HomeMy WebLinkAbout026-182-08-0402-LUP-1994-034 Application for Land Use Permit �
County of Sawyer ��
The undersigned hereby makes application for a Land Use Permit and agrees that C�
all_ work shall be done in compliance wi�h the requi_rements of the Sawyer County ��
Zoning Ordinance and the laws and regu].ations of the State of Wisconsin. �fi
PRINT - USE BLACK INK OR PENCIL � �
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/ C/-�l9/l✓� /� ���r� S�L,�- G�iuN�
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Owner Builder
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Mai ing Address Mailing A dress
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City, State , Zip City, State , Zip
Building Land Use Zone District �/e Z r �
0
( ) New ( ) Filling l � � �
( ) Addition ( ) Dredging Lot size /0O �( 2 `�y, 7� `� �
v
� Alteration ( ) Grading �
( ) Moving On ( ) Acres , �g -� �
(,� D� ( ) ,C l
New Construction ,� �
�l�F'C( � �
� � �
Size _� ft wide wide wide
Z / ft long ' long ' long •
�
Floor area �/O sq ft sq ft sq ft a
� �
� �
Total hgt to peak ' hgt ' hgt x'
Stories �� �
No . of Bedrooms t� jR� CGu�Zrf O/Lf/L�4s
Q�/� - ' '�•:e � waterline o
(year round) or (seasonal) G rt
Type of Bldg , Addition, Use a o
( ) Dwelling O �• �*
( ) Garage (1 ) (2) car IQb���C�1 v+ . �s°t� ,�£ r•
( ) Storage Building� 2�� �f�k n � SrE�� �, \,
( ) Boathouse � � 3'iz� � � , r,' � `�
( ) Livingroom .T �is�. — � V T� i
( ) Bedroom � �"-' ��: ' '��"'`
'�` o •�z�.
( j Kitchen-Dining �'"'-"� _�- � �
( ) Porch (enclosed) (roofed) , ^ I
(�O De c k - op en �9.0o i-r-�o-✓ � �� 3'/1� °
�O LrC,.i}SS /N ��STI�vl� SC�2FE�//Po�tc// 'C r
� ) �� J8 �
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Type of Construction ie �`
(ud' Frame ( ) Block �
,� r `
( ) Log ( ) Concrete , , �'' p � " F��
( ) Pole ( ) Steel � �zS ,� �° a3 �
( ) ( ) Pole/Metal �, � ��� s � v�
Construction Cost $ 7440
io5�4 � �' n
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Vol t�..-71D Pg 2, of Deed � ` 2 � � �� 1�,�
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CS Vol � P 3�
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Cer . Soil Test � - Q�(.p N � �
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Sanitary Permit � - �� ��� �L road 33' '-' .�
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/CTv2y /-d�rc-FrTs C�I7�c� o
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Issued 19 April 1 94 Denied �/s�:�j��{� q9Y_�p��,v� � • z'
S�"70ILT8*0 [,�.�'!C� .? ��/NG-t-i1G6T's `�' on
��6�Y- �te� s �
�- c� _ u N �
Own�r oning Admini tra or �•
Sawyer County Zonins; l�dminis tration
0
Inspection Rcport '�
�
n
Owner Richard R. Land
Address 927 Perkins Avenue Wa �k �ha W;�consin 531�6 ' �
ty
Agent/Purchaser � �
H
Address �
B1der Plber/CST �
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z
Address
Inspection ( ) Dwelling (��Setback - lake
( ) Mble Hm ( ) Setback - road
(� Private ( ) Public ( ) Commercial ( ) Setback - lot lir_e
( ) Garage ( ) Soils Verif
Violation ( ; Addition ( ) Add to ex dw o y
( ) � �
( ) Zoning ( ) Sanitation �
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Application for Land Use Permit
County of Sawyer �
The undersigned hereby makes application for a Land Use Permit and agrees M
that all work shall be done in accordance with the requir.ements of the Sawyer
Count"g Zoning Ordinance and the laws and re�ulations of the State of Wisconsin. ,
PRINT - USE BLACK INK OR PENCIL
Audrey K. and
Carl E. Boettcher oGaner
r
Owner Builder
1033 Brookwood Drive
mailing address mail_ing address
Neenah Wisconsin 54956
Builyiing Land Use Zone District RR-2
( �� New ( ) I'illi ng
( ) Addition ( ) Dredging Lot si.ze 100 ' x 299 . 71 ' o
( ) Alteration ( ) Grading
� �
( ) Moving On ( ) _ __ _ �cres _ ___`�G � �`
( ) _ ( ) �-- --- b'
n o
� r�
New Construction H
� H
f , n
Size 24 ft wide ft wide �"' x
'��` t�
�n ;d
3 0 ft long ft long
n
Floor area 7 20 sq f.t �! sq ft �
- � �
TotaZ hgt 12 ' to peak to peak � �
S tories 1 },,,C Q �
i
No. �f bedrooms ------- rear---�:_-�s�e-�r waterline ;
_�. �1 ^
(yt��uund) __..or (seasc��al.) _ ^ -
�
Type of. bldg or addition � �
( ) Dwelling
G rt
( ��Garage �S? (?) car '7,�' a o
( ) Storage bui.lJzng i �. �'
( ) Boathouse �' i
N• ; i
( ) Livingroom `a �
;� � 1 �
( ) Bedroom �� i
'3 3 • N I I
( ) Kitchcn-din.in� . � i
( ) Porch - enciosed/roofed �} a �
( ) Deck - open � �` �� �v
9
( ) � ---- CU � �� n a �
L ) '" '�, �� , ���� ' C i
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Type of construction .� � ,� j� z= r�-r ci
( ✓�Frame ( ) I�lock ^ , � �
( ) Log ( ) Concrete fo5' �C i
( ) Pole ( ) Steel i �
( ) Metal ( ) t � c\
- ---- I -4-, �'
:.�
I o� � `D
Construction cost $ . d�0 �
_ „ ,
`I�C��
�'
val 326____ Pg �_ 129 of deed { c.�
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Cer. Soil 'I'est 80-016 ___ � � � �
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Sanitary Pern�it 80-009 T-� � �w
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Carl E. Boettcher °�^�11i-z � %��!�it�� t1c.lmir.ititratbr �
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'NOT A TRANSFER OF OWNERSHIP -- "
�� SANITARY PERMIT �`"��.,, -
P L B 6 7 — � State Permit # 19 9 0 6`�
Sanitary Permit # 80-009��
county Sawver '
Sanitary Permit Transfer Date 17 November 1980 Original Permit Issuance Date_�7 A�I'll 1980
A. Property Location: -- - -'/4----'/4,Section�, T�2 N,R���Cb6�4 W Lot #�_City
Subdivision Name, Nearest Road, Lake or Landmark BLK # 8 Village
2nd Addition - Victory Heights Township Sand Lake
B. TYPE of Occupancy:.Commercial Industrial Other (Specify)
Single Family X Duplex No.of Bedrooms 2 Variance
C. SEPTIC TANK CAPACITY B� Total gallons No.of tanks 1
HOLDING TANK CAP ITY Total gallons No.of tanks
Prefab Concrete Poured-in-place Steel �_Fiberglass Other(Specify)
New installation X Replacement i
LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place Other(Specify)
D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 5 'Total Absorb Area 41 0 sq.ft.
New X Replacement Alternate(Specify)
Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches_
Seepage Bed: X Length�Width�Depth 3� Tile Depth(top)�No. of Lines�
Seepage Pit: Inside d�ameter Liquid Depth No.Seepage Pits
Percent slope of land 3° Distance from critical slope 14O �
E.WATER SUPPLY: �J Private ❑Joint ❑Community ❑ Municipal
Present��[�[r1q�P�F'.QQ�P���C Phone No. A�5-�(1 7 S ���y���Transferred To: Phone No. 9 4 3-�Z 2 0
plumber Lincoln Quinn Name Aaron Zesiger
Name
Address P•0 . Box 13 3 Address Route 1 Box 6 2
Stone l,ake, Wr Z;p 54R7fi Exeland, WI Z;p 54835
I,the undersigned,do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with
section H 62.20,,Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared
by the Certified Soil T t and/or any additional soil tests that may have been required.
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' —�Plumber's Signature MP/aVQtPQ�C# 151 Phone #�.3=Z 2 2�
Plumber'sAddress Route 1 ox 62 Exeland, WI 54835
Information obtained from Z oning 0 f f� ce (owner or agent)
PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord
with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh-
bor's ro ert . If well has ot been r' I �
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Signature of Issuing Agent G� � �
1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH
� -' ' -- `^--���^^���� P.O. BOX 309, MADISON WI 53
REPORT ON I NSPECT I ON OF SAN I TARY PERM I T # r�'D - o0 9 ,�
(1 Name and Address of Permit Holder Person/Persons at Site 2 Date of Inspect
(��UtiL �,�yTTei�1�s� ,',Ccc�.,� g��',p
l�f��-�v,R� (,u�s, l $ �l� v �C� , .
ame, ress, icense o. o ns a ing plumber Time of Inspectio
i2a Z C`�IG'�" ��i�c , , /t>j,�C�� � ' L(`� �°�►-
3 INSTALLATION CONSISTS OF: � Septic Tank � Seepage Trench �Dosing Chamber
❑Seepage Pit [� Seepage Bed ❑ Holding Tank ❑ Fill System
B N ermanen re erence�oin escri e:
j� (�' o,2 n��, a f" C�'�c2o(�J� �2 C,'l��b�
E1 evati on of verti cal reference poi nt: ,�}-�j ` S1 ope at s i te: �� ��;
(5)MATERIAL AND DEPTH OF SEWER: /�► � � � "
(6)SEPTIC TANK: Manufacturer: ��- Liquid Capacity: / �,C,�
Tank Inl et E1 evati on : q6 � Tank Outl et E1 ev: �'� ' /O
# ft to 1 ot or property 1 i ne: g� # ft to we�l l : 7,2�
(7)DOSING TANK: Manufacturer: # of gallons :
# of gallon pump set for a cycle • gallons ; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑YES ❑NO Wired? ❑YES ❑NO
8 HOLDING TANK: Manufacturer ; o ga ons ;
construction ; depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ N0; ft from residence;
ft from well ; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑N0; Wired? ❑YES ❑ N0;
Locking device on cover? ❑ YES ❑ N0; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well ; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than ; seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: � ft width; ��- 'L ft length; � tile depth;
�li.neal feet tile; � ft to residence; ?�5 o ft to well ; �_ ft to lot or
property 1ine; j9C3� ft to ordinary high water mark of lake or stream; � �� ft to e�ge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed g' ' ft.
11 SEEPAGE TREN N: Total length of seepage trench ft; width ft;
tile depth ft; ft to well ; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes ,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? �YES � NO
(13) Has system been installed in floodway? �YES �NO Floodplain? (�YES � I�O
DILHR-SBD-6095 N.05/80
Si gnature of Inspector: ����/��M,, �`�I'1 ��,/n�r:
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Discussed ti,rith owner yes no �, � �
Discussed with builder yes no �+
Discus5ed with plumber yes no `� �c,
Discussed with � yes no
D at e f g �p til �';
Signa�i;ure of Officcr � ����,,�_ �
Department of Zoning and Sanitation � �
Sawyer County
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Inspection Report �
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Owner Audrey K. � Carl E . Boettcher
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Address Route 2 Box 150 Waupaca, WI 54981 �
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Name of business �
Builder `�
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Address +
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Plumber Aaron Zesiger �
Address Route 1 Box 62 Exeland, WI 54835
Inspection
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(�(� Private ( � Public Property �C Sanitary-instal o �
� Dwelling Setback - lake � �
Violation Niobile HM Setback -- •road "' o
Garage Setback lot lin �" �''
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Discussed with owner yes no �. � �
Discussed with builder yes no �+
Discussed with plumber yes no �' �
Discussed with yes no
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Signa�ure of Offic�r � ^
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