HomeMy WebLinkAbout030-737-14-3301-LUP-1994-137 Application for Land Use Permit
County of Sawyer -.;ti,,.,��
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The undersi�ned hereby rnakes application Eor a Land Use Permit and agrees tha ;�
all work shall be done in compliance with the r.equirements of the Sawyer County �� �
Zoning Ordinance and the laws and regulations of the State of Wisconsin. �fi
PRINT - USE BI.ACK INK OR PENCIL ``
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Daniel L. Meyers �' 7"]()V(j�Y - �
Owner Builder Q � �
�ZV�J J- ��Cti,�(�� �/1C- �
Route 1 L.��� �� �d �� �� � �
Mailing Address Mailing Address -rJ�.�`(ZGj
Exeland WI 54835 � �
City, State , Zip City, State , Zip
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Building Land Use Zone District A-1-'� ° �
( ) New ( ) Filling � �
( ) Addition ( ) Dredging Lot size 1287 ' x 1287 ' �' �
..
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres 39 . 55 �
(X) Replace ex mob(il.�e home fD
with new dwelling � �
New Construction �
Size �_ ft wide ' wide ' wide d
w
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�_ ft long ' long ' long ��
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Floor area sq ft sq ft sq ft t-�
m
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Total hgt to peak ' hgt ' hgt � x'
Stories � �'
No . of Bedrooms �_ i ;rear lot line �.-.�rat�,1„il� o
;
(year ro��nd) or (seasonal) ' l -=_,`-` � � cn rt
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Type of Bldg , Addition, Use w ``�°'� � r
OO Dwelling � a o
( ) Garage ( 1 ) (2) car � r• �
( ) Storage Building �- �,, ;
( ) Boathouse /� � '
( ) Livingroom -
( ) Bedroom
( j Kitchen-Dining o
( ) Porcfl (enclosed) (roofed) o �
( ) Deck - open �
( ) � W ��r
( ) �1 �
�;. r--� �n
Type of Construction � �
� Frame ( ) Block �
( ) Log ( ) Concrete �__ 1��i� ---�. _�..�_.._._ _ F�
( ) Po.le� 1 ( ) Steel } � � ~
(�c) �e �i tt ( ) P o 1 e/Me t a 1 `�� h��-�- N v�
���!�iLE.. ,� � yp� �o
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Construction Cost $ �(p�0�1p. .�.-__--. ' � '
Vol 332 Pg 61 of Deed (ul� �
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Cer . Soil Test ----- `��{ � �
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Sanitary Permit 71-26101� CL road -------------- ~ V
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^Engaged in agricultural activities on premises o z
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Issued 17 June 1994 Denied �-'
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`'�_�'F V(�� Jr32-, � �1�7 � �
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-��C.[ �i !����i — d� �
Daniel L. Meyers Owner Zoning Administr tor
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DOCUMENT NUMBER AFIIDAVI`i'
� �� 1 � `J � EXISTING SLY`1�I� .�Y:;�1�LM
ONE AND TWO FAMILY .
�'�F�.�,C?I'd�w: �
If the existing septic system does meet thc miriimum re- S`'"'�- - '��'r^' y
F���:,;..._,_ ;:� , ..Y�. 1; d�i b7
quirements for groundwater and bedrock depths and if it ��'�'-
is functioning, an addition to or replacement of a hab- -��`-i - '`' �y Ut �Q��
itable structure can be made in most instances without "/- ��� " ' " ' "''`=''�'t•-`-S�=�-
updating the existing system. If the existing system ~�f ��� ��'; ' " ?-�?-_
is utilized for the addition, every attempt should be "`"z' "' `�-�'�'-�--A`�-��I:�=��
made to locate and reserve an area which is suitable ��,
�:.,,r,._._.._<_.,.-,_..�
_ for a code complying replacement system for when the
system fails. If the addition will substantially in-
crease the wastewater discharge, the existing system I2ETURN TO
will be replaced with a code complying private sewage Sawyer County Zoning Admin
system. P.O. Box 668
Ha ard WI 54843
owner(s) Daniel L. Meyers
Mailing address Route 1
Exeland Wisconsin 54835
Property description SW4 of the SW4 S 14 , T 37N, R 7W. Parcel . 11 . 1 _
QCD Vol 332 Records Pg 61 . 39 . 55 acres . Town of Weirgor . _
030-737-14-3301
(I) (�) Daniel L. Meyers plan to
( ) Add onto existing dwelling
( ) Add onto existing mobile home
( ) Replace existing dwelling
(� Replace existing mobile home with dwelling
The present private sewage system has been working satisfactorily as far as disposing
of wastes. If the present private sewage sy��L-em does fai7., it will bc replaced with
one that is cod� complying.
.�yC.c' � / , ' :�� � 1�=�,�_
Daniel L. Meyers date
date
Personally came before me this
� {C �__��-, �, .��•.`•�'-L
/ _ day of 'ii C�C�� , 19 � =; ��C.;• � `
�_ '� ��-t � �� ����1� i - � � � � ��
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" Notary Public � �'•. _ J
✓._ i� �
� ��CC� ��� County, Wisconsin �.t
My Commission is expires ��" , ! �'
Existing septic system - Sanitary Permit 71-26101
Date system installed 02 Sep temb er 1971
�l�,r,�;(,•�� {r� ZA or AZA
�� - ��� ��
' date
This instrument was drafted by � ��
Daniel L. Mevers � �p � � � �
, APPLICATION FOR SAtaYER COUNTY -
f� y � : Sl�NIY�A.RY PFRI�'IT
- AppZication # °� ;� � Dute ' � �� �` 7� -
�
Fee o f $Zoo 0o reeezved ` , � j ..�f,` � �,�
O ' Date Courty CZerk �
�
� AppZicatian is herebr� made for a Sar�yer County Sanitary
N Permit for worh to be done on the premis�s d�seribed herein. .
� �R N �rl�y�� ,
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Ou�n Efd ress TeZephone �
The �� o f the i� Sec� �____ Tran. %�'J ` R. /"�'/..,
o r �T ���'
Lot BZock ,Sub--division < <'1 �'�� 6U�1���(�
- J/ -- �: G. ��LGZ ws�i
��= �. /� �` � ,
yJ rk e tem�i ,¢��e ^ o , performed by
Number o f Bedrooms "��' Number o f Bathrooms �,�
Dish�asher .,�� �� Garbage Grinder �� .
� Automatic Washer -�
�� ��
SoiZ �escription ���,_ ����� ,�
�.;- �—=. .
Septic T�nk Size qaZ.
See�;uge Pit HeiSht L�iameter _
See.page 1 renen _�_ Length �_ t�idth .; a Depth fr,-: '�
. � .. T
Septic 'lank Perm.it # � �� f;� �
<< 1
Perco2ation Test Form P�B 43 aztached �
Ye� r10
��
' Contemp�ated completion date. _ ' �,- ?/
AppZication Approved Permit # � (oll� `
�� � ~1 : � �,�i c �}
sanitarian �;�-�;*-�.�:�, 1<, `a� `x.'"�`;'T'-� `. � ' �`�. ! t
O�ner Agent ilot2 fzea Date-T—
Remarks '
i _
Final Inspection ' �
Sanitarian �-�'- �/ � �� . <<�-,�
O��aer/Agent i�loti,fied (Date)
�
Remarks �`�3' p��-�✓ '�� � ��-�� �
�
,'
**�' Ser�d orig�naZ� anc� t"hree copies �i�h . � *� -� ' .
fee o f $ZD. 00 to Countz� CZerk �
wisoonain D�p�rt4eat of Health and Sooial S�rvioes
�Alb. �67 3�70 Division of Health
~ ' � SEPTIC TANK PERMIT APPLICATION
?YPr or U5S BWCK INK
�. E�itiiER OF PROPTRTY
Nem� Addreas (Str�et, City, Zip Code)
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l.L.,�! �'�. :�.I - ;�<%� . �-'!' , �'J•+G� -M'� ('���.
(� �ii.
B. LOCATIOlt OF PAOPERTY i1f�RE SYS7'Q'I WILL HE CONSTRUCTSD ALTERED OR EXTENDED COUNTY
Cheok Ones
ITY VILWGE LEGAL DESCRIPTIO� / ,.�- /�j
TO�NSHIP ����� �� ..�<��Y'� ` lC� `� „I�; ,�./ W
4 � �
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C. IS LOCAL PERI�IIT REGUTAED FOR 2HIS WORK? �` YES NO '.) PERNiIT NUMB�R
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D. SEPTIC TANK CAPACITY ����� Callons NEW INSTALLATION HTPWCIIgNT ADDITION
MATaRIAISs Prefab Conarete Poure�.�� Place Steel / "� Other
HU►�EEi OF TANKS ?0 BE INSTALI�:D s �
E. 'fYPE OF OCCUPANCY
�heak Qne: One or Two Family Residerice __� Coamercial Industrial Othar
� Speaify
Number oP Peraona to bs Aoco�odated -� N�ber of Bedrooms �'
�
F. APPLIANIIES, ETCs Food We.sts Grinder YES �f\NO AutomQtic Clothes Weaher ���YES HO
DishKasher YSS —�;NO Automatia Potsto PQelsr YES�,,N�
Other (Speoify) �
G. MA51TR PLUI�IDF,�MAK G INSTALLATIO@j.. "� �
/!�- l'+S �' �, y->
n � �:��:
Names ���/�•'�f ,{�� � ��+;:l�'�,!'�'""�'==1� Addresss � Lioenss Numbert
, , � �f'�.�`'
,., 4.
,
Signatur• of Applioant: �..:%��-• -��.��,`;'_�.�`-.='•�a�`• � � MP RSK
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Addre a a: �'..i'�� ��'� '�'✓�-f r
, �
H. (To be Completed by Inauing Agent) �
Date of Applieation �`:' � ( �-' ` � Fee Paid = ��,'�^''
Permit Iseued (date) ��, ` j �{ ' y Permit Number �`. �( �;_ (
,, , ' ` ,
� ���
�'�- `':,`,. `_�-� �� � 7, � Fort �. ���
Agent (Name) ',y ^-'�R ..� ' --r--==t-�'C� � �_ '�. . 'c.-+
"� � Toxn, Yil age, Cit County, etc.
��T,1�1 '�* �t.•l�i-�,/'f' �.��t"L.n,��tC. t.L,r�l,.��% (Speai
Note: The appliastion oannot be considerad Por filing until all of the above questions are ansr+ered and the
fe• paid. Agents will foresard appiioation, the fee of S1.OG for aach asptia tanx and the tnird oopy
of th� permit (oanary) to th� Division of Health, Cheaks and money orders should bs made payebl� to
ths Division of Neatth.
, ' Do not xrit• in space betorr - FOR DEPUtTl3ENT USS ONLY
I. DATE RSCEIVID ...._.:.:TED BY RETURNCD
! (Initisls) (Date) See Corres.)
FEE RECEIVED YALID. No. PERMIT N0.
es or No
REYITfdED BY APPROVED DA?8
(Initiais) Yes or No
COMP�"'"R; OTHER
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SBP1'IC ?/►HIC PtRMI? M0. ' ~ .
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RSPOR ? ON S OIL PtRC OL � TIOtI ? tST
� N D S 0 I L B 0 A I N G S
TO
DIYISIUli OF HEAL?H � PLLTfHZNO 3�7Ft�i
P.O.Box :i09, Ma,diaon, liis. 53701
Pursuariti Lo S 6?.20, 1iis. ��ainistrativ� Code
p S x C 0 L A T I U H 4 r S 'f
Teat Dapth Ck�araot�r oP Soil •Hours Mater Teat Tire� Dtw in itater Level Inohes utas
Nt�Dar Inohas 'lhiolono�s in Inohas Sinc• Hole in Hol• Inta3�va1 Second to Next to Last o Fall
lst Katted Ovel�sti in Hinutes Iast P�riod I�st Period Perlod On« Inah
Exnmpla
P - 0 36+� To Soil lON Cla 26H 25 Yae or No 30 1 2 1 2 1 2 60
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(G �� =�``�.�:�..� `_ �1 �l-f� .�
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RECORD DATA FKOli PSINIMUH OF 3 7'YST HOLES
Computs siz• of absorption ar�a in aocord xith H 62.20 itis. �deinistrative Code.
S 0 I L B 0 R I N G S - tiinimum 36�• Below Pro oaed Abeo tion 5 stw
Boring Total Depth De th to Ground Hatsr De th to Bedrook
Number Inoh�s Observ�d �stimated Obaerved Estimated Charaatar of Soil with Thiolmeas in Inohea
�aple
B - 0 72!� 72'� Hlaak To Soll 12" C 18" Sand 18"• Gravel 24��
/ �F /, ��f� Y V°s �%f: / /,�: � � '.� ^' f�..4.%�' � ,<�� � i� i
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„� ��l ., �7�, e� �1' r � , , � f .
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RECORD DA?� FROM KI.'IIMUM OF 3 BORE HaL£S
YPE OF OCCUPANCYt � �.r.--
RESIDSNCEi Nunber oP Bedroans u OTHER: (Speoify) Number of P�rsons
D WASTS GRI.*JDER� Yes No ,� D1�tnrashart Yes No /�! Automatia �lothe� itasher: Yes �� No ��
FFLUENT DISPOSAL SYSTEM: NEFJ '� EXTENSION ADDITION REPLO�IT
v / � ,,
T31e Sizs � No.Lin.Feet !��� Trenah Width � Depth �d Numbsr of Lines �
Seepags Beds Length Width Depth Tile Size No. Lines
Sespa.gs Piit Inaid� Diaaeter Liquid D�pth
I� the undersi�ed, hersby oertiry that the peraolatlon tests r�ported on Lhis foro► *ers made by se or under u�y auper-
vision in acoord xith the procedures and method speaified in Chapter H 62.20 (13)� wisoonsin AdulnUtrativ Cods� and
that th� data r�oorded and location of tesL holes ars oorreet to the best of knoxledge and belief.
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Type or Print
REGISTRA?lOK-�AW. or MASTER PLUt�ER LICENSY N0, l j ,� ='
ADDRESS `:�'�`�e;'� 4s°.'"7 %
DATE �� l r �� S IGNATURE L_._�� P �4� ��':.,�':j�.
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