HomeMy WebLinkAbout002-940-07-5201-PVY-2023-014 SAWYER COUNTY ZONING & CONSERVATION ADMINI � �i�"���:�.. _.
v,. F,�. �� �,,, � �� ���
10610 Main Street,Suite 49 ---=���.�t.f,� _
Hayward,Wisconsin 54843-0676 t
(715)634-8288 AUG 0 4 2023
www.sawvercountveov.or� SAWYER CQUiV i Y
NON-PLUMBING SANITARY PERMIT APPLICAT�6rAiv�A�M»visTRATiUry �
In accordance with Chapter DSPS 391,Wis.Adm.Code and
Sawyer County Private Sewage System Ordinance �
APPLICATION[NFORMAT[ON-TYPE OR PRINT PAGE: 1 of 3 �
Property Owner Nume Properiy I�al Ikscription �
� Ii.:Z.� GL�1—��`�—'��' S�'T—�(`N'R-�W
Propcnp Oercr's Mailing Address Lot Numbcr Block Numbcr �
J�Z r L � _
City,State Zip Codc Phonc Numbcr 5ubdivision Namc or CSM Numbrr ('
�c►� � 1 ✓�--. . �l� .�fS��2,� �-�O6�- �Y 24
TYPE OF SUILDING:(Check one) State Owned Ciry Ncnrest Road
Villuge p` `u''`�
❑Public �] 1 or 2 Family Dwelling-No.of bedrooms �Town oP S 5 �
C a ��� �� Lis�—�--� Fire Numbcr# �/
PUBLIC BUILDIIVG/LAND SE: [f:xplain thc usc/pu�xe forthis Pareel Tax Number:(12 digit legacy number)
permit,(i.c.,campground,festival,rccrcationlenicnainment event etc.)� � � 3 _ �� �'I `j _(� 7 .S � U �
TYPE OF PERMIT: TYPE OF NON-PLUMBING DEVICE/SYSTEM/TOILET/UNIT:
❑Privy-Pit Toilet(CST# )
[�Non-Plumbing(Privy,Toilet,Restcoom,Etc.) . . quired)
(Vaul ' cubic yards
❑Other: Vault Privy Type:OConcrete�Steel❑Polyethylene�Other
^ n tem ❑ incinerating Toiie�Device
Portable Restroom Unit Other
RESPONSIBILITY STATEMENT:
[,the undersigned.assumc respansibility for thc installation of the non-plumbing sanitary systcm for which this pertnit is issued. 1 further agree that
any d�velling in conjunction+vith this permit��•ill not be provided with indaor plumbing and/or�vater hookup. 1 will use thc non-plumbing system
indicated as a mcans of���astc disposal,anJ I will ca�ry���ater to und from the structure. 1 understand that bcfore indoor plumbing and wuter hook ups
nrc instAllcd,thc pruper Stute and County 1'crmi�s�vill bc applicd for. 1 further understund that nny dcviations from the above+vill constitutc a
violntion of Suwycr Cuunty Ordinnnces and would subject mc tu the penalties of the Ordinanc�s. By signing this Application,I nm ulso grnnting
permission to thc zoning depariment personnel to enter my property at sny reasonable time for thc purpose af inspection to assure compliancc with
thc zoning and sanitation laws relative to ihe issuance of this pertnit.
Qtivrter's Numc:(I'rint) Oµner's Signnt re:�
� ���^
OFF C USE ONLY:
(� 6 ❑Disnpproved Pertnit Fee: CST N . l)ate Issued Issuing Agem Signawre
�pp p� ❑Owner Givcn Initial S�$�.Q� A, ' •r(/l k�,�QL�-f-Llit��tti
Advcrsc[ktermination !v I � �' ��
COMMENTS:
*Expires 2 years from date of issue
*NO REFUNDS AFTER ISSUE OF PERMIT
SHORELINE PROPERTY:�YES�NO If"Yes,"Name of the body of water: U`l� �I� —
CONDITIONS OF APPROVAWREASONS FOR DISAPPROVAL:
--�, �;� �
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11_ .�y �9S 3
Rev.04/29/16 __1�..._-...__.____
h0 R�FJND�AF�'�R ';k# I I�i -
ISS�JE OF PER#Itff .,.,fi� 3to�i 3
NON-PLUMBING SANITARY PERMIT APPLICATION
PAGE:2 of 3
Privy Plot Plan
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Please include thc following info ation with distances on the above plot .
❑ North Arrow
❑ Nearest Road
❑ Site Address
o Structures
o Well
a Property Lines
a Lake, River and/or Stream
o Wetlands
Minimum Setback Requirements:
• 10' from any siab conswcted accessory building
• 25' from any habitable building
• 45' from any property line
• 50' from any water supply well
• 75' frorn the ordinary high water mark of navigable waters
• 130' from the centerline of state hibhways or 66' from right-of-way line, whichever is greater
�� �
Rev.04/29/l6
NON-PLUMBING SANITARY PERMIT APPLICATION
YAGE:3 of�
General Requirements,Recommendations and Standards:
1) The privy structure should be insect and vermin proof.
2) All windows,ventilators and other openings should be screened with#16 mesh to prevent entrance
of insects.
3} The privy structure should bs provided with cross ventilation of 2 square feet of screened opening
for each seat.
4) Privy doors should swing and be self-closing.
5) Privy seats shou(d be provided with hinged covers.
6) The entire installation should be kept clean and sanitary.
7) Freshly slaked time or other equally effective disinfectants should be used at frequent interva(s for
odor control.
8) Floors,walls, seats and urinals should be scrubbed as often as possible.
9) The outer base of the privy should be banked with earth.
10)Concrete,cement block or metal flashing should extend 6"above the ground and 12" below the
bround to prevent entrance by insects and vermin.
11}The footprint of any privy structure shall not exceed 40 square feet and not be used for storage.
12)Maximum height of any privy structure is limited to 10'.
13)Privies for public buildings shall comply with SPS 353.63
14)For open pit privies the bottom of the pit shall be a minimum of 36"above any restrictive factor
(ground water, saturated soils, bedrock,etc.).
I S)A certified soil test is required for open pit privies and must be filed in the zoning of�ice before
permits will be issued.
16)A certified soil test is not required for a sealed vault nrivy.
17)Sealed vault privies shall have a water tisht vault made of materials approved by the Department of
Safety and Professional Services(DSPS).
18)Seaicd vault privies should be ventilated with a pipe of at least 3"in diameter which terminates at
least I' above the roof of the privy and in accordance with s. SPS 382.31 (16)(a)to(�.
19)The sealed vault privy should be pumped out when nearly full by a licensed septic hauler/pumper in
accordance with ch.NR 113.
20)According to DSPS 391.12, the storage chamber of a sealed vault privy shall have a minimum
storage capacity of 200 gallons or one cubic yard.
21)The storage chamber of a sealed vault privy shall conform with the requirements of DSPS 384.25
relatin�;to holding tanks.
Rev.04/29/I 6
8/4/23,2:36 PM Novus-Wisconsin Access rev. 13.1108
Real Estate Sawyer Cot�nty Property �isting Property Status:Current
7oday's Date: 8/4/2023 Created On:2/6/2007 7:55:06 AM
�Description Updated:7/9/2018 � Ownership Updated: 12/22/2022
_ __.
- _ __._..
Tax ID: 2952 RICHARD LARSON TOMAH WI
PIN: 57-002-2-40-09-07-5 05-002-000010
Legacy PIN: 002940075201 Billing Address: Mailing Address:
Map ID: :2.1 RICHARD LARSON RICHARD LARSON
Municipality: (002)TOWN OF BASS LAKE 502 FIELDSTONE CT 502 FIELDSTONE CT
STR: 507 T40N R09W TOMAH WI 54660 TOMAH WI 54660
Description: PRT GOVf LOT 2 LOT 1 CSM 24/299
#6624 � Site Address *indicates Private Road
Recorded Acres: 1.540 16581W RAINBOW RD HAYWARD 54843
Lottery Claims: 0
First Dollar: No
Waterbody: Mud Lake J Property Assessment Updated:9/13/2012
Zoning: (F-1)Forestry One 2023 Assessment Detail
(RRl)Residential/Recreational One Code Acres Land Imp.
ESN: 406 Gl-RESIDENTIAL 1.540 15,100 0
� Tax Districts Updated: Z/6/2007 Z'Year Comparison 2022 2023 Change
1 State of Wisconsin �and: 15,100 15,100 0.0%
57 Sawyer County Improved: 0 0 0.0%
002 Town of Bass Lake Total: 15,100 15,100 0.0%
572478 Hayward Community School Distrid
001700 Technical College
�Property History
__ _____
+� Rewrded Documents Updated: 1/30/2014 N/A
__ _- -_
O WARRANTY DEED
Date Recorded: 12/1/2022 442513
0 WARRANTY DEED
Date Recorded:3/8/2021 430364
O WARRANTY DEED
Date Recorded:6/15/2020 424397
0 WARRANTY DEED
Date Recorded: 2/28/2018 411281
O WARRANTY DEED
Date Recorded: 5/15/2006 71
O CERTIFIED SURVEY MAP
Date Recorded: 7/15/2003 1 1
https://tas.sawyercountygov.orgl/Accesslmaster.asp ���
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