HomeMy WebLinkAbout024-741-06-5805-LUP-1994-279 tlpplicati_on lor Land Use I'ermit �
County o•f Sawyer �,- ��
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"1'he tmder�igned hereby makes application for a Land Use Per.mit and agrees tliat ��
all_ wor.k shall be done in compliance wi�h the requirements of t}ie Sawyer County ��
7oning Ordinance and the laws and regulations of the State oI Wisconsin. �fi ,
PRINT - USE BLACK INK OR P�NCIL --i
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Owner ,Po�.+�0 7, I�ox 7�i� ,y,��,,,�.,� �y Builder
o�i C���wc�� �,_ �a S �r�r3 ��!� � ����� .�� �9 /� h..._.
Ma�ng Ad�ress Mailing Address
f_ � � nG-, r`Y� n 5.��f�a ��/ C,.�T S����
City, State , Zip Ci y, State , 7ip
�� ��,� T��-, _ 3 3 �-s� �7 �s--) �5rs"-.�.�� � r o
uilcling Land Use 7one District ��. � � �
( � New ( ) Filling -, m
O Addition O Dredging Lot size �do/►o� >c Z�c3 1�`i � �
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres � -=�-� �'
( ) ( ) — �,
,� .
New Construction '� �
s
Size �� ft wide ' wide ' wide -
� ft long ' long ' long
�
P'loor area ,�'j� sq ft sq ft sq ft � �
�
Total hgt /� � _ to peak ' hgt ' hgt x' �
Stor_ies 1
--1 , � ;_ �_� ,�
No . of Bedrooms i ar lot line or wa.ter_ line o
�
(year round) or (seasonal) . � �*
Type of 131dg , tldditi.on , Use � o
( ) Dwelling i ' � o3 .s �' � �' `�
( ✓� Garage (1 ) � car � �•
( ) Storage �uildic�g N•
( ) 13oathouse °
�
( ) Livingroom
( ) 13edroom �
( ) Kitchen-Dining '� �J
( ) Porch (enclosed) (roofed)
( ) Decic - open
( ) ' r�r�
( ) '� .
� __
Type of Construction � F��e�-� C�
(✓} Frame ( ) Iilock ��' � � (�
( ) Log ( ) Concrete - � \ � � r��
( ) Pole ( ) Steel_ �,�,�,1ir�
( ) ( ) Po�_e/Metal " U'
m
` �� � � ��u5z ; , ;.:� °' n
Constructzon CosL $ �6 Cd� 2� /
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♦ + ` }�
Vol .� 3/ Pg /U? �/ of Deed ���L „r,i�L� ,
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cs vol } � Pg "' 1;=; �-� �+ `�3' ,.� �
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Cer . Soil Test ���� -- �:; �.`:� • 4��r i '\� � .��.
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Sanitary Permit � ; ,� ",!' -----� --- �L'ro�dd - ------- z
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Issued 23 August 1994 Den�ec� ,.(; x
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$awy�•r County ��
Rc�.vivad tor record lha day d -
A D 18 a�/ 'e1oc�
M au�1 rccudcd !n vol. 0
ol �� on �o�o ��
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Hepister -
Deputy
,o � �E�TII''IED SIIRYEY MAp N�.
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�v� � p�' `� ,t,� ��L O S E T 3/4��x 2 4'� I.P. � a t. I.I 3 Ibs./ft_ z
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� o .�� .�h `� Ss9 ` • FD. 3/4��z 24� I.P. , wt. I. 13 Ibs./ft• �
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/4 5 ec. 6 . � � ,�p, � � \ 80
41N. R7W 1424.75� �� ------ ---J_OJ,99�-- --- - --------3.ZI..���--- `�� � \
S89°29�29��W S ggo2g'29��W 5 30.00� So. lin f R\` 30��
e o Sec_ 6 ( base of bearinqs )�
STJRVEYOR'S CERTIFrICATE
I, I,yle I,. Elliott, regi.stered land surveyor hereby certify that by the direction of
JACQUELINE ri. ArNNDSON � I have surveyed and mapped the �and parcel which is
represented by this Certified Survey Ma.p:
That the exterior boundarys of the land parcel surveyed and mapped is described as follows:
A part of Goveinment Lots 7 and 8, Section 6, Township 1�1 North, Range 7 West, Town of
Round Lake, County of Sawyer, State of Wieconsin, and more particularly described as followe:
Commenci.ng at the South Quaxter corner of Section 6, thence N 89� 29' 29" E along the
South line of Section 6 1l�24.75 feet to an iron pipe being the point of Beginning;
thence N 1�9° 29' 20" � 161 .95 feet to an iron pipe;
thence N 21° 40' 55" E 277.15 feet to an iron pipe on the shore of Tiger_ Cat Flok•age;
thence S 50° !�9' 30" E on a meander line of said Flowage 57.72 feet to an iron pipe;
thence s 39° 28' 20" E on sai.d meander line �85.71 feet to an iron pipe;
thence S 59° 08' !�5" E on said meander line 121 .07 feet to an iron pipe;
thence S 67° !�5' 25" E on said meander line 306.78 feet to an iron pin;
thence S 89° 29' 29" W 530.00 feet to the point of Beginning, said paxcel contains
2•29 acres more or less, including a11 land from said meander line to the waters edge,
and sub3ect to any easements of record.
That I have fl.il.ly complied wi� the provisions of Chapter 236.3l� of the Wisconsin
revised Statutes and the subdivision ordinance of Sawyer Cownty in surveying and mapping
eame.
I hereby certif� that this survey is correct to the best of �r �owled.ge and belief.
This Certified Survey Map is the �
same as record in Vol. /o L . , land surveyor
Pg. /!�/ Wisconsin egiet�b��!�.,�00
of Certified Survey Maps. Date: June 12�.��� ��'��,,
1't �.
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S�-i3�j 9� � � �' j. LYLE L.~� �
ru.�.c�,���� _ 2 ELLIOTT = -
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�' �� �r /f��d�� ' i� Spooner, WI j ;
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�' �IL R SANITARY PERMIT APPLICATION �
In accord with ILHR 83.05,Wis.Adm. Code CouNrY ,
��•� CST 89-025 Saw er � �'�
STATE SANITARY PERMIT# �i
—Attach complete plans(to the county copy onty)for the system,on paper not tess than 1510 4 0 �
0
8'�x 11 inches in size. ❑ Check if revision to previous application �
�ee reverse side for instructions for completing this application. pa� Gov, lot 7&S STATE PLAN I.D.NUMBER
I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION �;.
Dennis Franson %4 '/4, S 6 T 41> N, R = � (or) W
PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# '
E � 2620 Se�rerson RD, 3
CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
ELera� Wis. �►+738
II. TYPE OF BUILDING: (Check one CITv � N REST ROAD
> State Owned ❑ VILLAGE �20und I4ke �sa�orth
❑ PUbIIC �1 or 2 Fam. Dwelling—#of bedrooms� RCEL TAX NUMBER(S)
III. BUILDING USE: (If bui lding type is public,check all that apply) 0 2 4-7 41-0 6-5 8 0 2
1 ❑ ApUCondo
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.� 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 � Seepage 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
14 ❑ 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. F►NAL GRADE
3�� REQUIR�F4asq.ft.) PROPO��(sq.ft.) (Gals/day/sq.ft.) (lylin./inch) 97 ELiVA�TION
1
Feet Feet
VII. TANIC CAPACITY Site '
in allons Total #of Manufacturer'sName Prefab. Con- Steel Fiber- plastic E:xper.
INFORMATION New xisting Gallons Tanks Concrete glass App.
Tanks Tanks structed
Se tic Tank or Holdin Tank
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): Plumqer' .Signature:(N t s) MP/MPRSW No. Business Phone Number:
��a.rence �etcalf ? i' �, -- 'y` .P. 149� 715-63 -�+�555
�zr
Plumber's Address(Street,City,State,Zip Code): ,
RT6 Boa 6900 Hayward, �i�. 54843
IX. COUNTY/DEPARTMENT USE ONLY
� Disapproved Sanitary Permit Fee(�SurchergerFeej Water ate ssue Issuing Agent Signature(No Stamps)
'�Approved ❑ Owner Given Initial -
Adverse Determination $115 . 0 0 3-12-9 �
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety 8 Buildings Division,Owner,Plumber
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY& BUILOIN
LA80R & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISIO
P.C'•. BOX 7969 BUREAU OF PLUMB'INC
MADISON,WI 53707 �.�,/
LSGCONVENTIONAL �ALTERNATIVE s�a�^P�a^�� ti�T,he�
(I�aSSiQnM'
❑Holding Tank ❑ In-Ground Pressure ❑Mound
Nn'.'F OF PEHMIT HOLDER ADDRESS OF PEH�.11T HOLDER �NS�E(;TION UAiE
l��v�n:S F'�c�n Sov� C. Z�olO S-eJeria.-, �c� C.�ev� t�I S 4 7 3� a-� - 9 �
BENCH MARK IPeimaneni refere�ce poin�l DESCFIBE IF DIFFERENT FAOM PLAN AEF.VT.ELEV.. C`'a�F FT FLF V
I
I
Nam�.��Piu��i1>er MP;MPfiSW N�� Cr�..�,:v _--- Sar�itary Prrmit Numt;tr�.
1
aU�k- 1-�e�c.ca�� 1498 So.w tr �S/o40 q/ -�a�o
SEPTIC TANK/HOLDIPJG TANK:
MANUFACTUREH LIOUIG CA4'ACITV TANK IhLE T EIEV TANK()UTLE i EI.EV IWARNING LABEL �:,CKING COVER
1 PROViDED� ==�vIDED�
T �"�L ST-�-2I 1 S� S•S S,7 � .�YES r-'NO ^YES ❑NO
NUMBER OF �� ��
BE[„JI'J(i VENT DIA. VfN i•.+:.'. ��I(�H l'J.;;�k 1� f?p4n ---'-�' ... ' . LL E _ . VcNi TO FRFSH
�i �.:t nH^.a �r� � I iN iNIET
FFET FRQti} � I. � ,
�-- YES___�NO 4 I C�_�.-,'�YES _NO_NER,FEST—�--� 35--17 (O�_ I ? SO �?tS _ ,> fS�
COSING CHAMB�R:
�'.. ..,�, ii�.:r.. AcLll)INC� �':�i", ..:�.1��. . . . , ... ... . .,�.., „ f,ir�c!� '.�:�H\ i� r.EiEL _—_ :KIhG(;OVER
.. IPWr� )�_�; ,�_:IDFD
��YES JNO _�YES uN0 � —YES ❑NO
GALLONS PER CYCLE ���.�Pallocor.l�,-,�;ocEaanr,na� NUMBER OF ''�.r,"e;:'r .,F�� uu�_�•,r, ✓ervrroFaesH
(DIFFERENCE BETWE-N FEET FROM `�"E �RiN�ET
PUMP ON AND OFF) �JYES C'NO NEAREST—�
SOI L ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing � • ��� ;�:��ar r<<; �;,r:4„u �,r.0•.��.�eK,•.
or excavation. (lf soil can be rolled into a wire,construction shall cease until FORCE
the soil is dry enough to continue.) M'4�N
CONVENTIONAL SYSTEM:
�•�;orH ;E�.:,r„ � -� :�:.���. .� —. - — ��o���
BED!TRENCH � � � .. .•. PIT � . - �=-„ � "
DIMENSIONS �l 3S — (o� S�'14„� .� � — ✓ —
�—,,... ����oearH i��si�, �.t oisra v�: ... ...�.:� , ,. NUMBEROF �:�P[HTv -:�e�i e - .. ve�,tTocaes��
u�,vE co�-c�� e�,�� , i
� " i�_�. . ,:, ... I FEET FROM '.` � , ,' I;.i�irv�er�
! 8 „ ��{ 1�.3 11.9 Qu� 3D3y � 7-- � NEAREST —s 725 TSO ?2S_L?2$ '
I�._— ---�---- -- --
�40UND SYSTEM:
IPAeund site plowed perpendicular to slope i Check t�F texture of the �ii� material for ; PROVIDE A DIAGRAM OFSYSTEM
and furror�s thrown upslope: ; mound s;ste��s to mak� cer;ain that it i ON REVERSE SIDE.SHO�V ELEVA-
__ meets the criteria for medu^- sanc�� T�ONS MEASURED.
_�YES ��NO
SOILCOVER =xr„�e .,.�.��tir-+n���.t�•_, �,��st��vatinv�s:.--
� '._.;YES �JNO �_ ❑YES ❑NO
UF'iri :�IiIHE�Y�;��HED UEP7HnVI�HTHEN(��� Fi�'� I�f�'�r1�)V I�rvS"�� I�F.: J[LUfll ��U;::��[D
� ii
CEr:1=u CDGES
_ �.Vc"S �NO �YES ❑NO �-�'ES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
��:i,^:-r� i_E^�(!1�� ti00F in�E�=c,.;G:.CIV(1 .��f�a�i�: e ��- ...��ivl F�ILDE�'iHAHr)VECn;�c_
BED/TRENCH �rvE:aaaEs
' DIMENSIONS
— „ �l-:I.D PUh�P � �.�Jlit)l'.: [)IST�a 7.:_ M1tA!���Cl�', .:�'� ; ;!ISTH I:.`�i a VI�E '.�11I�iiBU11C1NPIPE'..� _ -_!1"..1RK1'J��
^LF. ELEV I',Ir. FIE'. � �'__ [)�1
EI.EVATION ANDI .
CiS7RIBUTION �.__ - � � I L---
IfNFORA7AT!ON �.,� _. ,i,'E ,�e s�=.. ,, i ;u� . �. ------ , ��� i_��i<<.;����_ . ;.o:.vaHov=_;,
i ' ' �_.,
i �--- -----_- ._YES _-NO _�---- _JYES L�NO
— - --
�•eNn�,n T as�v�:,. c :____. � +oceaT�� �ti�__ sui�cir�c
CC)6;�i:���!TS: ; ''" '•' _ TNUMBEROF
FEET FHOM ��
I i_:YES __:NO __� ,_ YES - =-NO -- 1NEAREST--�---- - --�
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Sketch System on Retain in county file for audit.
Reveise Side.
SI(�NATIIHE TITLF
DILHR SBD 6710 (R.Oti�2) o.,�ti �S S'{- --�aH, Tu..�.4
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1lpplication for Land Use Fer►nit �
County of Sawyer ,�
0
Tl�e undersigned hereby makes applicatio�i for a Land Use PermiL- ancl ayrces
� �
tliat all work st�all be done in accordance witli tl�e requirements of l-i�e Sawyer �
County Zoning Ordinance and the laws and regulations of the State oE Wisc�nsin.
PRIN'P - U5E ONLY llL11CK 1NK/L'litlClL
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Owner Builder �
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E����-a <�'v�,�s�:� �� ;r.
maili��g address mailing address r'
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city, state, zi�i� ��...-d4�.� city, state, zip
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Building Land Use Zone District �_
� New ( ) rilling
( ) Addition ( ) Dredging Lot size �GY�' �D�i� � J �jF'` / ��= � � �
( ) Alteration ( ) Grading J -�7� m �,
( ) Moving on ( ) Acres m '�t� ( _ v ,J �
( ) ( ) !' �
��
� �= �
New Construction <Q�.C� �\ 0
Size �$� f l wide � f t wide a, �
.� d
� f t long ,� ��,� f t long C t�1
, �- �
Floor arez %/ �-d sq fL- 4!(p sq ft -`• H
�
� �
N[� +�t--f",;`` � - c
Total hgt � C to peak -t�pea#c n'r' s:•" x �
`.�.� � c>
Stories /' ` �--� � �� i.__1�,�� n
�"- ; �, 0��--�= C
No. of bedrooms p� }'l rear lot ' e or waterliiie �
(Year round) _- sea�'�fi'�il) ` i �-'..' — ---� ____.
• i � i �
Type of bldg or addil-ion i i cn �
(J� [haelling � � �
i i
( ) Garage (1) (2) car i tf i �� �
O Storage buildinq i 7�� ��U � C `�
' � F..
( ) Doatliouse � �'
i
(.�) Livingroom i , ' , '�X � � i o a°
� �
( ,) Bedroom i � `�e�� i �
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( ; Kitclien-dinitig i ,�X � y i qi}
( ) Forcti - e►iclosed/roofed i �� i
(�) Ueck - opeii �j�{-_ "��--�- 8 � a
( ) � i -� �I -- _ j`� �—�✓'� � �
( ) i. i �,
_ i i + »�
' • �� f 't' � �
Type of construction r i i
� Block � � � � ` a �
Frame � ) � �
� � i _
( ) Log ( ) Concrete i i �I
( ) Pole ( ) steel N ' i -- � "'
i �
( ) Metal ( ) �
i
i l i � �n
i i �o
Construction cost $ �p p�U. j i �
t i �� i
Vol � 5�L Pg 4 g� of deed �.
i i I
csrt vol � C �g r'}�!3 i � ; w
I 1 ( 'j �
Cer. Soil Test ti� 2 j ,� � �D
�=---Q—� iJ
'----------CL roac�---f��------------- z �
Sanitary Permit 91-006 _ , �- ,,�.`, � �
` 4- 1{"' .
,�,`t� r_C��' �.L.��'�.�.'� ' �J, z
Issued 13 March 1991 -'benied � Lr �
.�� � �r, �
/� �����
Dennis V. Franson �
� �__ - � � �, t--�.�--
owner. Zoning ncl-m�ini tratdr