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
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Owne Bu'lder
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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 �
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Cer. Soil Test 78-014 � n
__._ � �o
Sanitary Permit 78-010 --��:�-� Road ------_=�----r--o~o z �
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Thomas H. oss Owner Zoning Administ ato �
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SAWYLR CO'JNTY ZONING ADMINISTRATION i
� INSPECTION R�PORT oI
��,
�
n
Oomer Rachael M. and Thomas H. 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 ( ) �� �
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( ) Zoning ( ) Sanitary '-''
rn
V 423 Pg 335 . Plat Env 63 . 1 . 06 acres . RR-1 . `,'�
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Signature �z officer _6.�1 ,�`c�-, W. �v-�. �ss� 54K.{a-u��
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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).
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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
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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
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� � $EDRonM � 1
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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