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HomeMy WebLinkAbout012-739-01-1101-LUP-1992-422 d,� D+��.�. 8��. Q�so�.-� - 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 requirements of the Sawyer County o Zoning Ordinance and the laws and regulations of the State of Wisconsin. � � J�A►�t n[� L, � ��::,/��,�-.� ;,,4} PRINT - USE BLACK INK OR PENCIL � t� ����..t=� � �� , _, D I �t�t�,�, �. ,c �,c���� �� ..�1,C� , �<— ��� / wner Builder � �� Ma'�ng Address Mai�g Address � � r �.�✓��%Q,��/� ���6�� Ci , State , Zip City, State, Zip Bui ding Land Use Zone District �� -.� o � (l�New ( ) Filling � � ( ) Addition ( ) Dredging Lot size � � ( ) Alteration ( ) Grading ( ) Moving On ( ) Acres /'� � � c ) c ) � New Construction r�"`-�� Size � ft wide ' wide � ' wide ��5 � f t long ' long �'i-,� ' long �n �V Floor area � C�i sq ft sq ft )�_ sq ft � t� . Total hgt %� � to peak ' hgt =�,.� ' hgt :��` �' �i ,,.,,�R P��t�� Stories � No. of Bedrooms �_ rear lot line or waterline o C f�e��or (seasonal) G �* Typ of Bldg , Addition, Use � r a o ( Dwe 11 ing - �`�ti��`-�t-- �' '�'� ( ) Garage (1) (2) car �. N• ( ) Storage Building "`�,�3�-��, o ( ) Boathouse � ( ) Livingroom ���'..� ,� ,` � .._- �..'.�� ( ) Bedroom �"`` ( ) Kitchen-Dining � ( ) Porch (enclosed) (roofed) � �� (�Deck - open ( ) Fw ( ) � Typ of Construction � (�Frame ( ) Block ( ) Log ( ) Concrete ' F�r ( ) Pole ( ) Steel \ ( ) ( ) Pole/Metal � � � Construction Cost $/�•� Vol .�.�.. (,� Pg � of Deed CS Vol Pg � ro Cer. Soil Test 2 --� � � m Sanitary Permit C" `<"'_ "�' ��i C ~ �• ---------- L road -------------- z �Low A��. ��p � z Issued �j �2 Denied � 4 _.. � � � � �� �L r� ���� � Owner Zoning Adminis rat r � � �� �� r � � �'� � o\\ � ��� � , �� � � �, � � � � ' � �� a � . � .N�� 'Z�' � \ �1 I i N �� � � — � '� I '�� � � o� z ° � � � � . � �v� �+ i , ` � � i � i 6 I ; �� o� � I � � . I ,� � i. � � � ° � `� , � � � � ; �� i �,� ��� � �� I � I , � ! i "�""' �OR ASSESSMENT USE ONLY T � �� �� O � � � � � � � NOT 1NTENDED TO SHOW CON- CLUSiYE EViDENCE Of OWN�- � SHtt OR BOUNDARY LOC/4� � �. C - I TV�JP 39 N - R _ 7 w TIONS. ;__� � _ ____------...__ _� ---------��___....�._...�_�_�_..____�� - � 3 6 � %! � ;i'�'�� �� f� � ����� �� _ � Oi�. EG ;� �/� � � �� ��r � � /—✓`— t_�_� � i r^ _ ^ � ,� . . �!�'—i-� '� 1` b �` '//�.—.-�\ / : , , . �____ � L A E ;35 . � ; -�-_- --_-� � x. . / /� ,;�/�/ .-=�_-�� � �n.%1 /� �/� � ��� ; ' �` � ,3� ` I �' - _ --=" -===�__�- �� i� - _ � � F ,��� ��1�� � � �. � -- i �' ���-� -- - - - � _ ._ ��,��` - '^ � _ � � _;-; �\�/� � �, ��- � _' _" - � —_ ,— __ _����� �� � � � �`. .'��j I j � �_ � (-� �• `' � ; � - - - --- � ^ ' � - �l� ; .� ' , ; / I , _- '__ �,_ i � � i- -� ' . � ��-'i�'•' �._ � ��. � . � � . i' � . �� �� �� - , '�� G� -. - �� � ��� I I i � , .. �� .�,J. �, ,\ � . . - � �/. ,� t \ � i i ' / / . : �,-/'J . - \ \� � �- -���--=��- __- -�'� '� � ` \ � � �� __ i%�" . 1 E-� '�j '� �,;�` �- �� �-r-=✓ :--' �..� r'� .._ . � ' • �_ �i..=------'"� �� - �/�. . - � �-_i � �•� `�`=� � � � � � \\ � " . 39 t G , , , ,_ , ' . _ i � �� _ .J -� .. _ � : ,.� E !� � - � w , : � 2 :--�.,.; � ` „ ,... 1 � �� ` I � � � ; � . . ` v < <I f -� � 1 J . ; i � ;� i � � .4a � .39 , 3 J .3� .39 39 V J 7./� ' g•' 3 .1 � -�2 -� �J . 3� � 4.5� � . � ,�o�� �� snwlLl� couv�Y zoNiNc n»rnN�is�ri�rzor� �� INSP�CTION RI�PORT ��' n I m �4h Oa-c- �cSorT r'f OWRC'.T � �a �n % ��qh�� S�� I�C.�T _ IO . Address (-�-�e ei t.�warcl l.�( SYflY3 7 , Name of business �4„� �4�. {�.Qso��- - Builder Address p� Agent/Purchaser � Address _ � 0 F Inspec�ion ( ) Proper�y ( ) Setbacic - lake �` ( ) llwelling ( ) Setback - road (� Yrivate O Public O Mobile Hm O Setback - lot line o y ( ) Gara�e (� yV�„�K� So;(s �evi�. � � Violation ( ) Addition ( ) � � o ( ) Zoning ( ) Sanitary M' � l .c T' � �� ��4 \N "s' a �� F rA a° �'� \ F r zxo � �� _{� _�S_ /� \ c, � �s v� r �. o 3 ��� .. rt �^ 3 F� I�—''oo I i �� r 8 � �,- -_'�-- cn o G rt L � 0' a ��' , b a � �y���— 3p-� 1 � OaK I, �, , a� o �b . j R�Ir�o��� � �a I`�°� M �- �t � �`° �� I N I _—� I16 eg r\" 3S �_ ` -'30 �30� � � � �a o� � o-�z s 1 S�d t�o�.ti d � pocl4�s o� I-to�' II � 4L�_4g.. . '�{Ti.� L6.Y'G.4 4V4.(�ty�P S3-bo�, sl fnP ,� �O� �C �da� '�- � gZ �-b6" mof@�i ro y s�l w n e _ �� n W Bs o-6D� do», n.�-{�@3i•:3 � (�ecl�c� ScI�iD�(G�� Mo�" _. Z Discussed with o�aner'�'; 'lder , - ;d Discussed with ; c-�� � s`� t�3 c -_ '_� �) `�� `;� � Date �- l�l-4 2 ����- }-'� L'S � ?T4f Signature of officer -F-F=yi_�-`. � s" ' •, -� SANITARY PERMIT APPLICATION � N �DILHR ���Nn � In accord with ILHR 83.05, Wis. Adm. Code � '�'�,..o,•,..,.^.�..� S a e r ' °° C S T 9 2 - 2 61 STATE SANITARY PERMIT# � -Attach complete plans (to the county copy only) for the system, on paper not less than 17 9882 834 x 11 inches in size. ❑ Check if revision to previous application �ee reverse side for instructions for completing this application. sra,TE P�AN i.�. NUMSER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S 9 2 - 2 O 7 7 6 PROPERTY OWNER ��d rj PROPERTY LOCATION j � /a a, S T , N, R E (o� PRO TY OWN 'S MAILING ADDRESS LOT# BLOCK # CI , TATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER � II. TYP OF BUILDING: (Check one CITY � NEAREST ROAD y � State Owned O VILLAGE � U� � `� � �D � � Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms — PARCE�TAx Nu BER(S) III. BUILDING USE: (If building type is public, check all that apply) 012 - 7 3 9 - O 1 - 1101 1 ❑ ApUCondo 2 ❑ Assembiy Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11� R�UBar/Diw�ng 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 � Other: Specify � � �TTif�Ges IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. �teplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued � V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 �Mound 30 ❑ Specify Type 41 ❑ Holding Tank: 12 ❑ Seepage Trench 22 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE /� . REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 6 D U � - -- �� . � Feet �Feet CAPACfTY VII. TANK in allons Total Site INFORMATION # of Manufacturer's Name Prefab. Con- Steel Fiber- p�astic Exper. New xistin Gallons Tanks Concrete structed glass App. Tanks Tanks Se tic Tank or Holdin Tank �� a /�Lt� Lift Pum TanWSi hon Chamber 60 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu ber's Name (Print): Plum Signature: (No St hips MP/ o.: Business Phone Number: � t�t�l� /�' 7� Plumber's Addre treet, Ciry, State, Zip Cod . � Z .J IX. COUNTY DEPART ENT USE ONLY ❑ Dlsapproved Sanitary Permit Fee (inciudes Groundwater a e ssue Issuing Agent Signatur (No Stamps) � Approved Surcharge Fee) . ❑ Owner Given Initial $ 2� 5 . 0 � -2 7 - 9 2 Adverse Determination � X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety& Buildings Division, Owner, Plumber W �I . � �I � �I � � �' CHIPPEjrA FLOWAGE � Dan-Bar Resort �� (high �ater mark is approximate) � Dan Seibert, owner o ' (distance to tanks is 50'--70' ) iJWl/4 El/4 Sec.l T39N R�i Town of Hunter -�'� ��--'� Sawyer County `�J � CS'� NORTH *Scale: 1•=40' , unless other- wise noted. � *The existing failing sewer Private interceptor sewer to ,�� �aill be pumped and removed septic tanks is ex�_stin . and the neta tanks installed Bar � Rest. in the same spot. 2BR 2BR 2BR � � a� � 19 Bar Stools CAB. CAB. CAB. y 1250 g• 8 Rest. Seats "All tanks by Skaw Precast. 1000 g• 1 Emp10.+ee =Soil Boring �10' � �OGO g. / � =B.M.(nail in oak tree,l2") ' ell (above grade; tree isj (10' from edge of blacl toP) � 2" F.M. o �75' O �i U P � r - ----- -- --- -- ----I `� � `� RIVEwAY � This area to remain � � � � =o Z D � UNDISTURBED. i Y � 7 ,es a � a z.5%SL. ' o O O '� N � � s w ga Q � �] ~ >o V 15 0 Q � �.�+ � 'yo Wu j 1a Q � Z w N � , U Q �o d • _ a � � — — — -- — — � CJ'L" o�F�owage Road � � _,.�_ � _.__ -'nr-,i ----..___� ,