HomeMy WebLinkAbout002-940-05-1215-LUP-1992-259 Application for Land Use Permit
County of Sawyer o
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. �
PRINT - USE BLACK INK OR PENCIL ,
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�G�'�" L�NQA J L�Nq.�P1�CT �LDI , LUN��1< ��— �
Owner Builder
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i� � �ox Cfl 5 5`7 2-�-� �ox C�S`J7 '`�
Mailing Address Mailing Address
v v��4-2 n �� s�3�f 3 i w � �nl i S`�8�3
City, State, Zip City, State, Zip
Building Land Use Zone District �Z` ( o �
(✓} New ( ) Filling rt
( ) Addition ( ) Dredging Lot size �C�S' X �-��� � �
m rt
( ) Alteration ( ) Grading `� �
( ) Moving On ( ) Acres /,5�- p
O O �
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New Construction � r
Z
Size L�} ft wide ft wide �
� � ft long ft long ' r
Floor area q� sq ft sq ft ' Z
� � � �-
Total htg (3 to peak to peak x �
Stories � Stories ?C_--
No. of Bedrooms — rear lot line or waterline c�
0
(year round) or (seasonal) �
� rt
Type of Bldg or Addition v� t-�
( ) Dwelling a; n
(✓j Garage (1) (2) car 3cC.i� �
( ) Storage Building �� ��
( ) Boathouse � o A
( ) Livingroom �
( ) Bedroom '
( ) Kitchen-Dining
( ) Porch - enclosed/roofed -
( ) Deck - open �'
( ) ,�S2 '�ij ,� �� -_
( ) ,a� ��b� ��� - ti
� N _
Type of Construction � rbz,�o , --
(�/f Frame ( ) Block '� � �
( ) Log ( ) Concrete � � � � � `�� `�
( ) Pole ( ) Steel � � '��5� `-'� � �,
( ) Metal ( ) i 's� ' �
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Construction Cost $ Sf30o'= � , �' 1� �' I
� l00 .� �
Vol 3�2 Pg �� of deed � "�?
CS Vol �p Pg � 1 �
7�- 3 04 ; � w �
Cer. Soil Test � �
_
11�5' � �
Sanitary Permit � - "L_(�J�;-�'� �----------CI, Road --------------- ~ O
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Issued � -u�l � L Denied
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�iv � I lw..k-�-� ' � �
0 er Zoning Administr tor
OWN OF BASS LAKE �
SEC.5 TWF 40 N . R. 9 W.
.i.io i.e �
223 I.II .1.9 .1.7
SOMMERS RD.
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Register's OEEice b m
Sawyer County }� / � � N. 2°J9' W- 400. /3' L�
Neceived lor record Ihe ,.i day oE a a� � �O• � D '
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�i�1 ond r�corded in vol. (,� � ��' D '
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of l�.t'.�,Y . �Cc.-y�G! on Page ,�a- �� � S. 2 'Ss'E. 4
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Registet � 4 ��
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� �. 'e� idi�.<i ;i��riey N.�. ���.-_:,... M � ��
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Lots i & 2
1, Robert &. Swanson, Wisconsin Registered Land Surve�or, do
hereby certiY'y under the provisions oi Ghapter 236.34 of the
Wiscon:in Sta�utes ana under the direction tlE Eileen L, and
riarold 0. Olson, owners of said land, I have surveyed, divided
and m�:pned the land herein descrihed and that said land lies is
tne fra�tional west � of thc: nortueasz � of Section 5, Township 4U
iVorth, Range 9 West� •iown of S�ss Lake , Sawyer County� Wlsconsin
des�ribed ae follows:
Commenciug at the north } corner of 5ection 5-40-9: thence
ea5t alon� t«e north line of sdid Section 66.u9 feet to tne iron
pipe whicn is the poi.,.t-of-oegiuning.
Thence �ast along tne ,.orth llne of said Section 5 a distance
of 330.00 �eet to a�, iro,� pipe.
Thence South 2�59' East 40u.13 feet to ac, iron pipe.
'1'hence Weet 330.00 feet �o an iron piYe on the east �.�..W. ',
line of a proposed 'lo.m Roxd.
'1'hencc North 2°54' Weot alung trie east $•�•�• line of tue
proposed Y'own Houd 400.13 feet to tne iron plpe which is the Y,D.d.
Said lots a�e subject to easements ana reservd�ions oY rec�rd.
Said lots are suh�ect to the restrictive covenants listed on
page 3.
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� �ocuMENr rto. GRANTEE ' S ADDRESS : � II
BTATE BAR OR WISCON8IN — FORM 1
BOX 98 � WARRAN9'] D&IDU
� . THU SPAC� RElBRV[D rOR RtCOR�INO DATA
i I '71 � '74 Hayward , Wis . 54843
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I This Dcecl, made hecween......TIMBERLINE,,.7�t�ND.._&...DEVEI�OP- enTer C`,cnmt� i
! N.IFa�I.��'.�....�.`�.T�.�..................................................... ecelved for record the �Y d
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,� _�_ M end recordeci in sd.�
...................................................................................................................................... Grn�tn�
� and ........S.�iQ�`.�...�,......�,U�I.DA���x....�n.�t..LINDA...J...._I,UNDB�RG.,...... , � �
of Recorde oa paqe
husb.an:d....an.d----w�.�.�.,-...��_...J.Qi�.t....tenants.--�----�-�-�--�-�--�-•--.....-�--------� � ��� �
� ...--�-••---�-�-�-•--�..........................•-..................---�-•�---........-•--••-•--•-••-•----.........••••-•-•........., Gra�tee, I
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' t�1tt1CSSCl�1, That fhc Sai�; ` �' nint (��r a ��alun��le rnn�idcratinn............................ '
' of....ane....do.�.�..ax...ax1.�i.._Qth�r.__v.aluable...c_onsiderat,ion.. — - '
rnn�-cys to Grnntr.c Ihc f�illowing dcsrrihc�l real cstatc Ifl._..._.�.�W,J...P4.r............. C011O�}'. RETURNTO� � � 7p,
I� �tntc �f Wisconsin:
I�rn6e..-lin� 1.�0.v. O�v. ►- `
i P. o , s� c�� , y I ��
That part of the F�actional West One-half of the �.+o,r�.[ , � � s ,
Northeast c�uarter ( W'�NE4 ) of Section Five ( 5 ) , i �
' Township �Porty ( 40 ) North , Range Nine ( 9 West , Tax Key #.:..........................___..._..__ .....
� more partieularly describ�d as Lot One ( 1 � , ri,�5 is .................. homestead pmperty.
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recorded in Volume� Six ( 6 ) of Certified Survey
ii Maps , pages 82-84 , inclusive , Survey No . 1157 "
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� 7'oget6et witli all and sin ular the hereditaments and ap urtenances thercnnto belonging or in an}• n�ise appettaining:
n„�� .---�--...TIMBERZI�IE...LAN_D...&...DEVEI,O�MENT.�....LTA.r.--��----�--�...........................................
...........................
I marrants lhat tl�e liUe is goocl, indefeasihle in fee sim��le snd free nnd clear oF encumhrancrs �..���......eas.ements,,...................
� � excep-t.i-ons....and--..r.esexuations....a�.--�'.ec�r.d........_...................�---.......-�- .........._.._...._......-�-----�--._..._...---•----._...... I
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I ,� and will warrant an�l cicfcnd tlie samc. !
I Lxecuted ac.....Hayward.�....WI...-�------��-------��-�---......... �►,;5........2. ..... Oetot�er
-••••• day of-•••--�--••-• •• • -••••••••••--•--•_•••---...., 19•._.7g.
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� fiiGN�D AND BEAL�D IN PItliSI•:NCP OF .. ����,� ..(SEAL) L I� 1•�
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� � Signatures of .....-•--•••.............•--•--.....................
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� I authcnticated this...................................••---........ day of...............--••••••...._......••----•--...................---•� 19........... I
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j I� 1'itle: D[cmber State Bar of Wisconsin or Othet Party �
Authorized under Sec. 706.06 viz. .....................•••......................_.._.... I
ISTATE OF WISCONSIN
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ii ....................Sc3.Fi.y.�Z....._....._......_....._.....County. I
' � October
I � Personally came before me, this---•-.....----••-Z�d•.............................. day of............. . _.............--•--••--••--•---••••---••••........._._.., 19.._79
I � che abo�c named............Roger Stillman and Richard Magnuson
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� I to me known to bg�dFM"p'F;�bS.:._.... who executed the foregoing instrument and acknowledged the same.
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i TH19 INSTR��+yT.'OVAB DRAFT�.O'�dY ........ � �'.� �� � ' _�� � .......�.. 1.....`..:..i.��:.��.»:.C.l'....::-•............
I 2 ly �,�. C '�'i� � '1.' . ' . �.�.........�.6......::...:...... / L
� Timber� i�fe ''L�d.:& Developement Hazel L . Magnusan
---�-•----...---- ��-----......................--.__......................-------�--�-------�
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The use of iFitti�sscs is ��c�onnL Nocary Public, ....S awXe r I
� . ...---•••------•••--•••••...........••••-..._ County, Wis.
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I /I� � � F � Tfy commission (expires) (' ) .....
y� . � �.._ �.�.... 98s................. ..
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� Names of persnns signing in any capacity should be type�l or printed below their ������ �` --__-.- I
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',•p L� 6 � r I ' State and County State Permit # 13940
�g Permit Application County Permit # 9- 215 �
for Private Domestic Sewage Systems County Sawye r
"DENOTES STATE APPROVAL REQUIRED CST 9- 304
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailiny Address:
P .O . Box 98
�v cl �-� d� c a c� CC�'�� �� � �
B. LOCATION: Ya a"� Ya, Secii � T N, R�.�{gy��- 1/1/ Loi# �_City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township ,5'SLQ/���
Off of Sommers Road °'
C. TYPE OF OCCUPANCY: *Commercial *Industrial "`Other (specify) *Variance
Single family � Duplex No. of Bedrooms .� No. of Persons .�
�• SEPTIC TANK CAPACITY �q(,� Total gallons No. of tanks _�
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel t-� Fiberglass Other (specify) _
New Installation �,/" Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) _
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate � --S Total Absorb Area �l�r sq. ft.
New�Replacement Alternate (Specify)
Seepage Trench: No. of Lin�al Ft. �idth Depth Tile depth (top> No.of Trenches
Seepage Bed: Length�_Width I� Dept�� � Tile depth (top)�No. of Lines..�
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land� Distance from critical siope —
WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I tiave sized the effluent disposal system from the EH-115 prepared
by the Cer ified Soil Tester, /
NAME !oc%�..e i � L� s �t�� C.S.T. # S.$ r�f 6 � and other information
obtained from (owner/builder�.
Piumber's Signature //�C.P.�f'�, l � PRSW# ���� Phone #?�S — 63�—�L-S�
Plumber's F.ddress �-- � � C � -s
PLAN VI EW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20.Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on ihe property or neighbors
property. If well has not been drilled please indicate.
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Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application 10- 12- 79 Fees Paid: State 15 . 00 County 15 . 00 Date 12 OCtobeT 197�)
Permit Issued�}�d�&�C (date) 10- 12- 79 Issuing Agent Name Elaine Nehrling
Inspection Yes�)y1,. No State Valid# Date Rec'd
1. county (white copy► 3. ovv;��, (c >-� copy) DIVIS►ON OF HEALTH, P.O. BOX 309, MADISON, Wi '.i3701
2. state (pink copy) 4. plumber ( copy) � . , � , „�
Department of 7onin�; and Sanitation
Sawyer County �
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Inspection Report y
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Ovaner Linda J. and Scott L. Lundbere o
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Address P.O. Box 98 Hayward 1Uisconsin 54R4'� r,
Name of busi_ness
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Builder �
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Address �
Plumber Lawrence Lamphear
Addrees _Route 8 Box 163 __H yward. WI 54ft43
Inspection
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(x� Private ( � Public Property X Sanitary-instal � �
X Dwelling� 3etback - lake
Vi.olation Mobile Hm Setback - road °
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Gara�e Setback-lot li_ne �'
( � Sanitar,y ( ) Zoning Privy
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D�scussed with owner yes no �
Discussed with Builder yes no �
Discussed with plumber �' yes no
D--scussed with yes no
Date ��__�j.�7-�'"�_
ignature of Officer �j l
__�c�,..�.�1_.--------