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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 � � � ? b / C/-�l9/l✓� /� ���r� S�L,�- G�iuN� � 2 Owner Builder � gL. � ���(T(NS `�G�L (/(CTl9/L yElGs�'?5 �?Z //O.+C�yT � r� Mai ing Address Mailing A dress �i{/�guKFs:�lA. ��s 53��6 S-ro,v� � L�1c s s`f�'7� 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 � �1 � 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 � � Vol t�..-71D Pg 2, of Deed � ` 2 � � �� 1�,� �� t� ` '� W, lor� (� � CS Vol � P 3� g Z5 � , ro � � � Cer . Soil Test � - Q�(.p N � � -- N� w Sanitary Permit � - �� ��� �L road 33' '-' .� -------V- ------------ /CTv2y /-d�rc-FrTs C�I7�c� o � •� Z � � 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 � / 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 � 0 RR-2 . V 476 P 327 . CS V 7 P 25 . . 68 ac . b '�' � / y � � k� � � � � �Q� � � �� � X �� �o � �, , � � x o� G' . Oo v •/ ^� � � o � ..o° \ �b\/ ' •�Q' � . i � i� ? � �� rt � � � � � � � � . / �^ t-' � � �• •c''� C!] O �'�� ��� �� � � v� ¢ r-t � � t°2 '�{ b, \ ;t v o i 2 / N I � °� z � �/ O � d � � 9 � `02� k� �`�oo , ���� N C i � . od i y � i � d � J�q/ � Q\� �C� I / .X� �p k N O `� � % v ''�J � i ,�� � r� � � i ��� �w x i �� l�7 i H G� ' ll ��- �U P , x F�~ '� pw�AtY' W� lti y CJ� � 2- 3 w�.5,. 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O � , � N C S�p � � < � � m c� o � , � rn O ! , 0� ,d�1 � � � � -�- \ � � _ o °° n <. --� � � �' Z � � � � D � � �, r-. f O rn o -� � � � n N ,-, O r, � _._ , ., �--�-� 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 _.___._— ,� _ �3�,�.--� z.`� w � 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.� cS vo1 7 --__ F�-_ 2_5-26 �� � - --- -3v �3' w y Cer. Soil 'I'est 80-016 ___ � � � � -- ----- - �----- --�-� --- + -�� t G..YJ� �, � `�� - ------� roac� ------------ ------ Sanitary Pern�it 80-009 T-� � �w ----- - o �D '�l[TO�� 1-1z11k�t-TS �1��'�, � � :� - - - --- --- - � � Issued__�� �T�.(�� ���� Dcnied_ __ rn rn ;d ---��--- � o0 � :' � � �� � • N - � =: -- - _ _____.___.-_____ _�- --�--- - �t.�_�-.�z_ � Carl E. Boettcher °�^�11i-z � %��!�it�� t1c.lmir.ititratbr � �..-:_._,._. _ ` T���RATN���P���1A � '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. r ' —�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 � � :l1 , � � � ' ., - � � � Q ` ..1{ i �� � `I � 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: . , • — � � � TU r��lV f��C�. (� F'' 1-+• O 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 � Inspection Report � � � Owner Audrey K. � Carl E . Boettcher n Address Route 2 Box 150 Waupaca, WI 54981 � � Name of business � Builder `� 0 � Address + � � Plumber Aaron Zesiger � Address Route 1 Box 62 Exeland, WI 54835 Inspection H (�(� Private ( � Public Property �C Sanitary-instal o � � Dwelling Setback - lake � � Violation Niobile HM Setback -- •road "' o Garage Setback lot lin �" �'' ' ( � Sanitary ( � Zoning Privy � �� r+ .w '� —___._._._.-- --------- .�' �, �. . C. U� � r - --- — - - — -- -- — I �, w x I � � 75' i ( i K � �rt�. r�o; �� � , — i � � , ��. a , ��r„ � �I� , � � � � �, �;(;j C.1,• � � � �� i IUDO _ �r � 2 � � �'iUS7.P1:fi. b ,� ���, _�'t.1, � i� � � a��'PN,:v_. I E� CS' (� I � ¢ 1�• C Q ' � �..�. � � � I � W � � O � '��� ' � ry �I y � � (� p� � , r+ ; o � Jo' � a w G a � N• x � TU i,��lY f�� �p F'' I--�• O Discussed with owner yes no �. � � Discussed with builder yes no �+ Discussed with plumber yes no �' � Discussed with yes no T)ate f � ��t� �`'!,� Signa�ure of Offic�r � ^ .�