HomeMy WebLinkAbout024-741-33-5303-LUP-1993-550 Application for Land Use Permit ,� � _
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 require- o �
ments of the Sawyer County Zoning Ordinance and the laws and regu- �
lations of the State of Wisconsin.
PRINT - USE BLACK INK OR PENCIL f,, �
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Owner Builder
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ailing Address ailing Address ( .
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City, State , Zip City; State , Zip '
Building Land Use Zone District F�-; i� � o �
(� New ( ) Filling
( ) Addition ( ) Dred in Lot size � `�
g g � �� �C ls� �' � � n
( ) Alteration ( ) Grading `�
( ) Moving On ( ) Acres / , � ,' c` , I
( ) ( )
1
New Construction 4`
� �,,,
Size � ft wide ft wide
, -,
� � ft long ft long
Floor area � ' -� '> sq ft sq ft
-' � �
Total htg � -� to peak to peak � '
Stories Stories
No . of Bedrooms
r�-.-�o-�----��or waterline o
(year round) or (seasonal) lJ� � rt
Type of Bldg or Addition 1��,� ; �^.��'E r�J"f ' � a o
( ) Dwelling
w ct
(✓� Garage �1�'.-(�� car �/ %- �..,.------'_-,` � �. �
( ) Storage Building /, � �
( ) Boathouse `�� i o�
( ) Livingroom / �
( ) Bedroom '� Z 1�' / �
( ) Kitchen-Dining '�- � � �,' � ��� �
( ) Porch - enclosed/roofed � �' ,���o�^ � �
( ) Deck - open �
� �' :Fi q.� 1 w 14 1 F
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Type of Construction �,,,�� : .. ,E,=. -• j / y � `
( N' Frame (� Block --- ' F��
( ) Log ( ) Concrete s F2b'a �'
O P o l e O S t e e l - �-""--""y cn
( ) Metal ( ) " �
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Construction Cost $ ,� ;%D<J, r _
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l:�Sf,�;'':, % � •
Vol ��" Pg /� 'L of deed ��� ?;
CS Vol �(�_ Pg 3lI>>G ' b y `�
� ;�_ `'�= � � ��
Cer . Soil Test �,r ,� I J � � -,r� ,,,,� , �
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Sanitary Permit � - � s � ----------CL Road --------------- z � -�-
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Owner Zoning Admin str tor
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� Application for Land Use Permit � -
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 require- o
ments of the Sawyer County Zoning Ordinance and the laws and regu- �'
lations of the State of Wisconsin. �
PRINT - USE BLACK INK OR PENCIL
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Owner Builder
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Mailing Address Mailing Address �
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Cit , State , Zip Cit , Stat , Zip
Building Land Use Zone District R � - � o �
(c�j New ( ) Filling , rt
( ) Addition ( ) Dredging Lot size �S(� x (�j�• Ll � � �
( ) Alteration ( ) Grading "
( ) Moving On ( ) Acres �, �
( ) ( )
New Construction ����5 -- 2 �
Size _32 ft wide Y� d--J� ft wide
�
m
� f t long Z�� f t long �
Floor area �/,s�O sq ft r7� sq ft �
O
Total htg ( � to peak Z/g / to peak � �'
-�
Stories � �� � Stories
No . of Bedrooms � rear lot line or waterline u�
0
(year round) or ) �, �
Type of Bldg or Addition C'�u,q-NA�/`d��.0 ���f=S Q' r
(� Dwelling a o
( ) Garage (1) (2) car �
C
( ) Storage Building / i"� c�n� �
( ) Boathouse � , / � ~'
0
( ) Livingroom ., , ��7 3Z' — 1 �
( ) Bedroom � �
( ) Kitchen-Dining �"�Z�
,j iJCGIC � � � �
( ) Porch - enclosed/roofed -� � - -
(✓f Deck - open � (�
1 >� - � 3�' � `
( ) (
Type of Const�uction �1�, �r Ip� / �
(Vj Frame ( ) Block 1 - -
( ) Log ( ) Concrete j 1- /�'�J� `�~
O Pole O Steel �, 105' 1 � �'
( ) Metal ( ) ; I � �D
, ( �
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Construction Cost $ ��d�G� � �
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LC Vol 494 Pg 182 of deed �--' `'`�
CS Vol �_ Pg �il- 31Z '� �
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Cer . Soil Test gZ- 9g �A�'�.�f"�% ��- � �
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Sanitary Permit 92-307 ----------�L Road Cr-Y=�w�---- z � !�
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Issued 28 December 1993 Denied � �
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Owner Zoning A ministrator � �;
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SAWYER COUNTY CERTIFIED SURVEY MAP NUMBER________
Part of G�verr�rner�t Lat 3, Sect ior� 33, Towr�sh i p 41 Narth� Range
7 West, Sawyer C� W i scor�s i r�.
�/ \ LEGEND
� 1 " x 3�0" iron pipe set
� \\ rnin. wt. 1. 681bs. /ft.
/ �� boundar of arcel
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/ � � I surveyed
� � �� � True bearir�gs referer�ced ta
r � I/ � the Sauth 1 ine of the SW
� `� / �� /� 1/4 of Sect i ar� 33, wh i ch
a \� PARCE� 9 �,� � I bears N 8�°�2� 5a" W. �
\ /61,000 SQ FT.x I' I I
N � ` z� �� � ��` This ir�str�ament drafted by
r I o� \a�, ��// �I Dav i d E. T 1�_ist y.
0
a ��� a����, /
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;I i�!/ s as�22'Se°E � a q � � n �
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72.88 116.52 i 30
20.36' : /'
/ IN I '
/ N PARCEL 10 N�° I �;
� �'N z a �, Re ster's Otfice
� N'o�N 31�300 SQ. FT.� o�A ' Sawyc: County '
SCALE� � ro o 28,800 �S07. FT. 1 _ I � U
I��= 100� I I m `� � r � �� 1` eceivc_' ;or record the � / _day of
� W
I I �I' � °j S 89°22'S8"E 213.82' I \\ _ �' � 19_ at � o'e;ock
T.: un recorded in vo1.1Q
� � 20.36� 106�PARCEL ' I I50 24 \ --p 1
�j o1�1•� on a c �'�'�
m � N '�� rP 4 ��/ -.7(�
_� / z � � 3 8,500 S Q. F T.x ��o � O�`"�----
/
-� ' `�' 33,600 SQ. FT.�x .� o \ F�g�:-:er
x _ �°'�`�-
-/ 0
°' N 39° O'56"E �/ �m� D�• ��y
't°D:P �� m 42.83I � �" \c� \\ �
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W- �33.72 " 276.15' 32' \
� ( z / 309.87 \
0 33 1 r N 89�22� 8"W 342'� �
� N ` POND
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a c�
33,'1�33
' � TOTAL AREA
*xTOTAL AREA EXCLUDING ROAD AND/OR
c�' y
� EASEMENT AREA
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JApproved t h i s__/�__day of_�,�4i1/u r4-✓�__, 19��
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"'�o SAWYER COUNTY ZONING ADMINISTRATOR
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° Dav i d E. T 1 ust y � � � 7 ��1,;,,�� �
:
� Reg i st ered Land Surve r �S-' �t t,1,-pr��;;p, .
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" � � SOUTH OUARTER CORNER ''
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4 S.uNE, sw V4� SEC. 33= �� SECT ION 33, T.41 N.� R.7 W.
fOUND BRAS8 CAPPED MONUNEPlT
� C.T.M. �_B" �_�—
� N E9°22'06��W 640.32
SET P.K.NAII /
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I, David E. Tlusty, Registered Land Surveyor, do hereby
cert i fy that, under the d irect ion of S. J. Poder�schat z, owner, I
have made the fallowing survey of par-t of Government Lot 3,
Sect ion 33, Townsh i p 41 Nor,th, Range 7 West, Sawyer County,
Wisconsin, mor�e particular-ly described as follows:
Commencing at the South Quarter Corner of said Section 33,
thence N 89°`�' S8" W, along the South line of said Government Lot
4 of said Sect ion 33, 645. 3`' ; thence N 9°�8' 38" W, along the
centerl ine of a private road, 276. 95' ; thence N 17°37' 30" E,
cont inuing along said centerl ine, 340. 68' ; ther�ce N 18°41' 39"
� E, cant in�_iir�g along said centerl ine, 300. 22' ; thence N 1E�
36' �8" W, c�nt inuing along said centerl ine, 298. 9@' ; thence N
11°1`' S�:," W, continuing along said centerlir�e, 3�8. 76' to tNe
point of real beginning ; ther�ce N 11° lc' S3" W, cor�tinuir�g alor�g
sa i d cer�t er 1 i r�e, 14. 55' t o a mear�der corner wh i ch i s 55' mor,e ar
less from the ordinary high water mark of Callahar� Lake; then�e
N 39° 1�' S6" E, alang a mear�der 1 ine of Cal lahan Lake, 4�. 8�' ;
thence N 11° �0' S3" E, cant ir��_tir�g along said mear�der, 1 ine, beir�g
also the easterly 1 ine of a 2�' driveway easernent, �05. 88' ;
thence N 15 ° �6' S�" E, contir�uir�g alang said meander line,
193. 91 ' ; thence S 36°�5' 34" E, cor�tinuir�g al��r�g said meander
lir�e, 23�:,. 8�' ; thence S �°1E' S4" W, c�r�tir�uing al�ng said nieande�r
line, 1`5. ��' ; thence S �4°�9' 08" E, contir��_�ir�g along said
meander 1 ir�e, 1�:,7. 68' ta a meander cc�rr�er at the er�d of said
meander 1 i ne wh i ch i s 3`' mr�re ��r 1 ess fr,om t he ard i r�ary h i gh
water mark of Callahan Lake; thence N 89°c�' S8" W, 309. 87' t�
the poir�t af real beginr�ir�g, ir�cl�_�ding all land lyir�g between the
described r�ieander- lir�e and the or-dir�ar�y high water mark cif
Cal lahar� Lake, betweer� the par�cel 1 ir�es exter�ded.
Said parcel beir�g s�_�b�ect tc� exceptions, r,eservation�,
easemer�t s ar�d rest r i ct i c�r�s, i f ar�y, i r� use or of recor,d.
I f�_ir,ther� cer,tify that I have s�_�rveyed the ab��ve descr�ibed
parcel accordir�g to official recr�rds and Chapter ��6. 34 of the
revised stat�_ites of the State of Wiscor�sir�; that the accr�rnpar�ying
map is a true and correct representati�n vf the exteriar�
b�undar,ies c�f the parcel s�_�rveyed ; that r,o er�croachr�ier�ts by .
ad�acer�t pr-��perty owners appear from said survey, and that this
survey is correct ta the best ��f my knowledge and belief.
• ' C�
Jar�uary 8, 19L��-r_���� /�
-------------- ---
David E. Tl�asty �
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Registered Lar�d S�ary or
�''�4�'� �+��'���- N1757 Rc�bir� Road
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ys�"�a ���'',�'`,`��:a,,`' __ Medfard, WI 54451
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� DILHR SANITARY PERIVIIT APPLICATION � N
i n a c c o r d w i t h I L H R 8 3.0 5,W i s.A d r r i.C o d e CouNrY o
�'o"'""""�'"�" S aw e r �
CST 92-399 STATESANITARYPERMIT#
—Attach complete plans(to the county copy only)for the system,on paper not less than 18 0 0 0 2
834 x 11 inches in size. ❑ Check if revision to previous application
�ee reverse side for instructions for completing this application. srATe Pu�N i.�.NUMaER
I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
���scif-� B2oTy6?�.r� ,�ult,D�s, �NG + � g 33 T' S�/
/a /4, , N, Ft 7 (or
PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK#
� J�� s,-r���� k; � L3ox so�� 9 --� �
CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
I-�by�,��z�>, Wi .s��y� ��s ybL C.��..�.-�,�s.��r SH-v,�cs
II. TYPE OF BUILDING: Check one ��TY � NEAREST ROAD
� > State Owned VILLAGE:ROt/N,b i�k� eo • f3
❑ PUbIiC �1 or 2 Fam. Dwelling—#of bedrooms� PARCEL TAX NUMBER(S)
III. BUILDING USE: (If building type is public,check all that apply) - 0 2 4-7 41-3 3-5 3 0 3
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. Lsl-New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit# — Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 �eepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
i4 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION
�3�e ��c �yc� • �Ls � %� y3��I3 Feet �r 9 Feet
CAPACITY
VII. TANK Site
in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- p�astic Exper.
INFO�MATION New istin Gallons Tanks oncrete structed 9�ass App.
Tanks Tanks
Se tic Tank or Holdin Tank X ��'� / �J rn us:Ser S
Lift Pum Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's Signature:(N tamps) MP/MPRSW No.: Business Phone Number:
���,�y ,���,u��-�y � � y�� �„- �y�3��-
Plumber's Address(Street,City,State,Zip Code):
p o. /�x �� , Gz6�, 1,.J� s�/��/
IX. COUNTY/DEPARTMENT USE ONLY
� Disapproved Sanitary Permit Fee(Includes Groundwater ate ssue Is ing Agent Signat4rq(No Stamps)
Surcharge Fee) �/
�'iApproved ❑ Owner Given Initial
Adverse Determination $15 0 . 0� 2-16-9 2 I\
X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL:
SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety 8 Buildings Division,Owner.Plumber
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SBD-6398(formerly PIb�7)(R.11/88) DISTHIt3U I IUIv: vnginai w ww��y,..,�o.....r� .....-_.-., --.-- .,