HomeMy WebLinkAbout010-169-00-2000-LUP-1992-190 v2;�
t�
Application for Land Use Permit �
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 —
VWI� �. `�' ��
�
� �v�1v1���I�'P �v,n�b �
Owner Builder O
�`t- � �Z�� (03�11— �
O
Mailing Address Mailing Address
�I�'�j w�r�� w� ����t3
City, State, Zip City, State, Zip
Building Land Use Zone District e� � o 0
('� New ( ) Filling rt a
( ) Addition ( ) Dredging Lot size m n
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres . � �
( ) ( )
New Construction �` �
Size ZZ ft wide ft wide �
� ft long ft long �
Floor area �P�G sq ft sq ft �
�
Total htg I 2 to peak to peak x
Stories � Stories
No. of Bedrooms rear lot line or waterline c�
0
(year round) or (seasonal) �—_ io�__;, �, rt
Type of Bldg or Addition b�� °} a o
( ) Dwelling M r• rr
( ) Garage (1) (2) car � �~_� �o �
(,)c) Storage Building t r•
�
( ) Boathouse � o
( ) Livingroom �' �
( ) Bedroom �P1lL � �
( ) Kitchen-Dining
( ) Porch - enclosed/roofed � � � ('�'� CFj
( ) Deck - open � a U �
( ) u/ � 6` �
� ) � �
I �
Type of Construction � $ Cy-� �`
( ) Frame ( ) Block � r,r.
( ) Log ( ) Concrete � N �
(� Pole ( ) Steel X rn m
(� Metal ( ) E - V' �
� U 30-� �J m
Construction Cost $ ,�� �
35�v 4S
Vol � Pg � of deed �
a
CS Vol ---p�- ' �
___ `b------___.._ 7 hi
w
n �
Cer. Soil Test -C� i �
�
' C Road ~ ^
--------------- o
Sanitary Permit - � "'-"-- L z
Cc�-�1 �Dr i� • z
I� �
Issued (����2 Denied �
��
r
��li� ��� -d�Jl�C`-I �� �
Oc,mer � Zoning Administ ato N
3.4 •
,. 4 25 24 23 ;-__T __: -�--�---}------�---�--
, , �
-- �---_. _ ._----1-_-}—___, ,
�----t----4-
SOUTH LINE 165� ' � � � ' � ' !
. ._.�
__.i � � ' NW-NE - E
3.7 3.8 -3.9 3.10 -3. 11 -3J2 3.13 3.14
7 8 9 10 II 12 13 14
CAROL ORIVE
3.22 3.21 -3.20 -3.19 3.18 -3.17 -3.162 3. 15
22 21 20 19 18 17 16 15
ais.i
SCALE: I INCH= 100 FEET FOR ASSESSMENT USE ONLY NC
DRAWN BY: S.R.D. DATE : 4/9/84 INTENDED TO SHOW CONCLUSI�
COLON (:) INDIGATES GO�T. LOT EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS
N �'�',1
O �F
\�q\ N
�Co 0
ti
' N r.� � �\
/ ' O O O
W N JO
< `
W :c �^.r
0 ��
N -a
w �o `n
I ti,�y z p
� Oqr v f � �
�' ( \-
w � �- Z
N
� N � 2� ~ ��_/ f V /
O N " �� (�
-0 � ,� n O
N
� 0 N � � , �
N 0 w �.1.-1.
L
� �
— � ^' O � � �J�.
�__ � �D ' � �
-� � r�, � � �
... ��� / N ' � --<
\J�
N Z �
� r� _ O z �,
rJ � o O — � T,
� 'C /Li
� �
� � _ - 0 N � c
� � �
� W
� wT �
� N N
O O � N W
� O
O
N O
� '� w O �
� � 0
O O
I �
�
il TMIS BPACi RESERVED FOR RECORDINO OA7A �
�ocuMENT No. STATE BAft OF WISCONSIN FOftM 1 — i98a
WARRANTY DEED
I 188921
--- — — ReK.1�fFr"e C�H1ca � �
.
�m• S ,�r :�,�u�h I
; This Deed, made between __.. TERRAN_CE._ M_._VRAN_IAK _and____.._. �, .,,, ,_ � _�^,,:,j tt:e � dv� ol
MARILYN L . VRANIAK his _wife . ____ _ _ ��
, ---
i ---.._..-• ----•-•-----...._----------•-•---•------•----'--------- - - ..._..----•--•-••----• •••- � --- A D 19 � el��_�cQJcch �
....-�---------------------------------------------------------------...--••--------••-•-------•-----•---•---- ,
� � � , � 'ri ic,ord�.i in vol. �J �
I -----------------------•--•-------••--•-_..••--••--•------•-•------•-•-----•_..----.._...._..___._, Grantor, S'' , ;
� and -----STEVEN__�....KIPP..�nd--�I^IE�--K-�--KI��->••hu�b��d--and-----------•-• ,-(_ o�' �u.�� � I
_wife__as..joint__ tenant —�=--� �
.....---- --- - •-- ..�-•-----•--•-••--•--•...__.•-••••-••..............••-..._.._. � Re�7i�ter
� -•-----------------•-•---••---•---� Grantee, '
Witnesseth, That the said Grantor, for a valuable consideration.._._ �
.-------. of__ one__ dollar._a.�d..v.�heX -valu_�1�_7,�_.�o[�s�,dex�.��.fli1--------- '� _- ---_--:---- ---________ .
RETURN TO
conveys to Grantee the following described real estate in .._._._..._Sa�er.____._..__
County, State of Wisconsin: �����. ,
I I=--_-- _
�
/� Taz Parcel No- ---------------------------------- �
I _ ' � �
ii Lots Twenty ( 20) and Twenty-one (21 ) , in Reissner ' s Subdivision,
; �I being a part of and located in the Northeast Quarter of the Northeast
� I Quarter (NE�NE�) of Section Thirty-three (33) , Township Forty-one (41)
' North, Range Nine (9) West . ; i
I �
' � �
II i
; ) This deed is given in fulfillment of the land contract between the parties � �
, recorded March 24 , 1980 in Volume 316 of Records , pages 467-468 , Document i '
No . 173549 .
I i
I, I
, T,��NSF�R
�� '
il ��� ` oa ii
I /D � �
� i
; i ;
� This •.--ls•-n°t••••----•--• homestead property.
(is) (is not)
� Together with all and aingular the hereditaments and appurtenances thereunto belonging;
� rantor
' - - - - - ---------- - - ------ - ----------- - ---- --------------� -------------------------------------
And---------------�- --•- -- -- - -
� warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
I
all easements , exceptions and reservations of record .
and will warrant and defend the same.
i �
� .----Se tember- ---- ----------- �_�_� 83
Dated this -•-••-•-•--•••---•---------------------••--..__ day of ---..._..-�- - p--••- --•-� - - - •--r-._, 19--------•/ ,�
_____
� / /i-.
, ---�-���
. � / � �-- -
.-•-------------�__..----•--•-----•••----•-•-------
---------------- (SEAL) l.! __._. ----%l�'��`�-`'�� ...i!�-tSEAL)
- --•-•----------------•--�- -- ----•-•--••-
TERRANCE M. V IAK
'M M
......................"".._......._........."'.......""""" """"""' . """""" _"""'__"""".... ."" I
.._._ . . ' "
ii' � ' �
----------------••---------------- (SEAL) �:" � Q) -°--•--•---------•------------- (SEAL) I ;
.. - --- ,
' ---------------------------------- ` ---- PIARILYN VRANIAK
-----------------�------......_. - - --- ----- ------ � - --------- ---------------- I !
i
AUTHENTICATION ACKNOWLED (3MENT I
Slgnature(s) --------•-•---------------------------------------••-------• STATE OF �5'ST$&'RRV�`bXD� AI.ASKA i
� as. �
------------•----•-------•--------••---••------••-•--••-------------•----- ----- �1.. .STZv �� reU I I
1�P_---•------------------------��--��'• -T�
� authenticated this ______._day of___________________________ 19______ Personally came before me this �7__'""_day of � �
� ________.�eptemher________________ 19__83__ the above named
--------------•----------------------------------------------•-•------------•--- �
---.Terx�nce-•M-�--Yx�n_�,3k_�md_.xla.x'.i_l.yzt__I.._._---..
`------------------------------------------------------------------------------ ---_rfarilyn .L-_--Vraniak .------------------------------• --��_. i !
TITLE : MEMBER STATE BAR OF WISCONSIN
-----------------•-------------------------------------------------------�-
-----
(If not- -----------------••--------------------------•-------------- � �
----•---------•------•--•--------•-----------------------•--------------------
suthorized by § 706.06, Wis. 5tats.) to me known to be the person5�_______.__ Rho ezecuted the ,
foregoing instrument and acknowledge the same.
j THIS INSTRUMENT WAS DRAFTED BY . �
I
-------•--"'•-------'---- --"-•'-•--•'--------'---------'-"--"•--"'-"-'- �
_.......__Thomas_1�1.._11uf£3'---------------------------------------- -- - - -. � ,
.
------ -----------�- -- -- - -
. _ _
i Hayward , WI . f
.._..
------------ - -
- -------------•--------•---------•------------•-------•-�- - --- - ------•-- -- Notary Public - -1 - ----- -------•---Cou ti�;���,.
- • - - - ----•----- ------ -------- '
(Signatures may be authenticated or acknowledged. Both �2)' C imi sion �s ermanent. (if not, state �,epira�ct� ` \
I � are not necessary.) ,
� i date • o-i�� - -- �
• - -- �- - -- ----- •------ �? '
-- - -- --- -- - —--- - -- _ _ � �
------ - - 9 �5.�
— — -----------�'�' � -- _ _ �
� -.. .. _ - - - _ _ -�- _
� � � ,;,,_ , > ,
•Namce o( persona eigning in any caPacity ehould be typed or print�o�'w t}�i�aig�yture�� \ \ _ . �'
L J J � `
�
i r STATE 13AR OF WISCONSIN � � � '� �
,� ARRANTY DP.'SD �Visconsin I,e�al Ulank � 1nG. _-�
Ff1�1�1f Ar.• 1 __. Iq99 ..rl_. , .J. . lCL .
� DILHR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis.Adm. Code SAWYER �
� STATE SANITARY PERMIT# i
CST 88-026 104212 �
-Attach complete plans(to the county copy only)for the system, on paper not less than STATE PLAN I.D.NUMBE� a`
8'/z x 11 inches in size.
-See reverse side for instructions for completing this application. ��� `�% '
PETITION
I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR va,RiAtvcE ❑YE:� ❑ No
PR E TY OWNER PROPERTY LOCATION
� '/a '/a, S T / , N, R C�('or) W
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME
l; 3` C 1. C I
CITY,ST TE ZIP CODE PHONE NUMBER ❑ CITY : NEAREST ROAD,LAKE OR LANDMARK
O ILLAGE :
� 0
II. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify):
III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4, if applicable)
1. a. ❑ New b�Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit# Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2)
1. a. �Conventional b. ❑ Alternative c. ❑ Experimental
2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. See a e Bed b. ❑See a e Trench c. ❑ See a e Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet):
V� U .' Feet �rivate ❑Joint ❑ Public
VI. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel 91ass Plastic APP
Tanks Tanks structed
Se tic Tank or Holdin Tank 0 � � � e tl'' ❑ ❑ ❑ ❑
Lift Pum Tank/Si hon Chamber ❑ ❑ ❑
VII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans.
Plumber's Name(Print): Plu er's Signature:(No Stamps) PRSW No.: Business Phone Number:
�c �� ��'� �• o /� - �"a
Plumber's Address(Street,City,State,Zip Code): Name of Desi ner:
� `�� .r- , � ��� �
VIII. SfJIL TE INFORMATION
Certified Soil Tester(CST)Name � CST# ����
P
CS 's ADDR S(Stree, ity,Stat ,Zip Code) Phone Number:
� � �
IX. COUNTY/DEPARTMEN USE ONLY
� Disapproved Sanitary Permit Fee Ground�.vater Date Iss Agent Signature(No Stamps)
�Approved ❑ Owner Given Initial Surcharge Fee
Adverse Determination $9� . �� $2 5 . 0 0 4-2 2-$$
X. COAAMENTS/REASONS FOR DISAPPROVAL:
SBD-6398(formeriy Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY& BUIL.DINGS
LABOR & HUMAN RELATIONS pRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON,WI 53707 -
�CONVENTIONAL ❑ALTERNATIVE s,a�ePia�i.o.N�m�e�.
111 assi9nedl
❑Holding Tank ❑ In-Ground Pressure ❑Mound
NAME OF PEfiM1T HOIDER: � ADDRESS OF PERMIT HOLDEF�. INSPECTION[)ATE-.
e Y � -a�-
BENCH MAfiK(Permanent reterencevoim)DESCRIBE IF UIFFERENT FROM PLAN PEF.PT.ELEV.: CST HEF.PT.E�EV.
Co o�.ra. e s(o�.b I oo `
Namr 1 Plumber�. MPHSW N�i.. Cni���iy Sanitary Perm�i Number:
o� SP�.�ckE�s 33 S�w �r�tz. 88-�0� te
SEPTIC TANK/HOLDIAIG TANK:
MANUFACTURER�. LIOUID CAPACITV TANK INLET ELEV. TANK OUTLET ELEV WARNING LABEL LOCKING COVER
PROVIDED PROVIDED�.
. NvF�evTT f �-O D y�. �oa� �f q • I ❑YES [�rvo ❑YES ❑rvo
BEDDING�. VENTDIA.� vEN7Mntl HIc;HWniEH NUMBEROF ROAD�. PHOPEFiTV t WELI. I BUILUINC�. AER NL07HESH
'� �' ALl�IiM � LINE
❑YES ❑NO FEET FROM �O � / �
C � ��YES ❑NO NEAREST �O >�d > l�
DOSING CHAMBER:
MANUFACTURER BEDUING L1011ll)(;�1'!�(;11v Vt1M�'Mfil)E l �'11h1P SIVI�f)N Ml�NUV n(;flifVEf� WARNING Ll�B[L LOCKING COVER
PROVIDED PROVIDEO�.
❑YES ❑NO ❑YES ��NO ❑YES ❑NO
GALLONS PER CYCLE: Punnaallocorvrao�soreaarior�n� NUMBER OF ''"�'PF"r` wF�� E+ui�owc. IvervTroFaesH
(DIFFERENCE BETWEEN FEET FROM ��NE Q�R iN�ET
PUMP ON AND OFF) �JYES ❑NO NEAREST—�
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing i F N����� �,�nn,f iF�� nia1�Hin. nn,u rsnNKirv<,
or excavation. (lf soil can be rolled into a wire,construction shall cease until FORCE
the soil is dry enough to continue.)
MAIN
CONVENTIONALSYSTEM:
6VIDTN LEN<;T11 f Nt� ()F I)IS1�� ��V[ tiVnt;IN�� �:�JVE�� INStI)E I)Ir1 =PIiS LI�U�D
BED/TRENCH ��� �� rvE�uc�+Fs � � �+n�r+in�� PIT � oearH�
DIMENSIONS �� J
GRAVEL OEPTH FILI DEPTH UlSiii �'IPf UIS7H PIPE OISTR FIPF MATEHIAL N(1 Ui51H ,NUMBER OF� PNOPERTv WELI. BUILDING VENT TO FRESH
oe�ow PiaEs �t neove cr�veF� e�Ev �rai i i E�Ev E vu ��ivE s FEET FROM urve ► t Q�� nia iN�er �
8 " �S.S —/S•�_�____� Y C O N E A R E ST—� I �v� C.)l) �' O
MOUND SYSTEM:
Mound site plowed perpendicular to slope �heck the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO
SOILCOVER rexruRe �ii+n�nNrNia+nrsKEi+s uiistr�v.�n���v�vr��s
��YES ❑NO �—�YES ❑NO
UFPi11()VFH TIiEN(:11 fiEfJ I)EVifl()Vf fl Illf Nl:�l 111 I) I�!I'fll�)V I()1'ti(Ill---'— :til�llf I� �f E!)f I)— "---' MUL(:HCU
CF�JTEN �U(;ES
L_�YES C�NO C�YES C_�NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
w��ni �ervcT�+ rvo-oa �nreNn�svnurvc cHnvF i_uEv�u�tae i�>w��iNi Fiu oern�nHovE covEF�
BED/TRENCH rReNcr+es
DIMENSIONS
MANIFOLD PUM1�P MANIF()LI) DISTR FIPE MANIFnL()MAiE171AL N(l f)IST1� UISTH PIFE UISTf718U7InN PIPE MATEHIAL&h7ARKiNG
ELEV. ELEv f)IA ELEV �'iPES D�A.
ELEVATION AND
DISTRIBUTION
INFORMATION "o�e sizE No�E sPnaN<�, u�.i��Eu cr�ru�tci�v c��vF���nnnrEHini vearicn� �n r cokFiesaorvos ro aPaaoveo
vLnniS
L�YES L�NO L_�YES ❑NO
COMMENTS: PERMANENT MAHKEf75 ()FiS�HVATInN Wf.l L;> NUMBER OF P�;��NEi2TV WELL BUILDING.
FEET FROM ��"F
I L�YES ❑NO ❑YES L�NO _ NEAREST _
S�E P ����E�s � �oT P ���
�-t�lST/�1,1.6� /�S �R.I�.t�Jt�l.
Sketch System on Retain in county file for audit.
Reverse Side.
si ruraF — Tir�r ,
DILHR SBD 6710 (R.01/82)
�
�
I
,
(� �3 I�� t�m ��-�-e_ �� � � � p�
�` ���5 cLQ�r� Q � c;ssy1e4-s ����c�. s��C. 3� '7-�-J����4�
" ���y,1 � ��-� �,e n �t � /� - �S' ,�r Q�!c�� �f1�)Z s c.�,► 33-s"d
�y s'7��'3'+� ��e U� � ?R�" �
N
�'a�a 9 ar_
�t
ti
c�1�i�
�: .�� � ��� � �
��� �l� � �'� I� ?; vt �/T
� �
� c,�' �,
� 1 � ` � 5 ' ���
i �
�� � �' � �
L S
( � ` �c
,� ��. \ p �rG,f
'_ �' � ,�,�y C
; �_ � �.. �-►
��
�'� �� I (
i� �s� I �
,�� � I 6 9� ��-
;'� . I � ��
. I I ��
' ►
` �� T �.
; .�
I �c�a� —j��'—
�