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HomeMy WebLinkAbout010-841-19-3305-LUP-1992-436 Application for Land Use Permit � County of Sawyer o The undersigned hereby makes application for a Land Use Periait and � � agrees that a11 work sha11 be done in complia^.ce with the require- o ments of the Sawyer County Zoning Ordinance and the laws and regu- M lations of the State of Wisconsin. � , YRINT - US� BLACR INK OR PENCIL � C-�-1��L �. � , , � � \ ��cpl�ert.1' �l�dc� S+a,�,er ��o�' Owner I�uilder ` �'+ I ;3�x �v83A :_ � �;ax � - ,�39 Mailing Address Mailing l�ddress HC�:/_4�11�.) .,,/ .. �t_'� _,: '.0 , -Y'� �,? City, State, 'Lip City, State, Zip Building Land Use Zone District �� —I � � (� New ( ) Filling � ( ) Additior. ( ) Dredging Lot size c� H ( ) Alteraticn ( ) Grading ( ) Moving On ( ) Acres � �j� �l ( ) ( ) -a-- ,) New Construction v` �J Size �(, ft wide __ ft wide � a� ft long ___ ft long Floor area �c2� sq ft __ sq ft i � �. Tota1 htg _ 3� to peak ___ to peak � � Stories / __ Stories � , - I '� No. of Tsedrooms �-'� rear 1ot line or waterline I o L (year round) or (seasonal) 2¢-`� `' Grt Type of B1dg or Addition , a o ( ) Dwelling � rt (� Garage �i �L car r• I ( ) Storage Building !� �L� �, I ( ) Boathouse -' I � ( ) Livingroom ;„�'` '� � ( ) Bedroom y � ,„ ; p (/1 ( ) Kitchen-Dining ���k ' - � ( ) Porch - enclosed/roofed „ � � ��_ "' �,.ko� � � 0 ( ) Deck - o en �f ' � c � p - ' �,�n� �,� w' _:� ' 93 � � �� , ��w� N � ( ) � — ' �� ��, -__L ..--- � Type of Construction ' " �� (Vj Frame ( ) Block � � � 1-- � r�" ( ) Log ( ) Concrete ( ) Pole ( ) Steel �' � ( ) Metal ( ) � � C n � � �n Construction Cost $ �;��� �U Vol -� Pg of deed '��\ \ i ' CS Vo1 � Pg t w � : f � Cer. Soil Test - ',� ° �I � _C_ Sanitary Permit -j�- -fC� ----------CL Road --------------- z 0 �-r�-, �—� . z -- " -- � � Issued Z`1 �u2P�'�C�. ��QZ Denied _ ,— Ul ����Q�,�, ,���—�w-�.e ���ti � �� Owner Zo�iing Administ ato " • I '. 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LOT EVIDENCE OF OWNERSHIP OR BOUNDARY LOCATIONS . �cf++m°016cv 1 - - Sow�yvr County y' 7-f � " krceived (or recotd��""" �� � � ��._A D 1Q 7y R/0•/Spr�ak � � h: ond �b�� °�_� �,�K �,�3y� ReQfeter N N 'n t N. 1° 50' 30"W. �----_i -� � � i oz3.8o' . � Lo c�s � � ' � N. 1`34' �"µi. 256.g5� � ��o6.oro• 190.80' � � � �9• � O O � � �, m d O � - �� N mz n tn cn m in # o m � � D SW � — .F o � -o o r w N � D ro rT� Z m � • vi .. � O Z � — ti p � Ri � ' � y �o � �l U y � ° D O -� v u� s, r, r o -� a�e 6. 05' oi l 4.54� r� � -n m r� m I ��5��' .�� � —i s � -i . � O N � � N � "� � N Ui p � y O \ ,,,., ..,`: . v � ,,�. n,�D`� �9 (0 c,'��..s.:' •.._ ��-. o � Oe � � " •� • % s ti �' � o � � ' S'���o i "r= (n 9 )v = :�i I F-_�m . �:_ I ^ C in,-'� f'7 66. 05' i s, ' < m�py . O` .. � B�cN. 1° 34'W. 2z3.03' 0� v � -i;o�Qy t���J� e � � � . S`' �q ''����hpu���P°�,�o, W �� � a$ O � � � ?� s y � — � v —_ , N N e r � � I � R r I �� \ � � a � �, o0 ti y s� � • 's. S 1' 33' E zO � Z — 9 ' tA N C 5 0� 5 O' 3 m ' v • Page i of 2 pages c���a s„rv�r rra l� �9 � ys � �-� - , � � �� � State and County State Permit # 13989 � P LB 6 ? � PermitA lication County Permit # 9 - 269 � PP co��c Sawyer ` for Private Domestic Sewa e S stems Y 9 Y "DENOTES STATE APPROVAL REQUIRED CST 9 - 207 Date Approval Received from State if Required State Plan I .D. # A. OWNER OF PROPERTY Mailiny Address: �/�"f�-N L . � ONN.ES EgD,�'S8 � f�•�i YGt/.�.e,A, �tI/.S• 55�8 �3 B. LOCATION: Sj�,LY4 S,^/ Y4 , Section f� , T� N, R �,p� (or W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village �/. �D /��t • .�► �S � 3f�'��i Township � C. TYPE OF OCCUPANCY: "Commercial " Industrial 'Other (specify) "Variance Single family �_ Duplex No. of Bedrooms Z No. of Persons 3► �• SEPTIC TANK CAPACITY �DD Total gallons No. of tanks �_ HOLDING TANK CAPACITY Total gallons No. of tar�ks Prefab concrete � Poured-in-Place Steel Fiberglass Other (specify) New Installation �C 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 sq. ft. New � Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:_,�.,.—Length �S � Width �� � Depth " Tile depth (top)����No. of Lines �` Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land � � Distance from critical slope 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 fiave sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, �j NAME �,�/�//1//S /�•S7SMU.SS��✓ C.S.T. # SS- �3 � and other mformation obtained from /�.�i✓�Y G (owner/buitder►. Plumber 's Signature Mp�����c# 3 938 Phone #G 3� � 7•�� Plumber's Address PLAN VIEW: 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 the property or neighbors property. If well has not been drilled please indicate. . . . � � , � 9, j � � .. . ..:r.-.�.�.y...�«� . . .._..... ` 'F�'/VCE L/NF ' ; �__ ; ; �._... � i ; � � ' � � . _r--��_��._.._ ._. .._._._ __�- __. . "..__ . .. . . �._ , _ _ � , : ' { � d ;m.... ... _..___�w .. > _.�.. . _ _._� _ ��.__ _ ���., .__w{� �_.._.. i �.�..__� . _.._ . _ ' . 9 t i I � 1 i � � � i �__._�_ _ .,d .__ . '_. __ ? ._._ �---�...' 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I ! � � � .,._.__,�;,.__.._.,�..._._..,.�._....a... . . . . ._._., � � �._. .... � �,.. �,.>_. .. _�_. »,..,...r_ Q_,.....» �. h...__.._.„q�_,� »......j e...�._ '. . .,,�._..� . ..... .. 1 � � � ; � � � ' i ` � � i � : g i � :, i { ( ( � : i � ` � �_._ _{�}...�.�..�.._.._ . . .�.� ._.,.;_ ` _ _ h- _ � > _ .�....K. e � _ ._�._�. � 3_.._._,.,.p.. �- ( ... . � t , 1 i � � � ' � ' � ; � � ( i � ; � � � � { � • � � , ,.._..� .. ,_r..._..�.._,.�.. .�.}—._� -d- q-.. .i. ..� ,}_ ..-.. . .._ �„_.-,�_..__y�_. __ � .__!___i_"'__ ' � 3 = � ; ! _ _ i �' ; � � ; ��_ �___w-_-�___ � � . .._ _ a. _��__. ; _� ` � � - , � � � - - .. . ____�---j— _._._ _. _ __,. ` __.____.. , �� ' � � � � � � � , � � , ._-- �- --- - _ ._ � � _ _ _ __�_{_.._._�. �� � � �� , � � _. _ , _ , i�.�6y 7aN��V � e _ __ _ ;_—_T__ _ _._.. 1 � � . . . - - . � � � - � Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 12 - 11 - 7 9 Fees Paid: State 15 . 0 0 County 15 . 0 0 Date 11 De c emb er 1.9 7 9 Permit Issued/F��a3�CdC (date) 12 - 11 - 79 Issuing Agent Name Elaine Ne�rling Inspection Yes�.No State Valid# Date Rec'd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2 �tate (pink COpV) 4. olumher (canary cnnvl , ��� Department of Zonin� and Sanitation Sawyer County � � Inspection Report � 1er Jean E. Tronnes � dress P•0. Pox 58 Hayward, WI 54843 w � me of business rn ilder '� � 0 idress � � m � Lumber Andry Rasmussen 3dre�s p,0. Box 66 _ Cable. W�54R21 Inspectior r y �) Private O Public Property }( Sanitary-instal h � X Dwelling ;�etback - lalce � Violat9_on Mobile Hm Setback road °, Gara�e Setback-lot li_ne �' ) Sanitary ( ) Zoning privy -- ---- - � � � r� w n' �s a �or j.INB — — — — — — — — '�— — --- — — 8' V�Nr �ANPY So�L W 35' � cn ao��.�. � � i 9'�.;. � t ---� �0 7a �-i� 4 sjr �a' s�oP� lu�l.� u�r iu i.oa � �, cntt�,v goo � oweuiu� Couc FI� � G a rn a �o � � m N p co � H S � a Y 5TN '�77'� Discussed with owner yes no � Discussed with Builder yes no Discussed with plumber X yes no o� D_scussed with yes no Date ��D.��._ '7 9 ignature of Officer __����'��----- -- �