HomeMy WebLinkAbout022-638-33-3301-LUP-1994-335 npplication for Land Use Fermit
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County of Sawyer N
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The undersigned hereby makes application for a Land Use Permit and aqrees '�
that all work shall be done in accordance with the requirements of the Sawyer ° �
County Zoning Ordinance and the laws and regulations of the State of Wisconsin.
PRIN'P - U5E ONLY IIL11CK INK/FLNCIL
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Owner Builder �^
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mailing address mailing address
�F� f�Glitl/ �%S�'_ �`�/��� ��1�L,fJ'!'4 i' �cSC�. �.�°/J�(' �'�
city, state, zip city, state, zip
Building Land Use Zone District � ` �
( ) New ( ) Filling
�nddition ( ) Dredging Lot size ���''�f x ��t` � � �
( ) 111teration ( ) Grading m n
( ) Moving on ( ) Acres v '�
( ) ( ) �
New Construction '
Size �1 , ft wide ft wide
L,� f t long f t lonq ��
n
Floor area ��� . sq ft sq ft �
� �
Total hgt ,%�� to peak to peak X �
, Stories _�_ i��
No. o��eeqs ` rear lot line or waterline �
(year round r (seasonal), I ����%y/E /�6�D t
__- -� � ' � I
i �
Type of bldg or dditio � i r' _ i o
a� � �� ; � �
( ) Dwelling � I �
( ) Garage (1) (2) car i � a �'
( ) Storage buildinq � � � � rt
i i N•
( ) Boathouse � � � �"
i ( V i o�
( ) Livingroom i �
i �
(� Bedroom ( i ,�_�d -� i
(�,��n-dining i � i � i
( ) Porch - enclosed/roofed Q�� a l�� ' �X�S��� i �
O Deck - open 1� �(,� �� ,3 i N
�i� E\f ���o �i N �
( ) i ,-�����'''T!�'a t �-
( ) �i 15 � 6 A.-
�� i i � cA
Typ of construction ��,,i 28' i 0� �
�'rame ( ) Block '�i i�DaTj( ' � �
I �D, i
( ) Log ( ) Concrete � � W
( ) Pole ( ) Steel �i � � ` i ' `�'
( ) Metal ( ) �� � � � � �'�
� � W
� F -� i � �
Construction cost $ '� lJ�; , i �'"�� � � �
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Vol �-�� � Pg Z�J"�7 of deed i i
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CSM vol i i w
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cer. soil Test N��t i ' � �
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�Sanitary Permit �4 --U��- • ��
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Issued 15 September 1994 Denied Kai
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�/O��LL.� �i.l-4 C,A ` " ��'�`�1� `��l��C�-1 '�,.
owner ' Zoning 1ldministrator �
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' - SCALE. I INCH=400 FEET FOR ASSESSMENT USE ONLY NO
DRAWN BY: DATE :7- 17-84 INTENDED TO SHOW CONCLUSIV
COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
. 80UNDARY LOCATIONS .
, �
Pib 67 � � `
State of Wisconsin and County
Uniform Permit Application �
for Private Domestic Sewage Systems
State Permi A9 County Q
Number �S�"�S]� Number� �� ` � �
A. LOCATION OF PREMISE W ER SYSTEM WILL BE CONSTRUCTED,ALTERED OR XTENDED
LEGAL DESCRIPTION: Name One:
(Sec., Lot, Block)
„�. CITY VILLAGE
.�'.. � �� S�7 C ,� I „3 /Lf �j � � TOWNSHIP
B. OWNER OF PROPERTY MAILING ADDRESS
Name (Street,City,Zip Code)
f
�y �.
C. SEPTIC TANK CAPACITY �5� Gallons NEW INSTALLATION � REPLACEMENT ADDITION —
MATERIA�S: Prefab Concrete Poured in Place Steel.__�Other ; No.of Tanks � �
D. TYPE OF OCCUPANCY ^
One or Two Family Residence �J� No.of Bedrooms o�
Commercial Industrial Other No.of Persons to be Accommodated�
(specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES �NO Automatic Clothes Washer YES �0
Dishwasher YES _�1�10 Other (Specify)
F. EFFLUENT DISPOSAL SYSTEM NEW_�� EXTENSION _ ADDITION REPLACEMENT—
Seepage Trenches: No. Lin. Feet Trench Width Depth Number of Lines
Seepage Bed: Length n� Width � Depth �� Tile Size _r�
� .i
_� No. Lines
Seepage Pit: Inside diameter Liquid Depth
G. Percent of slope of land (�—% direction
H. Indicate Slope of Land &direction of slope on sketch I. Tile Depth����
PERCOLATION TEST
Indicate Soil map number And Soil Type
Hours Water Test Time Drop in Water Level Inches Minutes
Test Depth Character of Soil Since Hole in Hole Interval Second to Next to Last To Fafl
Number Inches Thickness in Inches lst Wetted Overnight in Minutes Last Period Last Period Period One Inch
3c ��a �� � -� � � � � � �' J�c7
J C� ,S. �� � � �f �C? / C
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RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
S 0 I L B O R I N G S —Minimum 36" Below Proposed Absorption System
Boring Total Depth Depth to Ground Water Depth to Bedrock
Number Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches
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RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
(COMPLETE OTHER SIDE) �r
- Name of Owner ���a �� v�.¢.. County � �w Y..+� Permit No.��
: ,,---
PERCOLATION TESTS �
I, the undersigned, hereby certify that the Percolation Tests reported on this form were made by me or under my supervision
in accord with the procedures and method specified in Section H 62.20 (3), Wisconsin Administrative Code, and that the data
recorded and location of tes les are correct to the best of my knowledge and belief.
NAME .��1����5�� h✓ TITLE
(Type or Print) 7
REGISTRATION NO. or MASTER PLUMBER LICENSE No.���S� �/ ��
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ADDRESS
DATE OF TEST _ /� ��� SIGNATURE Q
MASTER PLUM�R MAKING �L.IC TI MP
Signature: ��h+��'�_ License Number: MP RSW 2
For: Provide sketch below of system
(employer) (Include direction and percent of slope and all applicable distances)
,_ _ __ _ _
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20� ��� � , . PLAN .Vl ��NI_l��-o � t Percola����& $����rie Holesl =- ;- , � � ;
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Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid.
- - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Do not write in space below— FOR.DEPARTMENT USE ONLY
- �, Date of Application Fees Paid State � • County �._
: •. ,.,�.�_.. .
. - `� `��sued/Reject�ed (date) C�ul-� � �Q�¢ Inspection Ye� o
.+
�"� Issuing Agent Name �Q��► �F-�j�2T— p UL j Valid No. Date Rec'd
�4, DIVISION OF HEALTH,P.O.BOX 309,MADtSON,WI.53701 —Revised 4-1-73
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Department of Zonino and Sanitation
Sawyer County �
Inspection Report
Name of property `�,,E �y��,f .
Description �S. � , /y<�b�� �/� ��G, ,�3,, T�38�c1 �6 c�J
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Owner Address
Builder Address
Master Plumber ��55,��,� Tj�y�so,J Address
Inspection
(?� Private ( ) Public Property Sanitary Installation
Dwelling Privy
Violation Mobile home Setback - Lake
Garage Setback - Road
( ) Sanitary ( ) Zoning Setback - Lot line
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Discussed with Builder � Yes � � No
Discussed with Plumber Yes No
Date of Inspection "7-f- 7`f
Signature of Officer � _ _ � �� �L.r---��
DOC:l1MENT NO. STL1�1�L 13AR OP WISCONSIN FORn1 �i--I�H�L T111S SF'ACE RESERVED iOH RtCOHDIN(i DATA
!� s.�� 7 � 6 � QUIT CLAIM DEED
�-- —-----_ �-
- M�on„�r.oYt�. 1 �
Saw z,r Ca �
._.. l�nclre�a__�.._..�u`�yt�' ---- --------� - ---------- -------- r � �
--------- --------- --------- Reoet.ad ior reocxd t�� deY �1
---------------------------------------------------------- -------------------------------------•-------------- ,��-i.v_�� A D 19Y d 3 o'da�
---------------------------- •------------------------- -•- ------------------•---------------------- ------ �f e,ad r�aoerLd in vol���
quit-claims to --��n�-z�`-�--�-�---�3'--'�7-1'-l�--a-nd---S�lly- A.__Iiuc�y_i_e' d � cn y� �77
-----t1.L1S��ilIl.(�_:iTlc�_y�l],F�i---�-�-S_..��J11"lt tC'Ilc"11�t-'---- ----- ------------ �: .- .� c� �Q--�-
._----------------------------------- --------------------- -------------- -------------------------- $e{Q�f
---------- - ---------- ------------------ -----------•--------------------------------------------------
-------- - -------------------------------•-----------------•-----•-------•----------------...---- ------
�c�FlyPY� . _
the following described real estate in _._t--•-'-•---=------•-•--------•---•----------- County, :'
State of �'Visconsin: REruRN To ------
LEZN I,A[-�J OFI'ICES
Tax Parcel No: _----•---_--------•-----__
.i
FVesi: Onc� IIal f of. tl�ie Southwest Quarter. (�°a 1/2 , S[�d 1/4 ) �f �ecti on
`i'hiri:y--1=h�-c�e ( 33 ) , '1'ownstiip Thirty-�ight ( 3£3 ) North, Rar�ge Six ( h )
tJest.
�E�
� -�� ----'
EX�MP�T
This 1' rint _ homestead property.
- -- -- ----�
(l�) (is not)
Dated this -- _ - --- - ����------------- day of ------.��9Y"`'�_t3.v�� , 19..9Z
-- -- ------ --- -- - -- - ----
------(SEAL) --- ---�---- -----�--- ......._._..(5EAI.)
_ - ----- ----- -- ---- --------------- ----------....--- -
' ----- -- ---- - --------------------------------------- � _A C�XG_�Q._�.�---�Llc��l.e--------� ---- ------�-
D ' , �J .
_ --- - - -� ---- --- ----------------------------------(SEAL) - - -?'LG�[Gc.�/-�f --- - --- - �"�-�-=--- - - --- .(SEAI.)
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* � -- ----�-• ��-- _..- - --•---------------•-------�---
- -- -- � -� --- - ------ �� --- -- .__..- -- -
AUTHENTICATION ACKNOWLEDGMENT
Si6nature(s) -------------------------------------•---------------------- STATE OF WISCONSIN
ss.
--------------••------•--------•-------••----------•-•--------------------------
�,l � n�� �����
-•--------�`-'-'-��----•-------- V� .
J S\ � �-i-c_
authenticated this _____.__day of___________________________ 19____._ Personally came be��.tn��o�l��r� � „�__-.-day of
1�`•,rx-. . ��.;_.�l9�_?—`�p �kabave named
--'-""--'-------"'---'-'---'-----'--"--------""'----••'---"""----""" �-'!--'-'Yy; � � s p�':� i
11ndr�c•i---�-•---13��c�:1'-�-�;--��- l�l�.��-.---;----�-----------
* ------------------------------�---=--` --------�-- +
---------------
---•------------------------------•--•--------•--•---•------ � y-•--------aa� o"�„-�--�---—--
TITLE: MEMBER STATE BAR OF WISCONSIN : a "'` q
-"--'-----'------'-----""-.'--'-"a'--r�.'-'-'-- ' }3'--e"'-"�--'---'•"-
. �'. :'��: ���7( �il Y! ,:i �
(If not� _______________________'_-___.._"_____.________-'__________ _____._____.__ ___"_._.___"__.____�L_.t_.___`1-ul_i.t�__;N_��A__4S_____'_____.
authorized Uy § 70fi.06, �Vis. StatsJ to me known to be the person._:_.::.__:�_``wlia`'e�ecuted tlie
forepoing instrument and acknQwledge �lie,4eime.
THIS INSTRUMENT WAS DRAFTED BY � `�-�� �
-- ----'------ -'-- '-'-'--'--'-'-----'-'-----'--"'--""'-.-
i�I�ir]: t�,. l:ol_�ir���n - Attorne�j _ _
------- - -- --- --- -- --- - --------------------------------
*
_- ------ - -- ---- ------ --------------•------- --------- Notary Pu tc --- -------- - --------�-----County, V�is.
(Si�;natiu•es may be authenticated or ac{.nowledg�ed. Both r�Y Commission is perm�uient.(If not, state expiration
� �n•c not nccessa�•y.) �_(�,� � ' 19 ----') _
--- - --------
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_ ---—--------�__._ _ _:_ _ -- —
_ _ - - _
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QUI'f CI,AIM DL':[�]D 5'CA'P1: 11.41t (1F' 1VIS('f)NSI[� 11'ism�nsin Lr��;��1 ISInu6 Cn. ln��
!�(1lt�t N=, '. . �'+w^
>:��.:v:�1�E;�di NT,7MBER AFFIDAVTT i
2 4 � 4 7 v EXISTING SEPTIC SYSTEM .
ONE AND TWO FAMILY �y�
/�` n l S`�rM'I' � T .
If the existing septic system does meet the minimum re- �" ` �
uirements for �'�` . , �,'''`'` . � :`.� `� _
q groundwater and bedrock depths and if it �, �C/ �Q 'f�+�.�
is functionin ' y ''
g, an addition to or replacement of a hab- ""� �'
,. ,,. � :3�
itable structure can be made in most instances without ""'� ' ¢ �
p4 ;�:,i::.: CJ('. ..
updating the existing system. If the existing system • � , � "
is utilized for the addition, every attempt should be ' � , :,��,�
_�:._,.... .
made to locate and reserve an area which is suitable
� �„_,,-,��,..- , ,
for a code complyiny replacement system for when the � � � t��:�t�_$
system fails. If the addition will substantially in-
crease the wastewater discharge, the existing system RETURN TO
will be replaced with a code complying private sewage Sawyer County Zoning Admin
system. P.O. Box 668
Hayward WI 54843
� o•aner(s) Sally A. & Andrew A. Bu�yie
Mailing address 1613 South Ranch Road
New Berlin Wisconsin 53151
Property description Part W2 �of the SW4 S 33 , T 38N, R 6W. Parcel . 11 . 1
Vol 481 Pg 277 . 80 acres . ��022-638-33-3301 . Town of Radisson.
� (We) Sally A & Andrew A $Ug�i P plan to
(X) Add onto existing dwelling
( ) Add onto existing mobile home
( ) Replace existing dwelling
( ) Replace existing mobile home
The present private sewage system has been working satisfactorily as far as disposing
Gf Wc1S��::3. i� "iC� prese::t 'yJ�1.:'wt� Se�•:3�� S1St�TM1 C�CeS f311.� lt i•7i l l ho Y'���_�CP� 471'�l"`
one that is code complyiny.
��' - � - �s- -- � �
` A. Bugyie date
,
��' C��. ,� �5 - i.S � `��
Andre . Bugyie clate
Personally came before me this
�,j day of � '�...��/�,yo'
, 1g� _9 �.:%
,-_ �'
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/' � �;
�2.��" _� ��-!C/� �- � a . " .
Notary Public - � f�,
n •�`-
�����J�,Q � County, Wisconsin ���� �
My Commission is expires �� "� �� ^ Q•7
Existing septic system - Sanitary Permit ��74-094
Date syst 'nstalled 7-1-7 4
ZA or AZA
� / � � / C� . date
� This instrument was drafted by
� �-� � �� !'�
Sally A & Andrew A. Bu�vie ��L,. Q,� �� �.- � � �