HomeMy WebLinkAbout024-641-14-2404-LUP-1994-205 Application for Land Use Permit
� County of Sawyer �� o
The undersigned hereby makes application Lor_ a Land Use Permit and agrees that �
- a11 work shall be done in compl.iance wilh the requirements of the Sawyer County o
Zoning Orciinance and the laws and regul_ations of the State of Wisconsin. �
PRINT - USE BI.ACK INK OR PENCIL ,
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W/,LL,Lt£/��,5,�/RLEv }�/c.kETT � GCJiV'E�@ �
Owner �-' Builder
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ailing Address Mailing Address
.�;�,� oo ��, s�'//�
City, State , Zip City, State , Zip
Building Land Use Zone District F� ) r �
0
(X) New ( ) Filling � � �
(�) Addition ( ) Dredging Lot size ��e7 X ,3��`� � �
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres , �6
( ) ( )
New Construction
Size �� ft wide ' wide ' wide
� ft long ' long ' long
Floor area sq ft sq ft sq ft �
m
Total hgt � to peak ' hgt ' hgt �
Stories � (`�
No . of Bedrooms - - �'�' ' F�� " �'�''�Y°" ' ���` r c�
�ea-�- �sT-'_—_�e or waterline o
(year round) or (seasonal) � � -_- . � �
r
Type of Bldg, Addition, Use 33 7 a o
( ) Dwelling �z5� �� `*
( ) Garage ( 1 ) (2) car � �•
(� Storage Building �s� - r•
( ) Boathouse � �' � 3� '�f��� �
( ) Livingroom �_�/ �p
( ) Bedroom � �-_
( j Kitchen-Dining ___� � '
( ) Porch (enclosed) (roofed) � �5�' `" �
� ;
( ) Deck - open `� �;7 � � �
( ) � rw
� �
Type of Construction � �'
�O Frame ( ) Block '-
( ) Log ( ) Concrete � _�_ r��
( ) Pole ( ) Steel
( ) ( ) Pole/Metal �
m
. �
Cons truc t zon Co s t $�Q(,�l.ao �
Vo1 :';� ; Pg of Deed
CS Vol .. Pg -- - '�
b �w
Cer . Soil Test � � �/ �
v r�
___ �
Sanitary Permit �� --�t'.�� ��� � road
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- - �(po,s E L A K� Ra/ED o
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.�o �sy vK u�c �,
Issued 14 July 1994 Denied �
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Owner Zoning Adminis rat r
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. �ocuMEN7 Nb. STATE BAR OF WISCONSIN FORI�i 3-1962 TH15 S�ACE RESERVEO FOR AECORUINO GATA
�U ;� 'f r� 1 QUIT CLAIM DEED �I
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— 8�tster'�C�Ft1os 1 , �
THOMAS PAUL HANSEN and JANE ANN HANSEN, his wife S°"`yu` c.�unt� f
...........................................•------......... a-�►Yaa t�: t�..-�Ta �hg l /� �.,7 a
•--•---------------•----------------------�----------- , ,
�`�Y'`'�- _� A D 1�,�_ > at o'doc�
•--------------------------••••--•--••-•--•-•-•------------•••---•-----•----•--••---•---•---.._._.......----- --- ��
..-----•-•-----------------------•----•------•---•-----•-•--••--• • - . " �.=_M end reco:d�d in vol.
- - --------�----------------------------------- l�_3 �L I
quit-claims to ___WILLIAM E. PICKETT and SHIRLEY KAY PICKETT cf N��„roras on �qa �
----------------•----•••----•---...--------•----•--•-----•--•--------•-••-•-----•
formerly Shirley K. Lindorff,_ husband and wife as joint ��c-c�.�-� ,-f-�•-. -= �
-•----------- ---
tenants_,being.nonresidents_.of__Wiscons_in �
..----••-----•--------•--•---------------•-------....-----•-----•----------------•----------•----------------•--- D�Pef► ��
---------------•----•----•-----------------------•-----•-----•-•----......--------------------•---•-•-•------.... �i
the following described real estnte in ......................Saw�rer_,.._,_,_,..._ �unty,
Stute of Wisconsin: RETURN To
I '' ) '� L V
/
The East Half of the East Half of the�Northeast Quarter ��
of the Southwest Quarter (E 2E zNE�SW�) and that part Tax Pnrcel No_ ____________________ __ I�
. ..__._.
of the East Half of the East Half of the Southeast
Quarter of the Northwest Quarter (E�E�SE�NW�) lying South of the
�Chippewa River in Section Fourteen (14) , Township Forty-one (41) North, Range !�
Six (6) West.
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ANSFER I
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$ �
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Thia ._...___is not homeatead property. �
(is) (ia not) �� ';
Dated this 9__...••-- day of .--••-•--•-----••�G/��1/-�'t � 86 li
-----••••--•••-•-•---•-•---...--•---.. ....-••-�--------•-------•-•--....---••---._.... 19._..-•--• �,
/�� ��
..--•-------•---••••••-•--••.........................................(SEAL) _..Ccl%t.1n��_/_.._�� ....�?.'�l':...._.....(SEAL)
I I
« . Thomas Paul Hansen I'
--•..........................................•-•----•-....--••--.. ..._ _..._..•-•-•-•----••......-•-•-••---•--•-----•----- '
-/ �
...........................•••-..........•-••-•.._._..........•••••-•(SEAL) ..C�.f�.l�G.1�Jl..�-�"Q:�'.-.�.-s'fC,�..._.(SEAL) �I
..._..
,
" --•............................�-•--......_...._.....------�------ ' ......Jane Ann Hansen I.
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AUTHENTICATION ACBNOWLEDC�MENT I!
Signature(s) --------•----------------------------------------••--------- STATE OF VP��� NEW �SHIRE I
( ss �
-------------------------------•------------•-------•----.....-•-----•---•-----• C �1�,� `
--�1. _L�\�5..�r�'�.-------•---County�. 1 n
authenticated thia ..._....day of........................... 19...... ersonally cpme before me this ..�`:I-�_�.._ �is}• of
, �,,�„» ��, „�
....�:. . .��:f_��...__., 19_86... th@.�ri6o�e n roe�1'�. I
.
................................•-•---•---•-•-----•---•---.....-----•-----...... Thomas Paul Hansen and Jane•'p n�-:�1� en ��'.
--•.........................•---••--••----•---•-•----...p..t3-;.,...---..i�.�..v� .�
' U�
...-•-•--•••...........................•--•...-------•---•••••••----.......... -•-•----•-----........--------•----------------._....._ti��:�-� ---••••�' `'' :
. . . ,
-- -•. - -
TITLE: MEMBER STATE BAR OF WISCONSIN _ _ _ _ __ _ :�y � � : ;', _
, -�--- : ,. .
(If not, ---•-•-•-•.....................•------••--•-•----•---••----• --•----- - -----•----------•-•---•••----...------x-----~-•- � :
authorized b � � � • Q �"'��
:
y § 706.06, Wis. Stats.) to me kno�vn to be the person5___._.__.... �vhb,eaeFuted3he,� ` '
foregoing ;nstrument and ucknowledge the sanue: : ,.•� �. ,�
THIS INSTRUMENT WAS DRAFTED BY ��� ' �
ThomasW. Duffy •---�--- - �----- -4---•--••--------------------------------••-----•---•--..
- ----------------•--------------__....----•-•---•----------------....._.--•--• ,
- �
Hayward, WI. Nota Pub�- -- ��/��__�'1���----------------�---- �:
- ---------------------------------------------•------------------ + N.H.
----•-------- Y lic •-�-��- - �� -•-------••--------County,��
(Signatures muy be authenticated or acknowled�ed. Both �Zv missioa is permanent.(If not, state expiration
arc not necessary.) c�e �A1�lC_C..Rqq:,t,qp{�}���t�,'�-otary'public� 19. _. � I
— — �L�=t�—� "� � V � P:iY �.o�m1S51o�-Lpfss�.#I}�y-} ,(�—fbr'0--.
�itt-r rr.er� nFFn �...._... .. .- -- ._.__..
Plb 67
Y�'� . �
State of Wisconsin and County
/ Uniform Permit Application
� `� for Private Domestic Sewage Systems
State Permit �` f County Perm�ij _O
Number � � ���,� Number "r ��
A. LOCATION OF'.PREMISE WHERE SYSTEM WILL BE CONSTRUCTED,ALTERED OR EXTENDED
\
LEGAL DESCRIPTION: Name One:
(Sec., Lot, Block)
CITY VILLAGE
,-�•� � ' c.t/% S� G, � --yl/f�/P�,t —�c:vi� TOWNSHIP
B. OWNER F PROPERTY MAILING ADDRESS
Name (Street,City, Zip Code)
o�� ��.-.� ��� � R T y /�,� - .. � �y �
C. SEPTIC TANK CAPACITY S �-' Gallons NEW INSTALLATION � REPLACEMENT ADDITION
MATERIALS: Prefab Concrete Poured in Place Steel � Other ; No.of Tanks
D. TYPE OF OCCUPANCY
One or Two Family Residence C1 /v �- No.of Bedrooms �
Commercial Industrial Other No.of Persons to be Accommodated �
(specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES �O Automatic Clothes Washer YES �'TVO
Dishwasher YES �O Other (Specify)
F. EFFLUENT DISPOSAL SYSTEM NEW � EXTENSION ADDITION REPLACEMENT
Seepage Trenches: No. Lin. Feet Trench Width Depth Number of Lines
Seepage Bed: Length � � Width � �� Depth %�`.�_._ Tile Size �_ 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 Fall
Number Inches Thickness in Inches 1st Wetted Overnight in Minutes Last Period Last Period Period One Inch
� .� � ����� � - ��� l �"' � �
-� .2� S<�/] � iJ4� �l � �
� �; J cc �=� �l� Y � � �`
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
S O 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
��i / Q r' p �pi�/ �' ,.li,/�'/.7 7�.
�
� S�' � � j�, ,� �' � �
� � a . % - � . . �
RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
(COMPLETE OTHER SIDE)
� . . .
• Department of Zonino and Sanitation
Sawyer County
Inspection Report
Name of property �o� ���oil/
Description II�rJ�T c,�%Y, �t-�, /� T�/,t�, �b�
r----
Owner Address
Builder � Address
Master Plumber �`�c�E Address
Inspection
(� Private ( ) Public Property Sanitary Installation
Dwelling Privy
Violation Mobile home Setback - Lake
Garage Setback - Road
( ) Sani�ary ( � Zoning Setback - Lot line
D��
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Discussed with Builder (� � Yes (_ � No
Discussed with Plumber ¢Cj Yes j No
Date of Inspection � -, -
Signature of Officer ��jr��