HomeMy WebLinkAbout004-149-05-0500-LUP-1992-062/'
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Application for Land Use Permit y �
( County of Sawyer o -
The undersigned hereby makes application for a Land Use Permit and � k
agrees that all work shall 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 0
LO��S 4 � '
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Mailing Address Mailing Address
GU�ul�oy�,!(�� ��3yi.6 /�l�s��6<v, �cJ�: ��s`� V
City, State', Zip City, State, ip
Bui ding Land Use Zone District ��- � o � �
( New ( ) Filling � �
( ) Addition ( ) Dredging Lot size,s 2�x ��� �D
�n n
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres .�� �
( ) ( ) �
1
New Construction �
Size �� ft wide ft wide �
�� � ,
�� ft long ft long �
F1oor area /.5�'� sq ft sq ft • �,
/ cb l�
Tota1 htg �Z �Z to peak to peak � �
Stories � Stories �
No. of Bedrooms � I
r ir. c�
0
(year round) o (seasonal) �, rt
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Type of B1dg or ition Q' r'
({.�Dwelling a o
� C rt
( ) Garage (1) (2) car /�
( ) Storage Building o � r•
( ) Boathouse � ~�
R, o c
( ) Livingroom �` N �s ��
( ) Bedroom � � p �p ��
( ) Kitchen-Dining p
( ) Porch - enclosed/roofed i �►u �
( ) Deck - open � � '"l �O �
( ) � � � � r�
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( ) - M• �3� �
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Type of Construction � N � L. 1,, 0 �
(✓J Frame ( ) Block ^ � G� � r�
( ) Log ( ) Concrete Z�
( ) Po1e ( ) Steel � �
O Metal O y y � n n
Construction Cost ��..SZ�. n 6 �� �1 Z
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Issued 28 April 1992 Denied � ' �
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\J 6 PARCEL NUMBERS F02 USE
�� �s /iV THE ADDR6550GRA/�H
Pj2 SYST�'M EXAMPL�E :
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SAWYER CGUNTY ZONING ADMINISTRATION
INSPECTION R�PORT o
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Owner Lois E ,_ and William D . Scharlau ,�J.
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Address 310 N . 89 Wauwatosa . WI 53226 r
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Name of btisiness
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Builder �•
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Address w�
— - �
Agent/Purchaser d
Address
Inspection ( Property ( Setback - lake
) Dwelling (� Setback - road
(�? Pricai� O Putlic O Mobile Hm O Setback - 1ot line o ��
( ) Garsge ( ) _ _ rt °
��icl.��tion ( ) Addition ( ) N �
_ — �� o
( ) i onino ( ) Sanitary �v, '�'
� �
Volume 229 �a�e 626 ; 428 page 92 ; 428 page 160 _ ____ �' �
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Discussed w� tn owner/bu�.lder v, �y
Discussed w�_t:� pni-S�'�
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Date _�_�J-' - 9a- °'
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Signature of: off=cer ����
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DOCUMENT NUMBER AFFIDAVIT
Fi w 7 9 5 4 EXISTING SEPTIC SYSTEM '
. . OIVE AND TWO FI�MILY „��� �� 1
�,..r,.r :^.o',miy � � //�
Sf the existi_i;g septic system does meet the minimum re- `�=-����<� '�� r�-���•r3 �}� +� �+1 �i
quirements fci- cJroundwater and bedrock depths and if it �� " �'Y_ s��d�o'c�o�
is functionin;, an addition to or replacement of a hab- �"'�• ',^"•"r�"��---��
itable structuc� can be made in most instances without p1 `'`^"" " �"""' --�
updating the existing system. If the existing system _�___�?�_.��,_:._M
is utili�ed for the addition, every attempt should be �
made to locate and reserve an area which is suitable � --'^--����
for a coc?e complying replacement system for when the
system fails. If the addition will substantially in-
crease the wastewater discharge, the existing system RETURN TO
will be replaced with a code complying private sewage Sawyer County Zoning Admin
system. P.O. Box 668
Ha��ard WI 54Rq3
owner(s) Lois E. and William D. Scharlau
/O /1/. 8S
Mailing address
GU �u u�A� oSA, z1� --
� Wisconsin 53�
---
Property deacription Lots 5-16 , Block 5 , Village of Lemingtor_
S 22 , T 38N, R 8W. Town of Couderay
� (we) Lois E, and William D. Scharlau p�an to
( ) Add onto existing dwelling
( ) Add onto existing mobile home
( � Replace existing dwelling destroyed by fire
( ) Replace existing mobile home
The present private sewage system has been working satisfactorily as far a� di.spes�n7
of wastes. If the present private sewage system does fail, it will be replaced orith
one that is code c mplying. �/
�!�I���(�'�" � � -
Willi m D. Scharlau °�'=e
�.!� � � ' � �_ y
i ,, � / � �>
. '�SG�f'll� �/�7/L� ,-'C .! ��//�-Gt'1L� .� �_�/ ��
� Lois E . Scharlau aate
Personally cair�N bef r me this
, ,�
S✓Y` --�ay of ✓19� /
� �^�" ,�c"�`—C � ;
�/` � � Notary Public
�
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� . ��� � County, Wisconsin
�---
' y Commission is expires �6 ' t� ` C`,�
Existing seotic system - Sanitary Permit 75-031
Date system installed �5 June 1975 �
� „, -p� (� �,�� __ _ �caec� As s t S an
. _�.�-��. � �`-�' ---
Merton W. Maki
16 March 1992
-- date
This instrument was drafted by
r�� __�,I;-1 �i�fii-I} -�+�ha��aii--- ��J�. � �W � L �
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Plb 67 � State and County State Permit # _132l+7_,_.
� Permit Application County Permit # -S��3�
. for Private Domestic Sewage Systems County S��ez _
�s-r S _ at� i
' "DENOTES STATE APFROVAL REQUIRED
�
Date Approval Recei�ed` from State if Required State Plan I.D. #
;� ,''
V��///) E � OF Pa�P TY r w �LL,�Rm � ���yA�� Mailing Address: ��f y� --� y�,�'
L,�� �6. .�� e j , � w �'�
d � i/ � F
�� � � ' .��c�cc-��-�-� 4��4
B. OCATION: YQ �-� Y4 , Section ,�, T�� N, R� ��- �1/ Lot _ _tCi�t _ �
Subdivision Name, nearest road, lake or landmark Bik# f �<<.,:� � , _ Viflage �C%r�.� , � :�_
LOTS S- � �� S \1111�b�. L�`'�11 �V(� TU l�/ �'' � Township Gpu ���
C. TYPE OF OCCU ANCY: Commercial ' Industrial *Other (specify) *Variance
Single family / Duplex No. of Bedrooms �— No. of Persons�
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES�10 # of Bathrooms _ �+ %�.
Automatic Washer YES �i0 Other (sp cify) ,�c��'L�> � �
r
E. SEPTIC TANK CAPACITY Total gallons No. of tanks C�ZLc'
*Holding tank capacity Total gallons No. of tanks
New Installation ' �1 Addition Replacement _ Prefab Concrete _
*Poured in Place Steel Other (specify) _ _
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1 ) ,� 2)� 3) �Total Absorb Area L��% sq. ft.
New_ Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. o renches __
Seepage Bed: Length ��1Nidth-__��Depth *,,� Tile Depth �� ,; No. of Lines �=e�'
Seepage Pit: Inside diameter Liquid_ Depth Tile Size _ L'f,_�_
Percent slope of land��i����„� ��.f� � Distance from a itical slope %�' �
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 have sized the effluent disposal system from the EH-115 prepared
by the Certifie So� Te ter j /G
NAME �-C'L ; �'l� � C.S.T. # ,�S -��-rl and other information
obtained from 7 -�. . (owner/�ri�Fder�.
r� .
Plumber 's Signature >� I , MP/MPRSW# ����� Phone # — J�%;
.�
- ---,
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, includi g w �I).
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D Not Write in Space Be�ow - FOR DEPARTMENT USE Of�LY
Date ofi Application 6 -6 -�5 Fees Paid: State 1 . �� � Coun y ate T�ne 6 , 1975 _
Permit Issued,��iX (date) 6 -6 -75 Issuing Agent Name •.... - De t
inspection Yes�No Valid# ate Rec'd _
� r�rint�- (white cor�yl 3: a�di��r Gareen ec�pv) [�IVISION OF HEALTH, P.O. BOX 309, MADISON,_ WI �,53701; ; ,,,
2. state (pir�k copy) 4. plumber (canary copy)
o,,..:..,.+ n..... o r� n c
- Department of Zonin� and Sanitation
' � • Sawyer County
Inspection Report
Name of propertY (1��� I.� � . SC.i�AP_l.Alt
lo�
Ilescription S•G-7• 8 a i' �EG.� T,�B�- � L� �i��E oG�( To�
O�nmer Address
Builder Address
Mas.ter Plumber �op VIT�� Address
Inspection
(K) Private ( ) Public Property Sanitary Installation
Dwelling Privy
Violation Mobile home Setback - Lake
Garage Se�back - Road
( ) Sani�ary ( ) Zoning Setback - Lot line
�w G
Ex�si�N� >S�
F�e M�.. ���
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10'
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v � 30�o s�oP�
Discussed with Builder �� Yes fX� No
Discussed with Plumber Yes ( No
Date of Inspection �0 ^s- '�5�
Signature of Officer����►q��-�rw-,---�'