--'—County. authenticated this ......._day oY........................... 19__._.. Per ona(ly c e before me this .._�:_G____day of _------•---�.t��-.�-•--_..__. 19.Y_Y.. the above named '-------'---'--'-----'--"--......--'----------------------------------- _.__GQ_��_�,�,_L,__T���le_and_Jerome__.___ '--------------- '- -�---�---------- �-- ---�- --�-- - ----- - - - `- Y PUB ---Ga�l.ik----------- ---- -�---.....-�---- --------- - ------- TITLE: MEMBEA STATE BAR OF WISCx_ Y]P� (/� '----�--._._---------------------...--'--._...-----'-----'--------- (If not, ----------------------------------s-f^- '----""-- -'- '-'--'--..-"-'..._"-------------'------------'------"----- authorized by § 706.06, Wis. Stats.YJ � 7HOMASW. known to be the person _5_-_... who executed the �� DUFFY e ing instrument an knowledge the same. _ THIS INSTRUMENT WAS �RAFTED BV � MyCO�'� � � '�� � /�� �� S�_ '_"_"'" ""'_"_ "__"__......."_"'"...�"__ "_"_"".._.._. �- --_Duffy_.I.aw..9�����---- ----- - - �� 4 �riqj F OF W�S�� � -- -- -- ---- - -- -- - - - - - ...Ha�eard,--h'�---...�4843...-.--------.----h� NotarY Public _.__._..'._..........'..__.'._.__...CountY. Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: ....................�---�--�----�----------�---y-y..., 19-------•1 •N�men o[ Deraune ai¢nlne in �ny capecity nhould be tyVeJ or pdnteJ below lheir ei¢neNree��4 0 � � • O ' WAnnnNTY m+.RD eTATF. IIAR OR WISCONSIN \Visninsi�� Lc�.-ul ➢luuk Co. inc. � Z � /.lI p.Gf ' .Ib.9 NOT USED Ib.lO ., ., Ib.l .. .. N Ib2 - .. '^ Ib2 ' . �' .16.3 �6.39 N � � Oc- ti I 6. ¢o �' � \ 2 � � a, v� � . 16.33 9e .16.3 5 g "� O V � � ' 16.41 f � � � z T � ..1_ 16.4.i ''° \ Q � .16.'5 Q � �� n'f, o � - �' .16.y2 � a = � << u � 2 z � Q i6 4 � � � ,16.i \ . . 33 z / .��l. .16.1 t ✓ �� +� 16.6 ; ' — ` � '� . .16.7 � i � � 16.8 , , � , , .16.2 8 0 � o / � �;' J6.2o 3 �6.21 , e � � 16.2 2 � CITY OF HAYWARD ' � , � SURVEY OF PARCELS IN THE S.E. I/4 OF THE S.E. I/4 OF SECTION 22 , T. 41 N., R. 9 W., TOWN OF HAYWARD , SAWYER COUNTY , WISCONSIN . N S. 8° 52 42� E. 235.81 35.75 200.06 ' 33.03 N e,o ��b N � s'S,., LOT I �`� r N N O ,; , o.�o ac. � m � � _ m Q N pM �eo N O N � w 3 oh�' 9 , o f _ oi� `?2 tri ai �n N. 89° 01� 48� W. 234.202 w a -p � 3426 � I � � m oh� '� Q m z r \.y3°26�h LOT 2 �\ N _ � \ o ,n � ,�, 0.86 AC. a ,� - pO 8. C\ O 91p N � � [ , M �p \\ p � 3y, _ o m � 3s � //�� N� �L p 33js„ .�yg9 .�•.., �win�q i / f�p � i � r �:Cl J �'�, sy _ g6 � �`V.�-�,,,.....,•.`�fj�': \ e2 �029\9 Y1 � � S� � 33� 33' =� y�xo�crs•r � � � �, SWA!iSG.J• tiF�\ o _ � :-io.:o m Hn7',;:„�t�, ? a = wis ' w o 4 = , ��i .••' _t , ui s � o U . d. '�+�; :ti��� � N � \ N Q 4 Q � t I "'• '� _o 'y w � 0 �o-�r�' .Q �s...'^'°'",� o '�� =� N I� _n ��-��'8� N N i/i�- z v- �O � �, � z�.-�J�� � � !a'a.u...O,�tL cc�� � z.,...�P (�- ( � � \ ,�o SCALE � I�� = 100 FEET I r � o I�� I.D. X 30�� IRON PIPE PLACED N � � h \ X P.K. SPIKE PLACED ? W J • I�� I.D. IRON PIPE IN PLACE : � 0 3/4�� I.D. IRON PIPE IN PLACE 'N m • I/2�� I.D. IRON PIPE IN PLACE °oo � � I 3 d N O � F' o U Q N O Page 1 0� 2 pages z 22 23 �Pf7e��y$�' S.E. COR. SEC. 22 - 41 - 9— �� 2.s' s.e.c. 27 26 �D � � � � I , Robert R. Swanson, Wisconsin Registered Land Surveyor, do hereby certify under the provisions of Chapter 236. 34 of the Wisconsin Statutes and under the direction of Kennedy Investment, owner of said land, I have surveyed and mapped the parcel herein described and that said parcel lies in the Southeast �tuarter of i the Southeast @uarter (S.E.4 of S.E.4) of Section 22 , Township 41 North, Range 9 West , Town of Hayward, Sawyer County, Wisconsin described as follows� Com�encing at the southeast corner of Section 22-41-9; thence North 00 51 � 24" West , along the east line of said section, 674. 95 feet to a point; Thence South 68°29 ' 19�� West 36. 29 feet to an iron pipe which is the point-of-beginningt Thence continuing South 68°29'19�� West 102. 56 feet to an iron pipe which is on the northeasterly right-of-way line of New S.T.H. ��77�� rThence North 47°34' 36" West , along said R.O.W. line , 189. 82 feet to an iron pipe; Thence North O1°00`'S1 �� West 208. 25 feet to an iron pipe; Thence South 88°$2 '42" East 235•81 feet to an iron pipe on the westerly R.O.W. line of Ranch Road; Thence South 1�C7°18 '26" East, along said R.O.W . line 128.6� feet to an iron pipe; Thence South 00�57 ' 26" East , along the westerly R.O.W. line of Ranch Road, 165.40 feet to the point-of-beginning. Said parcel contains 1 .56 acres more-or-less and is subject to easements and reservations of record. 176364 �e�e om� ' �, Sa�ryet Couaty Received Eor recotd�he_�_daY oL ��..��������r���. NOV_ AD18�at�38clock �'� �;��,�N����'�. �, ...... �2, �,PA md recorded(a vol. � � 3,.+"' w.. W�y_'on Daae_�� _ . �'ROPERT R�'•. , S4VAI:riON � ' Reyi ter = ,1 "�10-:� � • G� }{AS6:::nD. : ' WU. D �� . 'Y�+n:e✓«w`'� .���, . ''+ '��111���1��•` . �a� ,�. �,�N Page 2 //-/d-90 31 Application for Land Use Permit 4 County oP Saveyer � The undereigned hereby makes application for a Land Use Permit and o, � agrees that all xork ahall be done in accordance with the require- ments of the 5axyer County Zoning Ordinance and the laws and reg- ulations oP the State of iiisconsin. PLEA$E PRIAT - tTSS BIACK INR OR PffiYCIL � �� Smittv ' s Inc . Dalc Jo�� �cnscn - � rnmer -- er � P. O. Box 513 Rotite 7 � � ma a ress ma a resa µ Havwaru . 1Visconsin 54843 [lavward , 6VI Building Land Use Zone District c:- 1 � h Nex Filling i� Addition Dredging Lot size '� Alteration Mining Moving on Grading Acres . 86 �n � �• New Construction (year round) or (seasonal) -conatructed _ Size 5o Pt xide ft wide l00 Pt long Pt long � cr Floor area 5 , 00a sq ft sq ft � � Total height Zp � to peak to peak ''' Stories 1 N Ao. of bedrooma rear lot line or waterline � e of structure �' IAvellin8 � s� Garage (1} �2) car Storage buil ing Boathouse m Livingroom Bedroom � Utility room � Kitchen-dining Porch - enclosed a i� Deck - open C � X Liquor Store � �" m µ n� e oP construction � N x Frame Slock Log Concrete Po2e Steel � Metal Estimated coat � 45 , 000 . 00 � CST 81- 285 � Vol 334 Pg 523 of deed Sd CS 90l g Pg 30 �je� Q��4C��� � Sanitax-y Permit : 81- 265 � -------CL road ------------ cyi � m N x oq � ee . l�8 / ° Isaued Denied � ' �, � , � � �7/i � �. .��� ,. �- �'3Wfi� � oning� �i�����dl� � � � �� � . � � � ,l � '.h���'_ / � ; - �- �� m / �� � �� � r � � o \� � ; 78,91� \ c� -- - - - — — - - y o,s� 'G •� � o�� I G� /� i ` � � ,o o I A 3 Gl � r .._i � m / � __""'T D' , i m C �O � b ' I�- . vQ . ��� � r ' n_..._6-_____' I .. � I l v m ❑ � C� � W �) � {,� w '` `� " a / � p � " � �o' y I ^I 1 so - � � �--_ � � � o �, � r m �' I ry f� _ � 'D y y "= 1 � �� � NTl �,�, y . a )U / o � � z � �, z 0 , 7 � �, "� � I 0 1� r � o T I � � C7 � � � i� o � � \� � c{ � � � � � C L- X � � � r � 8 -� � I � t� � r 0 \ A � � ?� (t� � r � �\ (A Fl 1 �'�,- I D _ \ � I ) A \\ � � � I �- - - -- - - -. -� - - - -- �- - � . I b s. 40 ' � w w _ • �.- --7-4;'� N--�.p.. __�I�Aric N R o� W w ------------------ • ' k� � /_i0°� DEPARTMENT OF �' APPLICATION �� � SAFETY&BUILDING$a INDUSTRY, FOR SANITARY DIV�SIOIrI���' LABOR AND - PERMIT P.O. BOX 79g9;n; HUMAN RELATIONS , (PLB 67) MAD�SON,WI 597071°u, Attach plans for the system on paper not less than 8K x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical charec[eristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed,sealed and dated by the designer. If designed by a Master Plumber,the date,signature and license number must be shown. The ownero copy or a legible reproduction of the soil test report must be included. — 2Z Property Owner: !7 � � Mailing Addresa: � � C .Q, 0 W ft � cS 8 Property Location: Bif�YiNega or Townahio: ounty: Ya,�� YaS � �T N�R (or) W � vy ..S Lot Number: BIk No.: Subdivision Name: � Nearest Road, Lake or Lendmark: Stata Plen I.D.Number: (lf assigned)8�•0 b��� TYPE OF BUILDING Number of �Public' ❑ Variance~ ❑ O[her (specifyl" Bedrooms: Q 1 or 2 Family 'State Approval Required. ly'�-yLQ� TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITV �-U HOLDING TANK CAPACITV IIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SVSTEM PERCOLATION RA7E ABSORPTION AREA (Minutes per inchl: PROPOSED (Square feet): � NCW ❑ Replacement ❑ Experimental � Seepage Bed ❑ Seepage Pit 1 /_ �� ❑ Alternative (specify) ❑ Seepage T�ench �� Water Supply: Owner's Name as Listed on Soil Test Report (lf other than present ownerl; �Private ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Signature: � � MP/MPRSW No.: Phone Number: �:/�t-P -N c� /�''1 Q�c L � ,��;, �, � �� ' .. __.__ l �l 9 S �)/sG,s'y�i 3 Plumber's Address: , ' Name of Designar: � V /`}- : , � � � �.0 � � COUNTY/DEPARTMENT USE ONLY CS'r 81- 2s5 Signa r f Issuing ge . Fee: Date: � qppROVED Sanitary Permit Number 5� . �� lZ- 'J- $1 ❑ DISAPPHOVED 23616 fieason for Disapp al; Alternate coursels)of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. JTION: White�County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DE398 IN.03/81) . .. � , � 0 � RI �`' � � oa H�N� '�Nmol �' O_ M — * - - - - - — = °h's9(- -- - - - - - I �� � � � o � � � I C ( 3 \ . � r___ ~ o ,�n I ¢ u v) � � � -! 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O , �_l D '__' J 'o I _________ \ � O W I ~ 5 � � ] d I � Q Z O , _ � Wa _______________ 1 111 I N / Z I � . c3 O ♦�� ai �. � � � `' ^i �\oP� - - - - - - s� �,�`?` ,I6'&L / �o � s �� / � u' � Q � v / � � / �� ..t `� - G,� : N --+�'(•— p . _ , - a . � Q c � c � � � w m n ° � �\ � � > o ,`�v P � m o a ? � � - � o0 00 I ` � � � � 9 ! o � 4c� I Q I° Z � � � � � f � F ' � � \ J � 4 ? � n i � � � ( � � � � , N i � � � � �D i ' � � I T N� 4 � O � I � A � z � ^ � � � `J 1 � � � � � 1 j �t �' � I _ m : 4 � � p n � � � ' a � ' � ' a ! � � C v � � ' � � � � � � i I � a � i �. i '� R ' Z ; ; �� J ; � A � a n h � ' � C ! � i � �� j � 6 p � i I � ( � � � � � 1 �� , � � I � ; � �- 7-- Z d � r^ � { ' � �' ° C � i � � j � i I � :t; Ix3' � + � � � ��i z ! —�_._' ' � C � � Q� � I i Z � d � i n � � � I G �' " � I� � � A a a I � b � i � j i Q 1 O � --- . � � ?7 i -� - -- � c � ` � N pp I Plb. N 60 �RC'zE � oF 3 � 1/78 PROJECT DETAIL DATA SHEET � r NAME OF BUSINESS �SM I TT Y S L I �L.�n R fdRYGu�+an Tu,asNP�.Saruv�2Ca LEGAL DESCRIPTION SE%y S�%Y S 7�-T4lN-R9ul I_oT � oF C,SM"/582 OWNER ��ANI( A. SM17H _ MAILING ADDRESS P Q ,I��X ,51.3 ��Y.i ,L�L2�11ZIR cS�Sy.� ARCHITECT, ENGINEER, (;LRRENCE M�TCAL� ADDRESS /�FD 6 PLUMBER OR DESIGNER M p �y 9 g AY�iARD�/Ul ZIP �t[BH.4 TELEPHONE NUMBER ���, ��{-� �y�3 l. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building New building Y E'S Addition ( ) Apartments and condominiums . . . . Number of bedrooms _ ( ) Assembly hall . . . . . . . . . . . Seating capacity _ ( ) Bar . . . . . . . . . . . . . . Seating capacity _ # of ineals served ( ) Bowling alley . . . . . . . . . Num6er of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number of sites ( ) Camps • • • • • • • • • • • • • • • ( ) Day use only Number of persons _ ( ) Day and night Number of persons _ ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Church . . . . . . . . . . . . . . . ( ) No kitchen Number of persons _ ( ) With kitchen Number of persons _ ( ) Dance hall . . . . . . . . . . . . . Number of persons ( ) Dining hall . . . . . . . . . . . . P�umber of ineals served daily _ ( ) Doq kennels . . . . . . . . . . . . Number of enclosures ( ) Drive-in restaurant . . . . . . . . Inside seating capacity _ Car-service -- Number of car spaces ( ) Dump station . . . . . . . . . . Number of dump stations (� Employees ( total of all shifts) . . Number of employees � O Hotel O Motel O Cottages . . . . Number of units with 2 persons per unit _ Number of units with 4 persons per unit ( ) Medical and dental office bldas. • • Number of doctors, nurses, medical staff _ Number of office personnel _ Number of patients _ ( ) Mobile home parks . . . . . . . . . Number of sites _ ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . . Number of persons ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . . Seating capacity _ ( ) Dishwasher and/or disposal? ( ) 24-Hour service (X) Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . . . . . . . . . . . Number of classrooms Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( J Service station . . . . . . . . . . Number of cars served daily _ ( ) Swimming pool bathhouse . . . . . . Number of persons _ ( ) OTHER . . . (Specify) . . . . . . . COMPLETE OTHER SIDE v 2. Indicate whether the following facilities are present. Floor drain yes _ no �j _ Number of drains _ Food waste grinder yes _ no X Dishwasher yes _ no _� - Automatic clothes washer yes _ no �_ Number of clothes washers 3. Septic tank capacity �pn� Holding tank capacity Septic or holding tank manufacturer 7'M C', Po S k 1 hl 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches depth number of trenches SEEPAGE BEDS: total square feet ��� width �� � length of bed 3 7 ' depth 3� " SEEPAGE PITS : total square feet outside diameter depth below inlet total depth from top to bottom of pit Signature of person completing form: FOR DEPARTMENTAL USE ONLY �//_I� �F � Address �� �4��r«r��T�ti,�c�' r/� � Z i p r� Tel ephone Number �f`j�5=/,��/� �,�y.� Da te /�G' ��/ •1 i �- �� Department of Zoning and Sanitation �- • Sawyer County 0 Inapection Report � m K Owner Smitty ' s Inc. � Addrese P. O. Box 513 Hayward, WI �. rr Name of businesa `� ti Builder �, � Address " Plumber Clarence Metcalf Address Route 6 Hayward, WI Inapection ( � Yrivate (7(� Public Property Sanitary-instal r o Dwellin� Setback - lake h � Violation Mobile HM Setback -•road o Gara�e Setback lot lin "' ( ) Sanitary ( � Zonin� Privy � o r .�1 NL— ---------- � , w ' 3:oo P M. bi { 39' I �' w vEur '� .FLe% 9a' I I a Is' � 66Gt� .2s'r�c � ,s'ai. � ro � _ �000 y �r Tr�c I � cn � m STI� I ~ r�r� B.M.E2&v,loo' —2��c,1, �� 1 I @ 6RqoE -� . F��„ I � � h7 � GJELL tioT �N. � s�os, ( `�" % � � � m I o' � a N• C .. ( �� N I N N F'� O I � H E � A F-� Discussed with owner yes no �y Diacus�ed wi.tti Uui.lder yes no P:i_ncuuscci with plumber X yes no � Di3cussed with ye3 no v�te �7 �(' f�1 Signature of Of£icer ���(� - �-j ,� � ,/ AwY,rvl/ � � INDEX � �� � _ � '' , Soil Test Data Sheet t�+ r�r, N �. N 0 Owner Smitty ' s Inc � Address, c/o Smith Realty P. O. Box 513 � � Hayward, Wisconsin 54843 '� Certified Soil Tester Clarence Metcalf � Date Soil Test Received 05 November 1981 � 0 � � Land Use Permit No. 81-277 � K Date Issued 09 December 1981 � � Sanitary Permit No. 81- 265 r N o rt � Date Issued 07 December 1981 �; Plumber Clarence Metcalf � � Tank Size 1000 No . of Bedrooms �' Zone District �- 1 Acres • 86 Volume 334 Records Page 5z3 � Icn z• M Certified Survey Volume 8 Page 3� a NEW OWNER: I� Hayward Family Dentistry S.C. Patrick Duffy � a� P.O. Box 1220 °' K Hayward, WI 54843 � �' Vol 540 Pg 470 � LUP 94-515 issued 12 December 1994 for medical clnc denti t y N N F� � � A N � F-� � � �n5p : lZ�7 ��I DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUI �.DINGS INDUSTRY, DIVISI'JN LABOR AND PERCOLATION TESTS (11J) MADISON WI 53707 HUMAN� RELAT O ' a,� �- ��— � . LO AT10 • ECTION:T TOWNSHIP/ LOT`NO.: BLK. NO.: SUBDIVISION NAME: � �/ � /1 N/R � (orl n �� �, COUNTY: OWNE 'S B ER'S NAME: AILING ADDRESS: s �v -��t' ,' � /-i�.s, . ,� ✓.� � �. USE � � DATES OBSERVATIONS MADE NO. BEDRMS. : COMMEF3..IALDESCRIPTION: I R S: LA ON ESTS: ❑Residence ' "' �New ❑Replace i �'`�-1 - y�-� � _ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUNaPRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) s ❑u os ou os ❑u os au ❑ s ❑u If Percolation Tests are NOT re uired DESIGN RATE: S STEM L 4 If any portion of the lot is in the under s.H63.09(51(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPrH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.1 � p ^ B' �� �/7�� � � I- � q / {/ f l ' B- �- � �',S" - _ �� \ e- .� �z � B- � 7.� � 1 B' i a� �� �� �\ . . B-C� � 9�� , PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. pERIOD 1 PERIOD 2 p RIo PER IN�H P_ � �p �9 � � �— � P— � �O -�_' Jr ,�^ / P- �? O � �-` �' I P- °L' �' s s' � P- � � .r' ;S�' ;.�"' P� v LS ,�' " � � PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. SYSTEM ELEVATION � �> „�,� �,�, � ; , � ��� �, � � � � __.— _� , a � , o , e � y t . . . . .. . _ ._—. .. ... . .. . . . . . „ ... . i. .. .. , �,. .. .. , �� �d� �Q � � _ � � � _ _ . � �, _ : �,,,.�� ,��� t . ���. € _� _. / p ; j � � � � r � � �I',� .� 1 ,.� � . ' � I_ ��� ^ �y � _ ._ _ , __. t i � � � �� , # ( ��" ' � , _ . _. �� _. � ..F . ._., .. . . _ , _ , a_ _�. . , _ � < � ; ; < f � . , , r : . � . � �. �� ' ' , � � { � � � � � [ � 3....� .—.} .. .?., ...x ,.3 .. .. . .._ ,.�... . . _ .. . ... .. ...... ._ �, . ..) . .. .. � _...... d,,... ,. .... .. � ,. , . � y � � ; � � : _ .. .. i �.,.. f . � �_. , .._. __,. , � p �. � ��� - ,�, � �.�-�" �� y� �4�� �� �. �'N � ��',�c.- f_a 0 � �`°� � � . _ � �.� .�p �� ��y,.o fy�, �� � � � /d � x yi // ✓� \ ` _ .iI —�/f � � , . � . . \� \ .. ... V+ ' / /�� �_ , ; 7 , � ��=�or-r'� , .._ R . , . _ _ ,, ,. , � � . � � `_ . ' _e ;.. _ .._ . �� � �� �,,a � . : � � F ; , , : � , � . , � . t_ . . � � E s � « � , � ___a { ._._ � _.� .�. � .. .. -. . ._ , t�-- � _ . . �.� � � i t : � . , . , � ��. . � . . , . 7 , . � ' f � { . .�.. ... i ,e_ _ , ... f _.... ..,-.-. .. .. ..._., _. . {.,. � � � f . ; , f-, .. _ __ _. . . „ ... � . _ : r , r , - �`_ _� � ... , _. . . . . � , � � � ,� � j � : . , � i .. , i � . � t - . �._ „ .� � � ; � + # . � . , � . . . . . . '� ` � ` f � + . l. ... i... ...� ._ f ; . � - : i I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : TESTS WERE COMPLETED ON: �� �� �.� , � / �/ ADDI� , CE IFI ATION NUMBER: PHONE NUMBER optional): � G � �l , r-.,� ._-, ; , . .� �-;-<-; J � ��✓�,� .,2,1y� CST� TURE: � � ' . DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. `!'� . DILHR-SBD-6395 (N. 03/81) P5/03/1999 08:56 608-765-9330 PAGE 01 Safety 8 Buildiog5 Division , 2226 Rose St La Crosse,wlsconsin 53603 - (808J 785-9334 � 7DD#�(60B)264-8777 � www.commerce.sfete.wi.us ` ,�7'{��nsl� � Tanmy G.Thompson.Go�remor De artmentofCommerce erendaJ.B�anchard,secreta� FAX COVER SHEET Date June 3,1999 No.of Pages EXCLUDMG cover Z Sant: sheet To: Cindy Kuczenski From: John Spalding Deputy Zoning Administrator Sectio�Chief RecipienYs Fax#: 7'15-638-3277 Sender's Fax#: 608-785-8330 RecipienYs Phone 715-634-8288 Sender's Phone 608-789-4693 Number. Number: Special I nstructions: Cindy: Thank you for the info you sent down yeSterday. That helped quite a bit. Attached is a copy of the Site Plan for the Duffy Dental Clinic on the corner of Hwy 77 and Ranch Rd.showing the existing building and the proposed addition that we are looking at. If I understand the setback requirements, there is a 730'setback from the centerline of Hwy 77. If so,that would put most of our addition within the setback area. If this is correct,is there a zoning variance process that we could appiy to in order to look at building this addition. Could you give me a call at your convenience so I can go over this with you and see what our next step would be? Thanks again for your assistance, John Spalding If there were any problems with the transmission or not all pages were received, please contact sender immediately at sender's telephone number above. ADM tO5B5(R.<198) Efi/03/1999 08: 56 608-785-9330 PAGE 02 , , , , ., , . , , . . , r184�of�'' � NcW ` � �c�vvc.e^ � r in.Nv�- p ar �v �;� � �� �'—�r ` .' r- — � N�T� j I \ � j � EK Wa7C+� I �� � b�ep'�tJ I aaa`�J : � Ft�Lc i _ / ,,'t 3 J � / ,r :`^ � � % .� � °o L- — --—� ,j/ � (c s •Z / \ za � �'`3R, : ,. .�6, / --_ y r,. /�, P�Pos�; � -� ., , 1�� /e9�, ` i �M% . 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