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Home My WebLink About020-639-23-5705-LUP-1994-059 Application for Land Use Permit County of Sawyer o The under�igned hereby make� application Eor a Land Use Permit and agrees th�it� � all work shall be done in compliance wi�h the requir.ements of the Sawyer County o Zoning Orciinance and the laws and regulations of the State of Wisconsin. � PRINT - USE BI.ACK INK OR PENCIL � C��.voi2 c� L. � � _ � 1'Y1�c, �� 11�e�' I� a I I r��►� ►� 0 w �►�.. ►� Owner Builder � ��-, �-� c�-r►, f�� , c.,_ 5�� . Mailing Address Mailing Address l�1��, �'-e � Lc.� Z _ ��-t "�9 cv S �. r►� �. City, Stat , Zip City, State , Zip o � Building Land Use Zone District �� -� rt (� New ( ) Filling ; � -� � ( ) Addition ( ) Dredging Lot size ��3 �( (p�~] v '� ( ) Alteration ( ) Grading � ( ) Moving On ( ) Acres �: /'� �` c � c � r� M� New Construction Size �,�p ft wide ' wide ' wide (` ' ��(� ft long ' long ' long � � Floor area �3{p sq ft sq ft sq ft 'd � Total hgt / i G �� to peak ' hgt ' hgt x' c�� Stories � � No . of Bedrooms rear lot line 'rta o (year round) or (seasonal) G�'�s �:: `' : � ct �� `,� �'�' G rt Type of Bldg , Addition, Use a o ( ) Dwe 11 ing �' 'rt �j � Garage (�) (�) car ��► Z �� T ( ) Storage Building L �-�. � fi ( ) Boathouse G G � ( ) Livingroom �' �: � ( ) Bedroom -j�� ' Q C, ( j Kitchen-Dining �v.,� C_ ( ) Porch (enclosed) (roofed) -f ( ) Deck - open �� l s ( ) y� �T9NI� ��,t i r�' � ( ) ---1 4�,` �, 10 0 _�, G� .�( Ty e of Construction T ��, � ' � V,► �j Frame ( ) Block y�,.. U �a � • ,L �� ( ) Log ( ) Concrete a�l �� ' s;, �`� yt• W `�~ � ( ) Pole ( ) Steel �.; ' 4y � ( ) ( ) Pole/Metal �'� S . �` � � '�'�` � � � Construction Cost $ �7UL) Uv �A �" lJ'1 � � Vol �3J Pg � �� of Deed �- � - ..� CS Vo 1 Pg G+ W ,� � �� w - Cer . Soil Test 7(o—p� ' 13 • � �� Sanitary Permit 78- �`1� � ~ � ---------- L ro d -------------- o ��C� �`=�- � � ,' �.. � � � � �. Issued 03 May 1994 Denied -� � (1 � � � ��-�- t�L - O�V�r •� � _ Owner Zoning Administra or � �; � V� Ga ... �o,r:� - -`--� t� :b. _ __,,.- r ,�� o, ry _. 1? „ .. , . :7.1 :7.2 '�� . . r., :7 b � � �z•�- � . :7.3 � � . :7.7 � { 3 • ,10.1 :7, 8 B :2.1 � .13.2 .13.! :7.4 :79 I -- � � I ; :�5 ` ,��. . , � �a :8.1 � � > ;8.2 .II.1 ;8.3 2 : I.1 .Ib.l :8�3 3 � :B.�- z� � � � � 2� 30 30 2 R � F : AE R I A L PHO�"D M 12 C b-5--70) SCALE: I INCH= 40o FEET FOR ASSESSMENT USE ONLY NG tJ S.G.S. W 1 N TE' R QU�} D ( 14 7 2� DRAWN B Y: D. M• E DATE : �� - 3 - t 9 7 7 INT ENDED� TO SHOW CONCLUSIV COLON (:) INDICATES GOVT. LOT EVIDENCE OF OWNERSHIP OR � BOVNDARY LOCATIONS STATE BAR OF WISCONSIN--FORM 2 I DOCUMENT NO. w,►►t�tnrv�ry uE�u '1'i115 SI'.4('E HlitiElt�'h:U FUIt ItECU1tU1NG i)a'PA - 'r; � � �' 1 �' I . � �� , c � .c�Hlw .....�UQr,v��.'".......:....c�.1�.p.-.........�.�.!��:................ • � 1///i /1 % ..... aY Gout�t7 .. . .. .....«'...!.,�,>>...6.....�C..�r.................................... 3 ................................................................................... -.,a�� i� �a ma_1___.1e�.! � ��, A U 19q_`,�,al�?o`�cioa� ..............................................................................,..... `_ 1+! nrYj tdX r'clu��YOI. �� C) conveys anci warrants to.,,.... ........... . . ..�1 . t:� � ��. .....................�.��..-�../.?;.1�Cs4.�."��"....,f.`.��`i�f�� _ ��, �7�� . — � .....................�/c�sB.g,�r��lc,��............................ ' - � ........................................... ... . . . . . ..................�i��E�7...,�..:-��..�..��J��...Q.�........ - - .................�L��ss��,....��`...��'.��9....................... HE'1'UItN Tu .................................................'.'..l....... ,�7 ......y C�v t� , lhe following described real estate in.......�..S/.'�.l.C��!I............... Count State of Wisconsin: _r� �J /' r Tax Key No...CY.��....�/...�....�.?.:.��'.:.�...... . `%/� sou�� 37�� "E�"" of �o�' �,10 r� .s�c. .�_�, �P . -3 9 � �P�' � w, ,�y,,v�6� r��'s>- o f c r�, � C� -�p�Pc�'o� � � . F�� ' _. • '�'his �/�.�:�Rl�:c:homeatesd�pro rt -. ___._ -�,,,,�„c:...,..�,.,- -� _ . . .__ _ . _ _ _ .. _ __ _ ___ ; ._ ..... -R� '�.!sa�a.`'.+r ' (is) (is not) Gxceptiontow:�rranties: ��S`t-'i7j�G��s � �� %��C�iCw 1 . /�f/ ,/`_''�Lr-'� 1)ated Iliis . . . . . . 8 . . . d�y uf. . . . . rEh1. . . . . . . , 19 . .�p�'��jk� ��, � ' h �`�f�,,�' .�� '` (St��)a�w� •F,..,;�1� .,�,, .................... . ............. (SlsAl.l ... .,"".'J � .. ................. `,a�� "'.�`�.. ;� . .. . , . �t .�G�'J'�----..... '.. � t...� ..��Ee.�,,L-�'--:. .. .... ..... .. ', � �,� � F, 3 � �s-�...,/� G .�••Y.............:`... ��-� . .��,o . ............................................. ...� ( •`��I��.D�1�.. ... ......................................... (Sh.Af.) �` r 3' � ....................................�3.^ �j��N,�'e�flGCCMV�� ................................................. . ............ � ,"'��a� i�9'��'�� ACKNnWI.EllGEMEN'1' A U'I'II E N T I C A T I O N "'��:;;,;�;�,�=a}�� Signatures authenlicated this ................................... day of STATL OF WISCONSTN �ss. ................................... 19........... ' Sa.!"!Y.e r............County. ........................................ .................... ................. . � Persouall came before me, lliia �rh............... ��y of .......................................................... y ................ . ...L:ebr.uar.y....l•991�................the above name�i ..P.1.I_'`�t,.l_...`,t '1'I'['LE:MERiF3ER S7'A7'E f3AR OF WISCON , r1 k�n.s �n.�i..[J;i,1,1.i:.u�i..P._.Pi.lb.er.i,5 (If not................................................. ............................................................ authorized by § 706.06.Wis.Stats.) ............................................................ THIS INSTRUMENT WAS DRAF`TED BY ............................................................ .........RohexC..F1.•...��kins........................... �o me known to be the person.S.......................who executed the ............................................................ fore oi ginsU•ument and ac opwledge the same. (Signetures may be aulhenticated or acknowledged. Both are nol ..`�11.�k�t..�..-..1'}�...�6i-�-'�--�........................ Ka ren..�l,..�h�........... necessary.) + ................................ Noca�y Public................................ .....S,a��x.G'..�'..........County, Wia My Commission is permanent. lf not,state expiration date: ..........................................�.-n�.- 19...��......) ��1�S I,AND T� , �ti�� -_ i �--- ?��, � --- — �^�� Prict �� ` 53 � � 28 �3 'Numca uf perauns eigning in any cupncily ehoulJ Le typed or printed below d�eir xignaturex. WAHItAN'1'Y ll6EU STA'Pl:BAit OF WISCONSIN (.,I,.,25 il, 1/dd N'Q17�1 Nu.2--1077 L� � � State and County State Permit # 1176 • � Permit Application County Permit # —8"074• for Private Domestic Sewage Systems County Sawyer CST 6-083 'DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Pian I.D. # A. OWNER OF PROPERTY W1111S F. Kruegar Mailiny Address: C�.) i I�i� '� /)� iA � ��-�- � c5� � �� .� �L'�. � C� �''a �C� ['n. �� .9� � ��3 B. LOCAT�ON: ��Y4 <AJ Y4, Section ��, Tj� N, R � E (or) W Lot# City_ Subdivision Name, nearest road, lake or landmark Bik# Village Township p�",' �ju� � ,��r-�:� C` [� u .J rL� �i�c�c.-��_.�l C. TYPE OF O CUPANCY: *Commercial "Industrial *Other (specify) *Variance Single family �_ Duplex_ No. of Bedrooms_� No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES _�NO Food Waste Grinder_YES }S NO # of Bathroom� Automatic Washer YES _�fV0 Other (specify) E. SEPTIC TANK CAPACITY ��O Total yallons No. of tanks __l *Holding tank capacity Total gallons No. of tanks New Installation �_ _Addition_ _ Replacement_ Prefab Concrete _ *Poured in Place Steel �( Other (specify) _ F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) � 2) �t� 3)-�'�3 Total Absorb Area . �j��"" sq. ft. New� Addition _ Replacement __*Fili System _ Seepage Trench: No. Lin. Feet__ Width Depth Tile Depth No. of Trenches___ Seepage Bed: Length�_Width / � Depth ;3,�, Tile Depth �7 �/�� No. of Lines _� Seepage Pit: Inside diameter Liquid Depth Tile Size �l�� Percent slope of land � % Distance from critical slope _S�� 1, the undersigned, do hereby certify that the intormation I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I tiave sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME .�� !-�D �'e I� _C.S.T. # ,S"'S'y(e � and other information obtained from �. r'//J �_1-��, ,� t� � w-. (owner/builder►. Plumber's Signature /�cr�r.�r..G,O"7��c ��.�.�Q/MPRSW# ��G� Phone #ta(?G— �� Plumber's Address ��!�!�!f`'� �--� �.� � S PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). f V' J� ,�t � 'yL � .�' 1 I� Q . �' ,� ✓ V � � S� d -� �\`,�'1 �d .`,� r l.� �—__ -_ __cC_�____—_ � �.C�'N-C S \ f ��X Y�' X�� ,� � � _` .�. � � � � J � G �? � � Do Not Write in Space Below - FOR DEPARTMENT USE ONLY Date of Application 6-29-78 Fees Paid: State__�Q__Q�. County 15 00 Date 29 June 1978 Permit Issued (date) 6-2A-7$___�ssuing Agent Name LOri Ca�� Inspection Yes No Valid# Date Rec'd 1. county (wh��1 _opy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 � �*,+„ �.,;,,i, 7��n�� d nliimhpr Iranary rnnv� .-- : � Department of Zonin� and Sanitation � . Sawyer County � co � Inspection Report � � Owner Willis F. Kruegar � c� Address 633 Ellis Avenue Baraboo, Wisconsin 53913 a K Name of business � r• � Builder � �� N Address ►� Plumber ponald Thompson • Address Route 2 Box 102 Winter, Wisconsin 54896 H O Inspection � (� Private ( ) Public Property Sanitary-instal ,°� Dwelling Setback - lake Violation Mobile Hm Setback - road Garage Setback-lot line o ( ) Sanitary ( ) Zoning Privy �, �- �' r+ E o a � 50'+ � u��l[ D�;�� i �goaM i o ►busC � i rt � ��~O I rt io' i ;o � i v , 1 �o � �r �o' 3 �n y`� M = �, � � � ' M �` c. � �f' � � �� rJ ~� N Utr� v � w H S �..y. L Q � • W � ��, Discussed with owne r yes no � Discussed with builder yes no �iscussed with plumber yes no o, Discussed with yes no • Date �j — �,C(— 1� Signature of ��'ficer , ��,�� P�,,�