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HomeMy WebLinkAbout016-637-08-4401-LUP-1994-167Application for Land Use Permit% y County of Sawyer o 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 0 Zoning Ordinance and the laws and regulations of the State of Wisconsin. PRINT - USE BLACK INK OR PENCIL Sherrie L. and Theodore S. Mataczynski Owner Route 1 Box 268 Mailing Address Exeland WI 54835 City, State, Zip Building Land Use (New ( ) Filling ( ) Addition ( ) Dredging ( ) Alteration [ ) Grading ( ) Moving On ( ) ( Replace ex ( ) mo i e—home New Construction Size 14 ft wide 70 ft long Floor area 980 sq ft Total hgt 12' to peak Stories 1 No. of Bedrooms 2 (year round) mrxXxm=) ) Type of Bldg, Addition, Use ( ) Dwelling ( ). Garage (1) (2) car ( ) Storage Building ( } Boathouse ( } Livingroom ( ) Bedroom ( ) Kitchen -Dining ( Porch (enclosed) (roofed) ( } Deck - open ( Mobile Home ( ) Type of Construction (✓' Frame ( ) Block ( ) Log ( ) Concrete ( ) Pole ( ) Steel ( ) ( ) Pole/Metal Construction Cost $24,500.00 Vol44.5 Pg 139 of Deed 1 Richard Moore American Mobile Homes Builder z aamaw m w 0 �t 0 0 Mai 1102 Lake Avenue West Mailing Address Ladysmith WI 54848 City, State, Zip Zone District A-l* Lot size 1287' x 1287' Acres 38.06 ' wide wide ' long ' long sq ft sq ft hgt hgt rear lot line r 0 0 rt — m cn 1­1 v n N H V t d � o x' CA 0 0 C Grt �r r 0. o H- rt r• Cn H- I 0 I I 0 F- W rn t� rn w V F\~ I O 00 Ln 0 F-1 r\' M m 0 V.4 OLRFI, C �z ji:f� � - sa10 GREEN TREE*. t4 1�-1� oa�= = f-/.7N/ i : ��d�s (��/_ -- s - �� ,� i � �1UHd � di��d : ��� L ) z� -s - g ���' ��/�/ H1;W� I g I �}.>� i ` I �� V I I� S ���Vj,i � - , �1 � � � � �9�0�� �� -� � �� �'�/ �' �, � �� � ,c� I i ��` \,5�, � � �L� I � ,� 2'�/ i"1'Z/ cb �. , ���• `9 G�� � I � i I i I `� I � � � � ---- � -- -------—__ _---------------=--- -- , ----- , -- -- - -_ __ _ __ �� 1 ; i ,�� ' ', � , '; i ' ���'� i j' ��/� �' I '6• �2'�. �'0�� � �`�- ��`'� I`s+.� � '`0 �� �o� ���, ��� . : ; �� I � ��,��. � , .�� �� , �,L�; � ; � � � � e ; � ; !, c , � � 1 I t ' ' �C�l � � � , ( � � . , I � � � - -- — _ _- --- L ; v I � I j ��'� „ , ,_� I �\ I y��=�t.�':� , �,�;� /�pplication for Conciitional Usc Pcrmit - ��,��'�'', ..�., �r4.ms..r �,�,,�"� � County of 5.:���yc1- � � ,.�,• ..«r. G {,��.y� rt�;::Ui'T'S1�JJ1Cc� hereb� mak�`s �lp�)11 C�1t10I� fOT' a CC�I1C� . UtiC 1�C'I'Iili i: a?1Cl � � :�`'` , �es t�hat�all w.o�rk�:shall be done in accordance with the require- "" ' nts o n'.t+11e Sa��yc''r f�o�:��ty Zonin�; OrcliTia�icc ancl .<t�� l ;:ti:�s �incl rcg- � � ��� �,�lations ot�� thc "St�ate � `.� Wisconsin . .;:;� PRINT t I: BL1�Ch �I�K �;�:: PENCI�. � � � , ;� � .��� ..-�-.--.- � 7 ` J / Jl.�l��.t� �,�,.� .�GiR/r4 Owner ' � ' ' �� �' 1� � � �� '"'y�t'`2' �' /� ` � � , -- � � iJ G'�C � �� ���� ,/,t�� . S S�� y�-,, mailing address maili g aci ress � , -- — . l�, � . :SY�'.��s— Bui ding Land �;�e Zone I�istrict �_— � r o (�New ( ) Filling o � O Addition O Dredging Lot sizc _ r., � ( ) Alteration ( ) Grading `� '� (t/�Moving On ( ) /lcres � �� c✓ ' �N c � + New Construction I , Mobile rome garage ��'� deck fV�vZ Si ze _ ��j/ ft widc __ fr ��i cie ' �Q _ ft 1 ong _ __ ft 1 ong r . Floor area b Q sa ft _ � sb it � i F—� Total hgt �� to peak _ ? ' to peak � Stories � _. No . of bedrooms � ne - (Ycar rouncl) c��1:G��c��cl ) o� Tvnc oL- I31�?c; , ;icl�litioll , or ti_;� �' 1 C rr ) Dtirell iil� �' �arage �) � j c�r �: o ) Storage building � �* ) Boathouse ' � �� ; Livin; quarters � a� , v�"' T9obile home � ' , .` __ I ' ( ) � fi���� � . �,��s � �' T��pe of construction mb���� � ✓'� I=ramc ( ) 131ock � I" b p'� � ) Log Concretc � , ( 1 nole ( ) Stccl ��.,�k �� Q�`'� � ( , �letal ( ) r I L 5 Q g,;ld.`k� �� Construction cost $_� ��� � �, c� � Vol Pg of dce --- � � CS Vol Pg � ��, '� � I ti � Ccr . Soi � . cst _ ___ _� ~ a 5�..�t;�r. - . . .- _ . � � o � �, ��1 : � � `�w-�,t.� � i — � I ssuc�l Pub . }Ic;ir i»� ~' � - � � �J � 01�::�'1' _C:1:11s : 1.1111I11St2'atOT �'�.1� y"l��-�. - elg1� 14,��. ►�.�� C��-wt� � w�sconsn - � APPLICATION F�R SANITARY PERMIT , � �ILHR ��<<--y�> >- COUTY � � OEPRRT7TIEnTOF �P�B 67� UNIFORM SANITARY PERMIT#'� � InDlISTRV,LFBORSHUTFf1RELFiT10f15 CST 86-018 77020 —Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Yzx 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PR ERTY OWN�R MAILING ADDRESS c�L-�r /.:� �I7� �� I'li' I < l�. i�� f Lc.�,�.5 ��"</SS � �', PROPERTY LOCATION CITY: >> 1/45 1/4, S , T� , N, R (r �' (or) W owA F„ '1 �4���tv� 1-cc��� LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER --'�-�'�� �7�_�� �I"1 �L �� � �c_� �-c� TYPE OF BUILDING OR USE SERVED i� 1 or 2 Family Number of Bedrooms: ��l [� Public (Specify): -�---- • THIS PERMIT IS FOR A: � New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy i� Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepaye Bed � Seepage Trench U Seepage Pit ❑ Holdiny Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steei Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity ,'� � !- Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer. � ; IF TNIS IS AN ALTERNATIVE SYSTEfJI C0IIIPLETE THIS BLOCK: ❑ Mound � In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA NIATER SUPPLY: (Minutes per inchl: REQUIRED (Square Feetl: PROPOSED (Square Feet): �l -1 l. � �7�; '_� L� Private ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Pnnt): Signatu{e: . j MP/MPRSW No.: Phone Number. , �; - /;� �1 !�..f:. � ,: � ,�-.:. 'rl, ' ? --� � ,_� � �� �� (ji�> 1 ;'y'; -� � ,'.;. Plumber's Address: ` � Name of Designer: - � i� i: ��L �-,_� ✓� f )�� `� �� "_ �1�_.�.�-vz��� ��/G�� 3�, ,,. _���- COUNTY/DEPARTMENT USE ONLY Signa e of Issuing Agent: Fee: Date: ❑ Disapproved �9 5 . �� 5- 5- 86 '� APProve� � Owner Given Initial Adverse Determination Reason for Dis p roval: Aiternate course(s)of Action Available: OILHR SBD-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber . � r ' � _,�����..:<< � + �.�1::.�1�. �� � � , ��i,�.�,_.,... f �f 1 ��� � . AL�DRESS ,�N�� �`��i � -------- - t t�l;� S'`X,�/Q�,. � ��. ; S ,S�/X���; � / � / . '��nr�.'��n� i� . ��"" , - ,,� � " ��!�� LEGAL DESCxIPTION '(; �� " - /�a� +- � _... � , � �j T;�l,�W ►� � ,� ����. . , � ��1�1���� ����� S�. ---- - -- . TowxsHlP ��-��(�c c;� �1/-t �-� .,__.__._. , LFI3END B.H. ,�c�o1i�i .;l S;�,.►uy �� {���is.�... � ����G /C� I� SiSITABLE SOIL AREA &Q. FT! � � . ��' ----------- !�_f�_ �.�� � �.=. � �� ^C� � . � � . SPFCIFICATIONS t . -. I���--�--_.��Y. � �...�.� �--� _ '—� � , •.� I . TANK HANUFACTURER ��'�.� �c,' � r � � � i I� Y � �' � �,_ �,�, ,. � -I� �' TANK SIZE /C�C^C� `7�-! / _ � � v � DRAINFIELDs Y `'� �� '_.-�"'_ '__---,_,_, _F, {�.� f � � • � � ���� ,� � � • o i �� • �� . '� TYPE & 3IZE �(�tti �l. S y �7� „ , f `1 _ S� __.__.,�I �y'�� � r SYSTEH EL. 9.�0 � � - _ �_..... n�`-C (�j Iv'�j � :,�, . --- � , �i �c,_" �'���' , � . -- - I , � �' '� 5t1N�Ds � ..._...,_.__.� / - f --� _ �.�_1� ____ . _ .___ ,. / PLUMBER �.� SSr Il `► �` �� �-S�� ---_ _.___ —- --- — � _��,� I ,/ . �- -----�—.$er�ci� _��_l � � �:, c � -- � ADDRESS ��J �7( �L� i,, � �c..- ��5 5�%�>' � LICENSE N0. �'I��S 4.' �7 7� �,L'��/ t . �1� �,�v��l, �� I �,`' . DATE `�_ ��� � �- ��y����i � • . . , ✓,� . Sl �v' U �LC • � r{ I.i . � • --•-- I ' �- �J' ---_--- ------ - ----------- _� '�v-'L(: f✓ l( r� , —•------ . _—_..__—_...,,� � . , . ��� I C� � 1102 WEST LAKE AVE_. �C � � � � � �k' * * '� LADYSMITH,WI 54848 HOME SALES � l � � �,�., , � �q� �o� � ��� : �i n�!/'"L -��Q__ '`'�� -1 �.�,1��'�..'� %//'J/'`��lf�, C l � ✓L(i / i � � � �%�G�9'.��� (�.J� ti���(yi2� � . , � (/J L�'l�l. ��-Q ���� -'�=�t�� � \ �� • �� � � ����1C ��,� �.� �' �;�--. ��� ���� ���� � ��� �� � , � � � � �:� :� �s ) , � ��-.� � � � � �� � ��. , T..� �- � . � S f�Q� -� � �� � � ��� , ��.rt� � - A �,� .��`��c ��'`�-c � � G�� /jv`'� �Q � ��L 2�� ! � S� � ,I•�.,a��'t'��,-� �� �in,c,�-a,u.� , -�°'� � . r � �� � /�r� — PHONE:715-532-3371 FAX:715-532-3431 RUSS THOMPSON EXCAVATING SAND AND GRAVEL - SEWER SYSTEMS - BASEMENTS SHOP RESIDENCE 703 FRITZ AV�. W.. LA�YSMITH. WI 54648 ROUTE 1. BOX 237. EXELAND. WI 54835 PHONE (715) 532-5892 PHon�E 1715) 943-2675 JUNE 1 , 1994 TU WHOM IT MAY CONCERN : I Russ Thompson , of Russ Thompson Excavating , have inspected the sewer system of Ted and Sherry Mataczyniski located at Rte . 1 Exeland , SE4 of the SEa Sec 8 TN37R6 , , state of Wisconsin , and to the best of my knowledge the system seems to be working properly . The tank has been pumped within the last year and there was no standing water in the drain field . RUSS THOMPSON EXCAVATING �� �� b y/ /�-Lc� ✓�Gh� � c�� ,�. MPRS 2777 m�r i cc� t�-� - �� "'� 1102 WEST LAKE AVE. * * * * * * * * * �' �':.y��'.-'_- ' DYSMITH, WI 54848 HOME SALES 'i��� � ` MAY 2 4 1994 � ���. -�`� -----------.----- � SAI�'YEt� CGl?�YTY n i�ia.�d�r ��l,�'�lcT�ar��P� 9.� t �`//���""' �.2.�'a.�%`'`" �y� �.�rt.0 � r /%� � . Q71 �l/h.� ` li��r/�`��i/"rC� r �f' � r + Ci�l�+�'i.crh�u7iKZ_ \ C.C!/r� '��n"� �''� 1��� � � i � � an�n � ��- i /�� �� l.� �� ' �.,. � ✓ -�',� ' ' � r 1 � ���%[�n�' �-�Sy� �1.� C� ��� ��(�'C.', �� �..�p _��:¢�f ✓✓s�.i2 � � r ,.�/�,�-t�j Q�� ./J+tiCrZ.c' t''�^ s � ( � /y�l� � � � ��� P HON E: 715-532-3371 FAX:715-532-3431 � : . , . ���i�-�.i� �. �- —C-�l��aC��?�, �, t�1 f��`fl�c..��{r�� . Ilv. l es �� - c� 3� �- � --�I L.L �°�- � �� ��i � 3� � ��sM�� �� flc-�=.� �-