HomeMy WebLinkAbout026-939-13-5247-LUP-1994-421 Applicati_on for Land tlse Permit ��
County of Sawyer � �
7'he undersigned hereby makes application for a Land Use Permit and a�rees tliat �
a1.7_ work shall Ue done in comp�.:iance wi_th the requirements of the Sa�oyer County o
Zoning Ordinance and tlie laws and regu]_ations of the State ot Wisconsi.n. 11j
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City, Stat , Zip City, State , Zi
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Building Land Use Zone District � l� 2 rt
( ) New ( ) Filling -� �
(x) Addition O Dredging Lot size � H
�( ) Alteration ( ) Grading �
( ) Moving On ( ) Acres �^IZ
( ) ( ) fi
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New Construction
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Size 1C2. �'p f t wide ' wide ' wide m
29 ft long ' long ' long ��
Floor area �8� sq ft sq ft sq ft �
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Total hgt 'Z3� to peak ' hgt ' hgt x' I�i
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Stories /
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No. of Bedrooms ,�e.a�-=,��t.],iYne or waterline o
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Type of Bldg, Addition, Use � ��,, o�
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( ) Storage Building r. N
( ) Boathouse ��d �9�� °
( ) Livingroom y� �
(��Bedroom �� �o �
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Type�f Const:ruction 38 - 2�� �° � �0'��25, p�`y''� `'- 1
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( ) Log ( ) Concrete v1 22 r��
( ) Pole ( ) Steel N ';% l
( ) ( ) Pole/Metal �: - � �n
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Construction Cost $ p Q�, 20 �
Vol QZ. Pg � of Deed � a�p, ' v �
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CS Vol �� � H
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Cer . Soil Test �q�.�� �
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Sanitary mit . � `; ---------- �L road �Ur.S,,��[_1.f�LJ� z
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Issued 18 October 1994
Denied �'
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Owner �oning A ministrator
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Sawyer County Zonin�; Aclministration �
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Inspection Report � :
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Owner Theodore Carlsen �
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Address6512 Indian Hills Road Edina Minnesota 55435 r
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Agent/Purchaser
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( ) Mble Hm ( ) Setback - road
(>C) Private ( ) Public ( ) Commercial ( ) Setback - lot line
( ) Garage ( ) Soils Verif
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( ) Zoning ( ) Sanitation �
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Oftice oE
Sawyer County Zoning Administration .
P.o. aoX sss
Hayward, Wisconsin 54843
(715)634-8288
27 September 1994
Catherine R. and Theodore Carlsen
6512 Indian Hills Road
Edina, Minnesota 55439
Re: Part GL 2 13-39-9 : 2 . 17
Dear Mr. and Mrs . Carlsen:
We have received an application for a Land Use Permit from Dale
Scidmore for the construction of an addition onto your existing
dwelling. The existing septic system is not sized for the use of
an additional bedroom. In order to add an additional bedroom, an
Affidavit of Existing Septic is required to be signed and
recorded in the Register of Deeds before the permit may be
issued.
Enclosed is the Affidavit. Please take it to a Notary Public .
1) Sign and date the Affidavit in front of the Notary Public .
2) Return the Affidavit to the zoning office with a check
attached in the amount of $10 . 00 ; made payable to Register of
Deeds .
We will record the Affidavit , issue the Land Use Permit and
return the original Affidavit to you with the permit .
Yours truly,
��l �---���
Robyn K. Thake
Deputy Zoning Administrator
enclosure
DOCUMENT NUMBER AFFIDAVIT -
� 4 � � 3 � EXISTING SEPTIC SYSTEM
ONE AND TWO FAMILY
If the existing septic system does meet the minimum re- Sa�C�n�� 1 � '�
quirements for groundwater and be�rock depths and if it �=
��d tbe,�_____��! il
is functioning, an addition to or replacement of a hab- ��� � D 19 9� � 3 o'dool
itable structure can be made in most instances without �F'�`j "=�'�'�`��'Sr--y/
updating the existing system. If the existing system of =:e�x'ar a' �"'S'•'e_
is utilized for the addition, every attempt should be _�..��._._.._---..-�—���
made to locate and reserve an area which is suitable
for a code complying replacement system for when the ��
system fails. If the addition will substantially in-
crease the wastewater discharge, the existing system RETURN `1'O
will be replaced with a code complying private sewage Sawyer County Zoning Admin
system. P.O. Box 668
Hayward WI 54843
owner(s) Catherine R, and Theodore Carlsen 026-939-13-5217
Mailing address 6512 Indian Hills Road
Edina Minnesota 55439
� Property description A parcel in Govt Lot Z S 13 , T 39N, R 9W. Parcel
: 2. 17 . Vol 102 Pg 80 . . 72 acres . Town of Sand Lake .
(� (we) Catherine R, and Theodore Carlsen __ plan to
(�Q Add onto existing dwelling
( ) Add onto existing mobile home
( ) Replace existing dwelling
( ) Replace existing mobile home
The present private sewage system has been working satisfactorily as far as disposing
of wastes. If the present private sewage system does fail, it will be replaced with
one that is cod com lying.
` %-�o -t�-
Theodore Carlsen �ate
��,�_� � �� �' � 3 � - �
�� <� - -
�--- �
Catherine R. Carlsen =��te
Personally came before me this
� day of ,�j��e�/i.�j- . 19 ��J • •
` ��' / �`�` MARY M. KOLLODGE
/-, � NOTARY PUBUt—MINNESOTA
LC - WASHINGTON NUNTY
Notary Publl:c . My Comm. Expires Sepr. 15, 1997.
// //�i�1/JCS'oc�icl
_,/7 P/�/7Glli/'l County, -��s�vnsi7r
My Commission is expires 5�,pE . /�, /y�7
Existing septic system - Sanitary Permit N/A
Date system installed prior 1968
,�,�i,�J�,��,� ZA or AZA
-� � -- -
/� � � � y �,
date
This instrument was drafted by �� � � � � � �
Theodore Carlsen
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