HomeMy WebLinkAbout002-940-22-5110-LUP-1997-362 Application for �and Use Permit �
County of Sawyer �
The undersigned hereby makes application for a Laod Use Permit and agrees that 5 �
all work shall be done in compliance with the requirements of the Sawyer County ° �
Zoning Ordinance and the laws and regulations of the State of Wisconsin. �
PRINT-USE BLACK INK OR PENCIL �
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�A1�i D� �(ZI ti� �/l.t?�U t� � r1�
Owner Buildcr r
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I�DI ��4L.F I�LRC'� �l(oD.� � �
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Mailing Address Mailing Address
I�I��A7��G<<S Y�1N�SyD.�—t9s"I �
City,State, ��� City,State,Zip
C��a� aP�- a�z��
DaytimePhone Daytime Phone o O
Building Land Use Zone District 2(Z-� � �
( )New ( )Filling
(�f Additionfs� ( )Dredging Lot Size �
( )Alteration ( )Grading �
� )Moving On � � �,�� �
Acres
� � iaA��= �2ek� �uC.�osEy�
New Construction l�dd� �.i1J ;��:f � �
Size 1 � ft wide �/` y' 'wide i n I� 'wide �
GG
�� ft.long 12' Iy 'long ' � ' ;'�� 'long �
�
Floor area_ 3'%w sq ft y`� �(�_sq ft �`.� 9� ' sq f[ �
� �
'Total hgt � �` to peak � �i 'hgt �� � 'hgt x
Stories � � � �
No.of Bedrooms —���� � rear lot line or waterline o
� 'T�TH L� �
(ycar round)or(seasonal� °"'-' �� �'
c r"
T e of Bld Addition,Use �
YP g� a' �1
( )Dwelling �
( )Garage(1) (2)car i p�
( )Storage Building �
( )Boathouse , ��"- �
O Livingroom I Oa t �,�,� Q
(y'Bedroom ���� �
( )Kitchcn-Dining 1 ��' � �
(vj"Porch(enclosed) (���cl) ,_ � _
;s� � o_
(��)-Deck-open ix , yy '
("j i.l�/�i.Li.Vh''`/ iY' i i` _ A.3 1
( 17, ., '/'KIZ� � I
Type of Construction . � -.__ (�a' __ �
(+�'Frame ( )Block � " ��� U' '�
��I' � '4'
� )1-�g � )Concrete v,��� ��t' � - - ��"� d �
( )Pole ( )Steel � � �' �� �
( ) ( )Pole/Metal =�' SJ
,'�) 2 i '° fiJ
Construction Cost$(y��j�G `-%' �
Vol S�l � Pg (�_of Deed y
CS Vo] �-- Pg -- � � �
Cer. Soil Test �Co -2�r�..��7-�� t �
---------C �
y ' ,� -^ ------- L road-------------- o
Sanitar Permit �(� -I 9 i �1,-:_- -, ,
,4V(o 5�3L=/�(p� Fire No. 8�(b C�NU !'o� v' z
� �
Issued 14 August. 1997 Denied � C
Esp 14 August, 1998
�6t�e�(,��`(�G4 i � � -
� '' �w'ner ZoningA• �in strato �
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� I .I I WINDIGO LAKE
CRESCENT
SCALE: I INCH=400 FEE'
DRAWN BY: p,
COLON (:) INDIGATES GO'
AFFIDAVIT
EXISTING SEPTIC SYSTEM
ONE AND TWO FAMILY
Documen[ Number
IF THE EX[STING SOIL ABSORPTION AREA DOES MEET THE
MINIMUM REQUIREMENTS FOR GROUND WATER AND BEDROCK
DEPTHS AND [F IT IS FUNCTIONING, AN ADDITION TO OR
REPLACEMENT OF A HABITABLE STRUCTURE CAN BE MADE IN
MOST INSTANCES WITHOUT UPDATING THE SOIL ABSORPT[ON
AREA. [F THE EXISTING SOIL ABSORPTION AREA [S UTILIZED FOR
THE ADDITION, EVERY ATTEMPT SHOULD BE MADE TO LOCATE
AND RESERVE AN AREA WHICH IS SUITABLE FOR A CODE
COMPLYING REPLACEMENT AREA FOR WHEN THE SYSTEM FAILS.
IF THE ADDITION WILL SUBSTANTIALLY INCREASE THE
WASTEWA7ER DISCHARGE, THE EXISTING SYSTEM WILL BE —
REPLACEll W(TFI A CODE COMPLYING YRIVATE SEWAGG DISPOSAL
SYSTEM.
RETURN TO:
$002-940-22-5110 Sawyer County Zoning Administration
P. 0. Box 668
Parcel Identification Number Ha ward, W[ 54843 _
Owner(s): David R. Brink —
Mailing Address: 1201 Yale Place #1603 _
Minneapolis MN 55403-1959
Properry descripcion: Govt Lot 1 Sec 22 T 40N, R 9W Parcel : 1 . 10 _
WD Vol 577 pg 105
��� ��g David R Brink plan to
(� Add 1 bedrooms on ro an existing dwelling; O Add bedrooms on to an ezisting mobile home
O Replace an ezisting dwelling with a new dwelling/mobile home containing bedrooms
O Replace an ezisting mobile home wi[h a new dwelling/mobile home conlaining bedrooms
The present pri��ate sewzge has been working satis(actorily as far as disposing of wastes. If Ihe presen[ private sewage system dnes
(ail, it will be replaced wi[h one tha[ is code com lying.
� ��
X --!�� � o�, Date
Date
[ have inspected the existing priva[e sewage system tank(s) and [ have determined that idthey meet the reqairements of ILHR
83.055 (3) (g) "Detennination on tanks" (i.e., leakage, condition of baffles, tank cover, and tank capacity). I have also determined
that the capacity of the existing tank(s) is gallons and is/are sized for a bedroom dwelling per current
ILHR S3 requirements.
Masrer Plumber, Master Plumber Restricted Sewer, Septage Pumper License Number Date
Personally came before me this Q��..��CA�dA��-[.1fi �J
day of , 19 ^r""'-'�`- Q� �'i"'�"J
� ,q� �Q�I'7�
'[!
Notary Public -
County , Wisconsin 0'�^'-z' �
My Commission ezpires � � '
Ezistmg septic system - Sanitary Permit 76-181
�� �
Date system installed 8-27-76 ��
MARY ANN STEPHAN
ir�^_�j•�1� NOTARV PVBLIC � MINNESOTr1
ZA or AZA `.�[V HENNEPIN COUN7Y
'4l'1��' My Ctlmm�BMplioe JAn.J1,FOAO
date
This instrument was drafted by:
David R. Brink