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HomeMy WebLinkAbout020-639-14-5301-LUP-1994-172 • Application for Land Use Permit '� County of Sawyer � o _ The under�igned her.eby makes appiication Eor a Land Use Permit and agrees that � - all work shall be done in compliance with the requirements of the Sawyer County o Zoning Orciinance and the laws and regulations of the State of Wisconsin. 'fi � PRINT - USE BLACK INK OR PENCIL �� ��`� �'ff�� � �J i � ��r , � .---/ � � � /�G'J���S ����, �l,V nl c� ;� � Owrier Builder :��✓�0:�-S� .��7m �,E..._- o< � I�Cai�ing Address Mailing Address �,�,� �-� w/ s� �'y� City, Sta�e , Zip City, State , Zip r �Building Land Use Zone District (Z.-� - �..--_ � � New ( ) Filling � m ( ) Addition ( ) Dredging Lot size v '� ( ) Alteration ( ) Grading -- ( ) Moving On ( ) Acres � ���-'� � ( ) ( ) � y^. New Construction ,� Size � � ft wide ' wide ' wide � ft long ' long ' long Floor area �G.�.� sq ft sq ft sq ft � Total hgt � � to peak ' hgt ' hgt �' Stories No . of Bedrooms ��- rear lot line o�-�,v-a=�e�tline o (year round) or (seasonal) v� � � Type of Bldg , Addition, Use Q' �' ) Dwelling � � � � a o Garage ( 1 ) (2) car �j � ��' � � r. Storage Building '� � ( ) Boathouse ~� 0 ( ) Livingroom � � ( ) Bedroom � ( 1 Kitchen-Dining � ( ) Porch (enclosed) (roofed) �.-:v � � ( ) Deck - open :� � � 'v � � . F 1 •\ � Type of Construction � � Frame ( ) Block r, �1 ( ) Log ( ) Concrete � ( ) Pole ( ) Steel �� F�`1 ( ) ( ) Pole/Metal a�"��- _�_� � � ��t 'u,p� L.1� m Construction Cost $ ��C?�• `' I � .-^ +r� � Vol � 73 pg 7� of Deed � �,��� V � fi � CS Vo1 - �°� �� `t? �_� 2 a's`'�-=-�� H � � Cer . Soil Test �5'S��C� f` �"�r( w ,����,;, ��t J n _ � � ,�I Sanitary Permi� �� _C�>�C� � , �, ---- - ---------- L road �------------- "' ���-,` _� � � o z_ I s s u e d 2 9 June 199 4 e'� Z 4?�t y �g 45t u,ac� Denied ` � � � Owner �' � ' "_-- ut � Zoning Administ ator ' /{�.� y�� ,;�,n�/ �/L✓ �r.-f��>�T Y� �.��S% � �aS 3 , 1 �.a a: � ° :��.� � .4.4 :�� :,, . — .�! ��1c .� ,�. � � � � �.�1L ( - ` �.. ,_� 10. 1 � � ; . ` .`i.l � - .c ai �-sc. , � ` ( � .. i ` �:� � �.�� - . .I4,1 �� :2,� �._`: O � ` ��. � � _- � � � � .9.2 �- �� -- -- _ .�� �: �� .� .I2.1 _ � � � :2 .1 �� Y� � RIVFR f ' �,)P //�i .� � 2 - - :31 - - - Q� � r� � i�--� ---�� �i . �` ,�' � �� _ G ,•%% _ ...._" /��/ 3Y. .l2.Z, � � ' I .I � � ` /i � /' � � 1I. I ., � � � ( �: I 5 \` � `\ ��/ � �� r2Z 23 D M E l0-�-77 23 .. RFF : A� RiAL PHOTO M I1 C � -5- 70) SCALE' 1 1NCH = 40o FF_FT ��° �: U, S. G. S WJN 7E R QUA 0 Cf 9 7 ,2) .;N� -_ � . �� c � � o rn� � �,�k-��, ��`7%__l�c'1 f;c���-r'a- 1 �CJ r 5 `l��/�� —. � / t [, --,. �'� � l�`'t' ��`�1__-� -��5 "'�l � �)_ �e�,�! C) t.UC� -- �L! �.tJ,��Y '_ . _ �3.� �_�-�_�_� �am�J`��r__ -----� _.��'�------- ---._ _- - -------------- _.-- � � � � ! � . � � ; ,, �$ � . . ,, � � �� _ ; �.. � _ _,_ ; ,,.,=-_�— f��_�-_�'_U�-z.4.._. _4�, cz ...�` -`\ � � I � _�— \ � � �'� � �� � �� � �� � � � � � � / \ �� � � \ ��� � � 1 ; � ^ � , ' � ___ I � - � ��-- ------- _ _ _ _ _ _ _ .-- _ _ - �� � li ' � I ' � , 9 ,.0 � � d- � ; _ � i i � � �_ I ' i � -� � `� i� /� � ' �� � � ��% � I an�, . � �.` V: � � � � :�` ��� ,, �—� � � � s'� , r, ,�La� _, i � —� �r� 7^J 7,5 d� �� (� �a 1 I , i � ' ' � `\ i ; ,�` � � . � ,�'� �-y-�F ,�T�_n._. O� f .� � 7�'` ,' ! �---�--�—�- � �' '� � �j �� c I ( '✓\ ^�' �/��r � �—''' �,� `J I �.I ,'i I �v'. i v� - a 1 n� � . �J � i I i � � � i i —_�_3�a ; ; , __ .__._---- � ; ; , � � , -� , � :�. wisconsin APPLICATION FOR SANITARY PERMIT � ,`� D I L H R SAWYER COUNTY `�' (PLB 67) o r,.�o oEPaarmenT oF UNIFORM SANITARY PERMIT.# G` 6� IfIOUSTRV,LRBOp6HUTRfIRELRTIOflS� CST 8 5- 0 5 9 6 514 2 "' Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Y2x 11 inches in size. See reverse side for instructions for completing this application. PLEASE PRINT 'RO ERTY OWNER MAILING ADDRESS e 1 ` L� � ` � 'ROPERTY LOCATION CITY: 1/4���1/4, S / , T�% N, R(o E (o LN GE: tc b � _OT NUMBER BLOCK NUMBER SUBDIVISION NAME N EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED � 1 or 2 Family Number of Bedro�ms: � [� Public (Specify): THIS PERMIT IS FOR A: [�Q New System ❑ Tank Replacement � Repair � Replacement Soil Absorption System ❑ Revision ❑ Privy �J Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. � Seepaye Bed ❑ Seepage Trench � Seepa�e Pit ❑ Holdiny Tank J 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 ,+''r of Prefab. Site Steel Fiberglass Plastic Gailons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holdin9 Tank capacity Manufacturer: � IF T�IIS IS AN ALTERNATIVE SYSTEfJI C01lIPLETE THIS BLOCK: ❑ Mound � In-Ground Pressure Total �''rof Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septfc Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): �y � � (}� Private ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (P�int): Signat e: MP/MPRSW lVo.: Phone Number: � t - � S ? c�7 O n � b`�-'� � a Plumber's Address: Name of Designer: �T� � .1 � t � J p — `— �—�—�---' COUNTY/DEPARTMENT USE ONLY Signa re of issuing Agent: Fee: Date: ❑ Disapproved r Owner Given Initial �g 5 . �� 6- 14- 8 5 �� Approved Qdverse Determination Reason for Disa oval: Alternate course(s)of Action Availabie: Dll_Ha-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner, Plumber