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HomeMy WebLinkAbout010-118-00-6600-LUP-1992-033 ��i Application for Land Use Permit y�� County of Sawyer ,� o The undersigned hereby makes application for a Land Use Permit and � 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 �- Rachael M. and Thomas H. Foss � 1 �OM4e r' V ivF'k�P�e� �oS� ���� �PE�k-Yi����J�'� �1-1Un„rtJ����� f, Owne Bu'lder �, �t�t � 3�2� ��'���� �� � ��� ��`��0 Mailing Address Mailing Address � � �����f�'�� �� S��''�3- 1��..��.�� 1,��, 5��3�F3 Cit , State, Zip Cit�, State, Zip Building Land Use Zone District RR-1 0 � ( ) New ( ) Filling rt �l Addition ( ) Dredging Lot size see plat m r�t ( ) Alteration ( ) Grading ( ) Moving On ( ) Acres 1.06 � o ( ) ( ) rn cn � New Construction � y Size �� ft wide ft wide o ,�.� ft long ft long � x Floor area S7�� sq ft sq ft td Total htg /� � to peak to peak x Stories / Stories , , No. of Bedrooms _ _ _� .- �-.- �:-.�_�r waterline I o ear r un ) or (seasonal) `-����^� �R�-� � rt Type of ldg or Addition '� � � � a o ( ) Dwell'ng ,�� C. rt ( ) Garag (1) (2) car .r� ( ) Storag Building ` ( ) Boatho e , � � i (� Livingr om a ( ) Bedroom , �"- �y� � '�v '� (� Kitchen- ning �° C�v �-'�- � ' � ; 4� � O Porch - e closed/roofecL- i a � � ( ) Deck - op _ � � � Qws�"'S � i { ). ���{ �bd w �,� � � I rt I ` � I Type of Construc ion ���� � ; (� Frame ( ) lock ( ) Log ( ) oncret �o n �� ( ) Pole ( ) S � cn (� ) Meta1 ( ) � �5� � - fD — �x n Construction Cost $ IS Ooo. 8 �`"" I -FI �.�I N Vo1 423 Pg 335 f deed / �' X3fiK�/:�4 P1at � Env 63 � o ro � � ,� w Cer. Soil Test 78-014 � n __._ � �o Sanitary Permit 78-010 --��:�-� Road ------_=�----r--o~o z � '��OP�_ o 0 �2�T�CR_ �Rt1 A'�F�'� �-tF��E� � L��� � � rn �`' Issued y�j� �QQ[� ��2 Denied o � o � � s � I � � �; c�,7.u�z �v-� �fiU t.l k t Wt� lf��-+ '� £ Thomas H. oss Owner Zoning Administ ato � � �C' p �v v V � - A. Q� 1• � n -� �� � . '�iI- . _-y��. ` ' \CS' �i � ' , I � � �• ��� sr . � c 1 •W h ' `W_ a� � t ` � �° ..� o _ � o . �� _ '�_ . . sr, . � �r._ ' � . . � . o. - . ^ � Z6 ys � � ^ _ � �` Qy1 \ _ O� . . . ' . ' . . � ` � D - , ' ' � � \ ''� \� . . b i � _ . , . `� = o . o. 09 _ r: :. - ; .o4r./: � , , - c�o -.�,� � . - w ': q +b , . ,_ � : o t !� �o •.� � '�,� � � . ..�- � - ,, _ _ r o . N` � � �..� . � . � , . , r ` w ( � � �o� � , � � �` � , . �« "' � \ (� � �,, } h � #" ' , � � ' . o� � o.� � °1 `�� �'-- � ' �- _ a _�-� -- - - - - - - - - - - -� - - . - - ; , \ �. - . , � � , � - A v, ��: . � , ' , � � ', , _ °� o . , � _ � � q :s �.�.. � o . cr. 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Foss o ---— � Ac�.dress Route 4 Box 4640 Hayward WI 54843 "' - H Name of busiress x — o BuiiGer ___owner _ � P_cidress x Agent/Purchaser N/A Address Inspection ( ) Property (vY Setback - lake ( ) Dwelling ( ) Setback - road (� Private ( ; P�:blic O Mobile Hm O Setback - 1ot line o ,-3 O Garage O Average , add to dw `t ° Violation ( �' Addition ( ) �� � �, o ( ) Zoning ( ) Sanitary '-'' rn V 423 Pg 335 . Plat Env 63 . 1 . 06 acres . RR-1 . `,'� — ------ ---- -, rn x - — cA w � L��Ic�f,D��e w H - P�aP�d qdd'.��-, ��4'xZa ` ?� � - Lak4 S�b�� � ge.,�e� Sf6k ak. �� �-� �� � 5�0� Vb „°� c� 0 b5 C Xv rt r x r \ ``$a. C rt — ; � � \ �`�� '15 ' G. Y 9O ot \ \ ` \ C�7 I � � � r�8� qp� `i� 45� N i \ � ., / g , w � �o ��0,��0 / � � � � � a � / � n � e� ,� � i ' • �� \ v i � � o � a �D , � ,/ ��,� w rr `i F �o;`''�• S�� � /� n � o �6 ° 3 a �J � � � � �➢ J � �r ���a l�� � °�~ �� �� 3�~ � � / � � � , t 4'(0' {! �pJ� rn �(1 �i � o � y S � H � � � 1�J (1 N f"iJeraa1e 5� �i�. iS �o� ' � r __ � � z 0 ]?iscussed with c��er/builder � � �iscussed with ��.� �e��, o�n s��-e rn rni 0 - o � T��tie 3 - 12-- 2 Signature �z officer _6.�1 ,�`c�-, W. �v-�. �ss� 54K.{a-u�� � 1� �O � ' 8 �' n � I I `\.\ .s .g " V / � 46 '� `�6 � \� Q 6 ,9 6.+.,g O i`•,; � � / \1�26 � ��6 r � / 26 v � �I� •8 s �S 6, ��, . �o ,8 �1 � s� � �'� ' �6�� �`�6�i I?1 � yO � � 6 � ^ �;,.$ ,2�8 ^ �jO � rLfo'a 6'r ��� S � 26.� � �j� %� .S 6y .0 � ' �/ ,26... � � �� % 2�O' ? �'� � � . S'r Z. J ' � �• ' ��' � � O� C/� s,S.g �'�e�9 26.z '2 � ' 6 .� r ti�^• '- �: e �° -;%" �26,— ��j� / . 's Q �s ' N . . / . s .a L� �'/ �� `,. :`� .w � � , s�6�� �, � r � - ;2 /��9 O � � �.� � � 00 � . V .26� ` � �� � �m �8 626•i 26,� 26 � . � 1� .g �2 g . � � � e� .$ ',26, � � r \ �.g' ' , � � � r� � �G� �26a�;A � �� � ��� � � � `�� � a..g s,W ��,`• �Rg:n �2G� � ^� \'J � � � �. i `.R .B r� `� � � � � �26# ' `� � �� � .26. ( `-�' t� 0 8 �` • 26 .26. � 6% 6 0 8 \� \ �_/ O �\ .26. \.. �� � �� , N '� ryj 26. `�\ � � � j w .D.Q �n � ' � / � � J 61 26'? 8 �\.,\ � �� Ir : m .g ,�26:� � � 39 ; �; � � a m .8' �Z6 • ��,� � 7 2- (�, - :_ V� �Q /� '� � �� ' •e ���� �,� � � � ��� � s •81� 26. /� / � �8 w .g m�6, � R6.� '46, � - � p y� ;26.� •8 _^ a ` R y f. �e•� 26. , 26, ..\ i � %-/ =2'0 ' .8 �ai -P m -� � �., m ]n aj '�G. � �� �� o .g W.B� � ,P �' ,\ , � 1�Ii a�l►ONAp� � �� � zs �2 c� �'� 01 z�� � � 26. ,�zs� � �M1� � � - � � � i �����Wsn» ,� ,g• � .a �z6.� "�a' 2,a � •e' ,, M � �lr ypN �,e s�z s� � a � W g. f : 'M � " 2� �N I �b d M l 9 Z ��� �_, � 'o� z S � a � ns H �d �e � � �-dN � ...� . P L B 6 7 State and County State Permit # 111� �_ � ; � Permit Application County Permit # � 8�'0��_'— for Private Domestic Sewage Systems County Sawyer __ CST78-014 *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # _ A. OWNER OF PROPERTY Walter �7. K3.Z1.OZ' Mailiny Address: _� ����� ��,-�' /1 j,? i C /� ,�'r�,- /�- .l �-' �� S" -'��,> � �1 ; � ��• :%�, ./�ti� r -�'�G�`� .�% � l B. LOCATION: _ Y4 Y4 , Section ]�, T�/1N, R t�� ;� (or) W Lot# �-,�City _ Subdivision Name, nearest r��, lake or landmark Blk# Village � -� � Township .�4�/,�/�r,'> �-�� L- �N�- TZ.-� f-�c= .:;,` /,- --- C TYPE OF OCCUPANCY: �Commercial * Industrial "Other (specify) `Variance Single family �_ Duplex No. of Bedrooms � No. of Persons =- D. TYPE OF APPLIANCES: Dishwasher YES j� NO Food Waste Grinder YES �\ NO # of Bathrooms_� Automatic Washer _�YES NO Other (specify) /t/�-�.L ` E. SEPTIC TANK CAPACITY ��^� Total gallons No. of tanks _ � *Holding tank capacity_ Total gallons No. of tanks New Installation __Addition _ _ Replacement _ n Prefab Concrete x _ *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1 ) !.. 72) 3 � 3) L•>-7Total Absorb Area ��e? sq. ft. New Addition Replacement � *Fill System Seepage Trench: No. Lin .� Feet Width Depth Tile Depth _ _ No. of Trenches __ Seepage Bed: Length _ �Sr Width %2 � Depth `i ---'- Tile Depth r�% No. of Lines �-' — �. Seepage Pit: Inside diameter Liquid Depth Tile Size � �/ Percent slope of land FG �T T" Distance from critical slope -� 5~ ' 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 Certified Soil Tester, NAME _��-.�iN.�_s .�( ��s-�y�/._s'�'��✓ C.S.T. # �S - v ��`' and other information obtained from J"C/i?L TZ-� � � h / 4%C��c' (owner/builder). Plumber 's Si nature �� .�i+ �,:� _„_,�-,.uc��-c.� �% �� Phone #�:�-��/-<'"�'IS -= 9 L MP/�# ,� -.�.:�, ; Plumber's Address � ��';�-�-_; t�t/�,5� . S��' G , - � . - � � S PLAN VIEW: Provide sketch below of s tem (include direction of slope and all distances in accord with /H62.20, includ� well). i � . i C'k�, i� ' y � � � �� `' fi' �`� ,� `�►"% � � � � � �� . �` �) : ' _. 4;��.ti�' �=G D � f` QY � � '�s �' _ � r� ���i �, �, �` � ; �v � � `" �i; --.... _, "-�' � ` ' , � � __-- �� : -_._ , i � , � s�rr.�, � % ��C��.%�Z- '::.� y / / ��,�2'�% \ � � � �: •- � . =_ "�' =.� / �' Lt/ct� /j, � / , .,\ �.� / Do Not Write in Space Below - FOR DEPARTMENT USE ONLY , Date of Application 4-07-78 Fees Paid: State 10 _ 00_ County 1�+ _ 00 Date 08 Anril 1978 Permit Issued/Rejec ed (date) t�-07�'J�__Issuing Agent Name ri _Carrvl Inspection Yes Aie�--�-"' L� - � O " �� Valid# Date Rec'd 1 . county (whitel� ooy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 7 �..,,-,. �..r.,�, �....� n ..i� �...,ti,.. l......�.,, ...,.,,,� r •-- I Department of Zoning and Sanitation o Sawyer County � K Inspection Report Owner Walter Kizior a r rr Address Route 5 Box 255 Hayward, Wisconsin 54843 n Name of business � N Builder o n Address Plumber pndr� Raamnsaen Address p,0. Box 66 Cable, Wisconsin 54821 H O Inspection � � (X) Private ( ) public Property X Sanitary-instal °, Dvrelling Setback - lake Violation Mobile Hm Setback - road Garage Setback-lot line ( ) Sanitary ( ) Zoning Privy x a r �� ouuc LAKE ° n a �E�� m � J � � $EDRonM � 1 I7j��� �0� LL�F_LIIAii� � bj 1 17 �J�� /c�' �0� x I y � c�s. �� b� � (a,L 1 �� 1 Z J�° ���`c��0�� i � J F�„ � � � c, a �n J �• � � C O r• � r• O N � � t9 � RR �oAD °' y co E � a M m n � ao r � a � Discussed with owne r g yes no �' � Discussed with builder yes no Discussed with plumber X yes no 00 Discussed with yes no Date 07 Aoril 1978 Signature of Officer David Heath