HomeMy WebLinkAbout002-939-01-5307-LUP-1992-200 �.
Application for Land Use Permit �r��
County of Sawyer p
The undersigned hereby makes application for a Land Use Permit and �
agrees that all work sha11 be done in compliance with the require- o �
ments of the Sawyer County Zoning Ordinance and the laws and regu- '''
lations of the State of Wisconsin. - I
{��ON�, (�7S- aS�3 PRINT - USE BLACK INK OR PENCIL
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G�+rtt�R ..�G�I f1d.)��r �% ! {�l ? i �
Owner Builder
W�c�!� _ L;�r';t:s; ��✓c._ �
Mailing Address Mailing Address
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City, State, Zip City, State, Zip
Building Land Use Zone District �.�. -2 0 �
( ) New ( ) Filling rt
� Addition O Dredging Lot size ItS� x ISi��IS� � � '�+
(�Alteration ( ) Grading '
( ) Moving On ( ) Acres . 35 {—
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New Construction ��S�YX��N I z
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Size ¢f�g ft wide �.L�- ft wide �.
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ZQ��Z � 2 ft long 2� ft long �
Floor area -�7j2 sq ft 57(� sq ft
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Total htg ��j� to peak to peak x
Stories � Stories'����
C_.P-hw�-S��
No. of Bedrooms rear lot line or waterline u�
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(year round) or (seasonal) �� � rt
Type of B1dg or Addition .c- a' r
( ) Dwellittg °'�' \`- p: r°r
( ) Garage (1) (2) car - � �
( ) Storage Building �� ~ �(�I
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-3�' _ - ~• �-
( ) Boathouse (,, _---zu — �
(;,� Livingroom � �,� ����A���
( ) Bedroom � �
( ) Kitchen-Dining �,��''��'_.,,
( ) Porch - enclosed/roofed ) � ��' N
( ) Deck - open �, �� _ I�' �°y �
t9� �,�����11c�.4T �`y p y,--- X rw
( ) _ -�,- ';` �
-` _,,�rti.�j� � �
Type of Construction �. �� D� µ �,1
(� Frame O Block y� N y � �
O Log F,�-) Concrete t=,�'"` �_ H6' � �
( ) Pole ( ) Steel I; � — m
O Metal O __.._,ex 6:: v1 �
Construction Cost $ .`_ � �
Vol _ � ,�- Pg ��of ^deed * J �
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Cer. Soil Test ._ � w
Sanitary Permit -15-O�9 ----------CL Road --------------- z -�
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Issued � �U�U ��qZ- Denied U,!
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Owner Zoning Adminis rat r
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�' Note- This parcel is an addition tio an existing parcel,
� and does not meet the building requirements of the
� Sawyer County Zoning Code .
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S'ec . 36 T9oN,R9YY. � - - 87°/S� W,
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MAY /3, / 97,2 RONALD L.
� PETERSON �
5-803
� FOUND /vIONUMENTS. �Y�y�p
• /'�X 36 �� I.90N PIP.E . wis, �,
B.EAR/NGS ARE 6AS.F4 ON ��lYd SURvCG�O /� ^ � ��--�
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DATA FROM W/NT,ERS PoINT
PLA T 1939 .
��.�/.�i .�,I.s� ���,//4i 01" ��/ ./7 . tLJ Q/�f�d � �// �
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Approved this �,' � day oF May, 1972 by /(� ;_�! � ;�� ���'., j �
Sawyer County Zoning Administrator
I, Ronald I.. 1'eterson, Wisconsin Registered Land Surveyor, here by certify that
in compliance with Chapter 236.34 of the Wisconsin Statutes and under the dir-
ection of Mr. David Rolewick, oWner� I have surveyed and mapped the land here
in described � that said land is located in Govt. Lot fi, Section 36, T. 40 N, R.9 w,
Sawyer County, Wisconsin, and is described as follows;
(Description on pa�e 2 of 2 pages. )
Page 1 oF 2 pages
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Part of Govt. Iot 6, Section 36, T.40 N, R.9 W, described as follows;
Commencing at a point on the south line of said Govt. Lot 6, that bears
S. 8']°15' W, 840.00 feet from the southeast corner of said Govt. �t 6,
Thence S. 8']°15' W, 444.88 feet to a point that bears N. 8�°15' E,
36.5 feet from the south J4 corner of said Section 36, Thence N. 3°00'40" W,
parallel to the north-south yb line of said Section 36, 150.00 feet,
Thence N. 8�°15' E, 445.56 feet, Thence S. 2°45' E, 150.00 feet to the
point of beginning. All subject to easemeute and reservations of record.
. this instrument drafted by- �
Ronalcl L. Peterson
May 15, 197z
14G�301
Rc�ietci c OEtice
Sa�r�ycr Cw,ty
{ic_,.irc;l G_i rc-�cr�l il�.e�',�day ot
Page 2 of 2 pages ---_�:n�:;�3��P.•.3oc;i.�:t
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SAWYER COUNTY ZONING ADNiiNISTRATION
INSPECTION REPORT � ' f
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Owner JoAnn L. and Gary A. Lavin __ �
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Address W10011E Burma Avenue Owen WI 54460 z
Name of business 9
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Builder FBN Construction '�
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Address P . O . Box 154 Stetsonville WI 54480
Agent/Purchaser _
Address
Inspection ( ) Property ( ) Setback - lake
( ) Dwelling ( ) Setback - road
� Private ( ) Public ( ) Mobile Hm ( ) Setback - lot line o y
( ) Garage � Average Lk Stbk; � �
Violation O Addition ) add to dw �'
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( ) Zoring ( ) Sanitary S�-T�� �'
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RR-2 . 35 ac . V 322 P 114 . d w
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Discussed with owner/builder I`O
Discussed with
Date 13 July 1992 �
Signature of officer F-��. 1�.�• �� _ Ttss� So,N.�o.r.ar,
rton W. Maki
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State of Wisconsin and County ECF�VEp , -.
. , , -, ,,, �' Uniform Permit Application S . � —,Z� ' �s
; , , � , . for Private Domestic Sewage Systems �P 1 � %S�4 , . Date
:,n:. .,. . . p�UM61 i ° z� . ,
State Permit �- � � ' � '�G �'_r-r, County��w � ��`.
; . . � �---- _ ��`�_ ._.
__ __ _ ._ . ..--- _ _. - - - _ - ; , , _. _ _ _. _ . . _ __ . . _ ... _
._ ___ . � �
Number �. � �D� • Permit Number
/ - . . - -
A. OWNER OF PR�OPERTY
Name: -- -..._ . :.+-� - - - __ _-- -. - - : _ _ _ . Mailing Address: - ' . :
�0 , _ __ . . _ . '
_/ io..3� d ���.v T -sr.
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_ . .. : _ . .. �'+//P � D /e I.tJ /G � � ; - , � --- . _ . _ _ . - : _ i ._.
_ _ _ _ _ _-,__ _
l�t/cs Tc if�S r�•� -f t c . � o/S3
B. LOCATION OF PREMISE WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
LEGAL DESCRIPTION: Name One:
(Sec., Lot, Block, etc.} �G� � � • � 3� ��� �(;,�h. CITY VILLP,GE
� 35 �, n 5 U✓ ���� � �E C�O/�l TOWNSHIP
. J`�,,,,,� e f l3�(-l J �--�r ►=
C.��3�C TANK CAPACITY Gallons NEW INSTALLATION _ REPLACEMENT ADDITION—_ •
/-loiD �r�G i000 At�p 800 . . . _ . _
MATERIALS: Prefab Concrete -_�� Poured in Place Steel Other ;No. of Tanks 7�� _
.,�, - _
D.TYPE OF OCCUPANCY � - - •
One or Two Family Residence -���/� � E �No. of Bedrooms � v C
Commercial Industrial Other No. of Persons to be Accommodated T/.t/D
_ (specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES � NO Automatic Clothes Washer YES —�-NO
Dishwasher YES � NO Other (Specify) _
�1,/(� n1� ►�;,-� �--�
F. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION ��AD.D�TiOiV REPLACEMENT _
Seepage TrenEhes: No. Lin. Feet rencT� idY�' �� f � De h �[` � Number of Lines _
� ���,,.,t �;� _: f �jC �',3... ���— .—.
_ Seepage Bed: Length Width _ Depjf�_„ ! Tale=�Size.-.� -�- � •����- .�lo_ Lines " _
(fT'iFl.t I 1iv ( �.r'� 1it� a t ..�:�..�.+ �.:,�
Seepage Pit: Inside diameter _ _ Liqui th �
G. Percent of slope of land % - - direction
H. Indicate Slope of Land & direction of slope on sketch _, _, - I. Tile Depth �__4__ � .
. -
PERCOLATION TEST ' - - --
Indicate Soil map number � And Soil Type
Hours Water Test Time Drop in Water Level Inches Minutes
Test Depth Character of Soil Since Hole in Hole Interval Second to Next to Last To Fall
Nu-nber Inches Thickness in Inches 1st Wetted Overnight in Minutes Last Period LastPeriod Period One Inch
" - .5� � TU �.tl T'e �
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
SOIL BORINGS - Minimum 36" Below Pro osed Absor tion S stem
Boring Total Depth De th to Ground Water De h to Bedrock
N�mt�er Inches Observed Estir�ated Observed Estimated Character of Soil with Thickness in Inches
RECORD DATA FROM MINIMUM OF 3 BORE HOLES iN THE AREA I �d INHiCH THE SYSTEM IS TO E3E INSTALLED
(C'C1��iP( FT� (�T+� � R Ctn�=1
�. CD ,�
. ��lame of Ovrner ��_��l (�� F� 4�U 1. � k._ County `--� ���� ��`. State Permit No.— 1 *w � '
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�ERCOLATIONTESTS -- • � � ��' - ` ' ' �
I, the undersigned,hereby certify that the Percolation Tests reported on this form were made by me or under my supervision in �
accord with the procedures and method specified in Section H 62.20 (3�,Wisconsin Administrative Code,and that the data �
recorded and location of test holes are correct to the best of my knowledge and belief. .
NAME �t �v h�t �/ ��4-S�US S �N TITLE �/�s-S �"'��P PL v •�s/3 F �•'^�i`, ".�-'
, � . (Type or Print) , .., ,_.
REGISTRATION NO. or MAST_ER PLUMBER LICENSE No._ .3�35
: ;
ADDRESS —�_N RL C` -. _ _ _ , , � .,....
DATE OF TEST " - SIGNATURE /c -�--I ti- � .....�,-„��.�.�.�-�
PERSON MAKING APPLICATION �c=�v�V/.J /r�S ��(i.-S.f� JtJ ADDRESS C� 3G � K '
__ , . _. _ . _ _ . �. __ ., ,
SIGNATURE •��� " 1 J•i ,/i �r�r�� t�. - �t'1
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MASTER PLUMBER MAKING INSTAL TION � -c/ � � S� fr.!S�ust�f✓ LICENSE NO. MP.�y'.�_�
SIGNATURE (i „ • . . --c,' MPRSW
r, _
Provide sketch below of system (Include direction and percent of siope and all applicable distances including weli location and
lot lines) � ; . _ . _ _- _ I
PLAN VIEW (Locate Percolation Test& Soil Bore Holes)
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Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. �-";- , �
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, Do not write in space below- FOR DEPARTMENT USE ONLY ���.� � � �
_ . , _ .._:__ .
Date of Application �L-'�-4 t� �y��s Fees Paid State 2.��� County ��C�
Permit Issued/R�ete�e�ed (date)SIUL-i' 2.S �q�S Inspection Yes No � Date
Issuing Agent Name ���� �������__��'(�UT"Valid No. _ ___ Date Rec'd. —_.
DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI. 53701 - REVISED 3-1-74 - -- -�-
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ORE I L L E S ! SUBDIVISION
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SCALE: I INCH=400 FEET FOR ASSESSMENT USE ONLY NOT
DRAWM BY: DATE: INTENDED 1`O SHOW CONCLUSIVE
COLON (:) INDIGATES GOVT. �OT EVIDENCE OF OWNERSHIP OR
80UN�ARY LOCATIONS