HomeMy WebLinkAbout026-938-06-6108-LUP-1994-373 • Applicati_on for Land Use Permit
County of Sawyer � ��3
, The tmc:ersi�hed hereby makes application Lor a Land Use Permit and a�rees that �
all work shall be done in comp�..iance with the requirements o[ the Sawyer County � `
Zoning Orclinance and the laws and regulat3_ons of the State of Wisconsi.n. '�� .
PRINT - USE BLACK INK OR PENCIL �'
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Owner Builder ,
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Mailing Address Mailing Address
���`o-�� � �1�/l n� i ��8`l�
City , State , Zip City, S ate , ip
/�/t � ~ c�
l3uilding Lancl Use 7one District ° :�
( ) �Iew ( ) Filling j / / � �j
( ✓j Addition O Dredging Lot size �(}� x �QD O�p�O v
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres �- ��� c`
( ) ( )
New Construction ����/ {
�� �
Size � ft wide ' wide ' wide
��_ ft long ' long ' long �
Floor area U sq ft sq ft sq ft
r,�
Total hgt �2�� to peak ' hgt ' hgt x' �
, � �
Stories � � h
tn
No . of Bedrooms �f r�-- -10-�:�=1�i�t'� or waterlirie ��
(year round) or (seasonal) �� � �C— �A' � G �+
Tyr�e of 131dg , Acldi_tion , Use � �
( ) Dwellin , '�'� � �-'• n
( ) Garage gl ) (2) car �� � 7� �•
( ) Storage Building �. �. \,
( ) Boathouse � �
( ) Livingroom ~ --" �- -
� � r
( ) Bedroom 3 �
( ) Kitcheri-Dining g % �j ��,�/ ' N
( ) Porch (enclosed) (roofed) '
(✓) Deck - open ��� ���' �; �
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( ) �� �� ���� � � �w
( )
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Type of Construction s�a `� �� � r� 3� �
(�I'rame ( ) Rlock QSJ ,r��.� � ���r �
( ) Log ( ) Concrete o � r�,.
( ) Pole ( ) Steel �
( ) ( ) Pole/Metal � v,
O �
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ConstrucLion Cost $ p(�Q. U-C
Vol �,21 � Pg �/ �/ of Deed '�761 �
CS Vo 1 Pg ,��
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C e r . S o i 1 T e s t r--�--- F t �
— �
Sanitary Permit �4 -d��_ � C a�a ' '-' �
- -------- L road -------------- �
V . - S 15�A-8R-C�A?�1 q-�O i4-1-� o
7
/��� 250+..�`;`.{ ':.; ;. . •o
Issued 23 Se t er Denied �
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' � Owne -- �-C-��t��� % .� �
i ---'� `Zoning Administr_aLor
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5awyer �oun�y ��nl_��" ��u��«���� �L« �1��� �
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Inspcct:ion Rel�ort ��
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Owner Richard B. Peebles ( �
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Address 10227 Blazer Court Rockford Illinois 61111 �
- �
Agent/Purchaser �
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Address � `
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Blder/Plber/CST a
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Address
Inspection ( ) Dwellin� ( �'"' Setback - lake
( ) NI}�lc �-Illl ( ) Setbacic - road
(� Private ( ) PuU1ic ( ) C�n�n�c�rc:i.�l ( ) Setbacic - lot line
( ) G�.i�-ci�;c ( ) Soi1s Vc1'i_j ,�
Violation ( ) Addi_tion ( ) o y
( ) � �
( ) Zoning ( ) Sanitation �'
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Discussed with ~
Da t e l g J c,�c.,y C �' �' �i' T ime �.C�Z� � �
Si.gnature of Ins��cctor� _ _ _ _ __ ____ _ �
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State of Wisconsin and County
r Uniform Permit Application
� for Private Domestic Sewage Systems
State Permit / County Perm� _ OO�
Number ��� S� � Number
A LOCATION OF PREMIS�E ERE SYSTEM WILL BE CONSTRUCTED,ALTERED OR EXTENDED
LEGAL DESCRIPTIOf�(; —i��� � / / Name One: — ,
(Sec., Lot, Block)
� ITY VILLAGE
3 N f� TOWNSHIP
B. OWNER OF PROPERTY-� MAILING ADDRESS
Name � � (Street,City, Zip Code)
� � �� � �
C. SEPTIC TANK CAPACITY 7 S"a 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 No.of Bedrooms � —
Commercial Industrial Other No.of Persons to be Accommodated —�_
(specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES NO Automatic Clothes Washer YES _� NO
r -
Dishwasher YES NO 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 cS ,��
G. Percent of slope of land % direction
H. Indicate Slope of Land &direction of slope on sketch I. Tile Depth � F/
PERCOLATION TEST
Indicate Soil map number �� � And Soil Type s �
Hours Water Test Time Drap 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 lst Wetted Overnight in Minutes Last Period Last Period Period One (nch
�l � /O�Q?--�-� - � �-� � �— -- � -----y-_l-� � �- —
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� 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
� J� O` O �/ � ��� 3 07
v� �� v� o' � � —
`3 7� � p � �-
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RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE ARFA IN WHICH THE SYSTEM IS TO BE INSTALLED
(COMPLETE OTHER SIDE}
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/ _ . � Department .o� Zoning ancl Sanitatfon .
Sawyer County
Inspection Report
Name of Property �����s
Description
Owner �/�.h�9Y d ��ec.t���� Address ��A�d L'`�� • -�"""' ����
Builder Address
Nlaster Plumber �"��� Address � bf�"� �'``"�
Violation Inspection - Check box
( ) Sanitary ( ) Zoning (X) House (X) Sanitary Installation
( ) Garage ( ) Setback - Lake
( ) Privy ( ) Setback - Road
( ) ( � Setback - Lot line
(x) Private ( ) Public
Comments �
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Discussed with Builder ( ) Yes ( ) No
Discussed with Plumber ( Yes (Jt) No
Aate of Inspection _
Signature of Officer . .�
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' �� SISSABAGAMA LAKE � �
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� SCALE: I INCH= 400 FEET FOR ASSESSMENT USE ONLY NO
DRAWN BY:�'{. _ DATE : 7/6/87 INTENDED TO SHOW CONCLUSIV
I II �VARRANTY Di��D I
II , OCUMENT N0. i �.
� ��� � � I 6TATE OF WISCONSIN—FORM 9�
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. � I � `_� � 11 O�'o � TNI/ lPAC[ REtlERV� R6CORDINO DATA
-� i e 28 PC�21 � ,
f J l�fa� tl ' J I I I
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- -- I __ _ — — -- ..Roginter'e OHtce l
TI1iS� IND�NTLIRE, Made bY----G..E--'Jn'�._L.,..:.�s!4.�.�.�.�._.aT.�a---AS?.�a.-S--•�T.._... Sawyer County f1 ' �
•--•--•-.E.....5'r_a.LLe_,....}si.a-•-wi.f��...aZld_..�.x�.._h�_x..Q�nlil-•-�1.�11�._.dTl_C�.__ R ived for record th� � I
�T�''���i:l._T. C��c, . : . ��d Patricia J. Cooperc--•his.._wif , �o°r• ��
- -•--- ••-•- --•--• 1'� A D 1�� �
a�c� zn �i�ei-�w;A � �_�t,1L--� ---• at � o����
___..._$d4� .P.�..................COunt WtsConstn 2��nd recordod tn vol. ����v�'
grantor..�. o _.._..._..•-•.............•-•-•••-.... �T y� �
y conveys and warrants to---,I3.7._Ckl��G�...H,._._,P�.G'�?.�.C:S_..s.�17��-••---......_. o[ Rc ords on Fa;A a/
here����.x'�.s..A,. .P��'bles.,_._.his---wife:---as---ioint---tenant . �s��,� �. �jc� .� ��,, ;
�----,I- � _ .
_. ._-----•••-•-•----•--••--•---••-••-•••--•-•--•-•--•-•••-•-••--•-•-••-••-•--•-•-•---•----•-------•----••••.•-••--••---- R�qi�ter'
of 6125 John Street, Loves Park, Illinois .-�--- - �
---. ..--•-----------------•------•••-•----...----------•---•-----._..._........---....._.._..._....----••--•--...._...._..-••--_•-• i'
...__�:.._._..---•-------•--••------------------------------•--•-----••---61]_11-----•----------•--.g ran tee--S--•�f i?eputy;
.___ _..._.�c�xz�qc,x�t.�a�n for the sum of �
. .-- •-----•----...-•-•---•--------•--•-----------•............. i
One._Do_llar__.and_._other__valuak�.le..consideration..__...._._ RET„RN To
�--- -
.... �---C----- --------- --------- --------- --------------------- ----------------_..........---.-. --------. --....---. ;
�-------- - -- - -- -- -----------------------------------------.._......._......---............_..............._...__...---..-.- ��
the following tract of land in..............S�H7.y.�r_.._._......................_..._.......__County, . ;
WiscQnsin: .-•••-••-•---•-•••-•......•...............••--•-..........._._.._._.._.._........_...--••--........_........---••----• t
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Tha�t part of Government Lot Eleven (11) , 5ection 'Six (6) , Township ,!
'1'��i'rty-eiglit (38) North, Range Nine (9) West described as follows : !i
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Beginning at a �oint on the North line of said Gov. Lot 11, 1751. 2 I!
fee;t F,ast of the Northwest Corner thereof; thence running North 89� i
2-� 'i East along said North line 219.8 feet to a:� i�on sta'te; thence ��
T����ii�ing South 29° 02 ' East 251. 1 feet to an iron �Stake on the shore ;� '
line of Lake Sissabagama; thence running Southwes'terly along said � !'
sho�re line 100 feet to an iron stake; thenCe runn�.ng North 43° 19 ' ;
Wes�t 393�,.1 feet to the point of beginning. �
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�i Subject to exceptions� easements and reservations of record.
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I ....---...�II.�9f-hd�of.�f�_�,.TSd7C1Lla�y.o.�.�.....-ha., A. D.e19_.7_7,.Gr .��Ae.7L.�'............. nd._S�_ and ea�.... this � '
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I, '..............�.�..:!�f`....... .._.....(SEAL)
ii ••••.. ... .. • ••..........••••••••-•.:............ ,
� $IQNED AND 8E ED IN PRE6ENCE OF e L• Skille
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' � �:. ....G...Li�.�,.�.......... ..:................�c..�.�.-�sL::.._......�sFnL)
' �.�z-G....,I.-�.................................. -n I
�� ' t' " Dor.is N. Skille
,i Frank A. Smith __ � � '
�� � ��.���� �..-� � ����-� -• ..................� ........ ...._. (SEAI.)
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,G2i.� �..... ._.z.,�.../............................ �.....--- --.�:..�....--- ..... ....._ . I
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I� Norman W. Cooper �
; -e I ui Smith i��.�1::.;�Lf c-�.:�::�:J..<'�:----...�.-:�.-� _.(sEnt� �
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Annet - i
' Patricia J. C�oper J li
I State of Wisconsin,
..,...._._S.di�y.�.x:..................County. Personally came bcfore me, th;s._..19th day of..__�a.t�uary...__.., A. D., 19._7.1, �
. che aUove named .....Gene._L._..._.kille_. a~�d._D�r.is...N._...Skiller.,...his_ .,.ife,__.and; Norman ; ;
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------------- �---•-- ------�-- ---�----- �-�----•--........_ �
I to me known to be the person,5 `a11�� C�c�i ted flic'foregoing rume t and ck 6 edged t same.� � I
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'� THIB IN9TRUMENT WAS DRAFTED $y�;•. cj' � � z'Frank A. ►SIl11t�1 ' I
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�,.� U�^J . . �I Y , ••••-•----- er-----------------------�--..__.. unty, W�s. '
�: � � otar Public S a:�'?Y.._ _.Co I
. � .
Howard E. Hanson, A�t �n� '
;, �,,•., Q . �Dty comrrussion (expires) ��-....A .�'1.�.....�.�....19.7.A....................
- — — - � l, .....•��
� (=��' + i?.51,(1) of the Wiscoruin SI+h����ritCr�rl�t�+t xll metrumcnF� to be iecorded ehil) hare plRinl� printed or typewrittcn thetcon
� tbc n,m�t of thc qrrntors,.grrnteet, wi�nc�e �rv1 nuler�. Sedinh 39.313 similarly rcquira thet tLe n�me of the penon wbo, ur govero-
h�����+1 �qenc� which, dnRed wd� ieefrumint, fhell be printed, tXpewritten, stamped ot writteA lhtrMn In a legible manner.)
WAF2rtAN'�� ti��U .�"'I'A'I'}� ()I� WISCONSIN Wl.consln L�FnI Blnnk Comnnnr
t��,rrt,t Nn. A �in..�„i.�� �cie r r,.�.��.,o� �