HomeMy WebLinkAbout014-942-21-3113-LUP-1992-022 /
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. 1
PRINT - USE BLACK INK OR PENCIL
'T'�.�p`MA9 R. lsND m
C�a�.�N� �. ��N � c��ti.t:-c__ z
Owner Builder �
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Mailing Address Mailing Address
Ha��WaRp , �, sua�3 - �
City, State, Zip City, State, Zip
Building Land Use Zone District RR-1 0 0
(f�) New C�r:-�-�� ( ) Filling � a
(Yj Addition O Dredging Lot size �5�,7�5'�"� � n
( ) Alteration ( ) Grading `� �
( ) Moving On ( ) Acres ',�;'7 cu' .
( ) ( ) - �
.trv,..-,�, .��
New Construction ,QJvlTi��n/ (�!�!�� N
�,��_��` r� „` i U! l0
- . �. f:,�:;
Size ��- ft wide �� ft wide /g �^^
,?_�'i ft long i� ft long �y 1�
Floor area �"7C�� sq ft ���� sq ft 'S�� m
m
Total htg /�� to peak j/' to peak �' '� Q
/ �
Stories / � Stories ,
2
No. of Bedrooms r��--;��� or watrerline o
ear rou or (seasonal) - c��� "� -� WnTc� �, rt
Type of B1dg or Addition �� �s,, cr r
( ) Dwelling 5' �o� : °; ,°Y
(�-) Garage (�jG) (2) car �, r ^ �
O Storage Building � '� v`� m�
( ) Boathouse ~'
0
(`�"Livingroom i`=. ;Tc«.� y a,1v- p�
( ) Bedroom � ��)
( ) Kitchen-Dinin � '•"��` � '
'• /
(+7 Porch - enclose roofed� Y�� � �� � �
C..__._..._ , , j I � ,�i
( i Deck - open ,
'/ �o cY'
f�-:�r,.t�:�-�� ��� ;I �
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I N (�.
Type of Construction ; '� �
(b) Frame ( ) B1ock � r�,
( ) Log ( ) Concrete
( ) Pole ( ) Steel �^' �,
(� ) Meta1 ( ) � �
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Construction Cost $ ;_ - �,.,, ��k��
3 S��u,���.na
Vol 463 Pg 361 of deed Also see 1 ;1
Inspection Repor I
CS Vol �_ Pg �/N� ,b �
Cer. Soil Test 9" I- U�D '' � �
Sanitary Permit ` �1—C>>`�� � -----CL Road - ~
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Issued 03 March 1992 Denied `O
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OL ,� � ��� � � -`sr—
�UN k- I�— �`�J�-1 I
omas R. Olson � Owner Zoning Administr�to
SAWYER COUNTY ZONING ADP•?ID;ISTRATIOV ,�
INSPECTION REPORT o
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Owner Corrine E. and Thomas R. Olson t�''
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Address Route 3 Box 3110E Hayward Wisconsin 54843 z
Name of busiiiess �
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Builder �
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Address �
Agent/Purchaser
Address.
I�_ispec�tion O Proper�ty O Setback - lalce �
( .� Dwelling ( ) Setbacic - road
( � .�rivate ( ) Public ( ) Mobile Hm ( ) Setback - lot line o ,�
( ) Garage ( � c.K�,� S<-�-b4cLs � °
\'iol�`iou ( � Addition ( ) � �
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( ) Zonir.�; ( ) Sanitary '-''
V 463 P 361 & CS V 9 Pg 428 . 3 . 67 ac . RR-1 . _ W r,
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Date. -----�- 2fc - RZ _ `°
SignaturE+ c,f �,*Fi�_cr �_,��-�..,�.�, /�ss-� S4._n��..=�,cj �
TOWN OF LENROOT
SEC. 21 TWP. 42 N. R. 9 W.
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O �RON P/PE /N PLACE �ENTER CoRNER oF
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Regist�s OfficE q - p o° /o�g 62•
Sax�ye: County }� $ N �''g . �a.B.
Aeceive� 'or record tne �� Bay oF ' po.
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ac rzcordec in vol.� 17 (% Q �
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Z , robert R. Swanson, ��isconsin Registered Land Surveyor,
do hereb;� certify under the provisions of Chapter 236 . 34 of the
VJisconsin Statutes , and under the direcztion oi �srent rriendshuh
and Johr '�iillard , owners of said land , I have surveyed , divided
and mapped the land herein described , and that said land lies in
the northeast one-quarter of tne southwest one-quarter (N.E.4 of
S .'r� .4 ) of Section twenty-one ( 21 ) , To�vnship forty-tv:o (42) North,
Range nine (9) �`+est , Tov;n of Lenroot , Sawyer County, Wisconsin
describec 2s follows:
Commer.cing at the center corner oi Section 21 -42-9: thence
South 2°05 ' �:ast along the east line of the forty $84. 10 feet to
an iron pipe vrhich is the point-of-beginning;
Tnence South 2°06 ' East 743. 16 feet to an iron pipe which is
the southeast corner of the forty;
The�ce South 87°26 ' l^Jest along the south line o� the forty
260. 00 feet to an iron pipe on tne meander line of ilelson Lake; j
�hence IVorth 49°40 ' �'dest along the meander line of nelson ✓
Lake 233. 0o ieet to an iron rebar;
Thence iVorth �5°88 ' 'u9est along the meander lir.e of Nelson
Lake 223. 90 feet to an iron rebar;
Tner.ce ivorth 2�°54' East 726. 32 feet to an i:on rebar; /
�'nence South 72°06 ' East 304. 62 feet to tne iron pipe �vhich �
is the pcir_�-of-beginnin;.
Saic Lots are to include 211 the land between the meander
line and the w�ter � s edge between the Lot lines estended.
Saic i,ots are subject to the joint use of the 50 foot private �
road - �'r.e centerline of wnich is sho�,n on the map. i
Saic Lots are subject to easements and reser�•ations of record . I
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�' �ILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05,Wis. Adm. Code couNry SAWYER �
e � -� CST H9—OLO STATESANITARYPERMIT}/ p
-Attach complete plans (to the county copy only)for the system,on paper not less than 123946 a - `"
8��i X 11 illChes Ifl SiZe. ❑ Check It revision to previous epplication �
�80 fBV81SB SIdB fOf If15tfUCtIOf15}Of COffIPl0tlf19 thlS BPPIICBIlOf1. STATE PLAN I.D.NUMBER
I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION.
PROPERN OWNER PROPERTV LOCATION
Z . '/<S '/<, S . T � N, R � (or 7
PROPERN OWNER'S MAILING ADDRESS LOT/� BLOCK$
��'7 �/ � C T �
CIN,STATE. ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
CIN � NEAfiEST ROAD
11. TYPE OF BUILDING: (Check one) State Owned ❑ VILLAGE �� T �r� . � Q
❑ Public 1or2Fam. Dwelling-#ofbedrooms� PARCELTAXNUMBER(S) `
III. BUILDING USE: (If building type is public,check all that apply) 014—94 2—21-3101
1 ❑ ApUCondo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify —
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. I�New 2. ❑ Repiacement 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 ❑ SpecifyType 41 ❑ Holding Tank
12 SeepageTrench 22 ❑ In-Ground 42 ❑ PitPrivy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill �
VI. ABSORPTION SYSTEM INFORMATION:
1.GALLONS PER DAY 2.ABSOFP.AREA 3.ABS�J fiP`AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REOUIRED(sq.ft.) PR /P-6SED(sq.tt.) (Gals/d^aylsq.tt.) (Min./inch) ELEVATION
U�� /v i Feet .�Feet
CAPACITY
VII. TANK #of Prefab. Site Fiber- Exper.
in allons Tota - Manufacturer's Name Con- Steel Plastic
INFORMATION New xistin Gallons Tanks oncrete glass App.
Tanks Tanks structed
Se ticTankorHoldin Tank .S �
LittPum Tank/Si honChamber
VIII. RESPONSIBILITYSTATEMENT
I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/MPASW No.: Businass P�one Number:
i
� � � r�sen � � ���� ��� � 'l'�� �'i:%�,� � : _�
PlumDer's dtlress(Street,City,Sta[e,ZipCode): �
';� . L��r � ' . �lt . _ �' .
IX. COUNTY/DEPARTME T USE ONLY
❑ Disapproved Sanitary Permit Fee Oncluaes Grouneweter a e ssue Is ing Agent Signeture(No Stemps)
�Approved ❑ OwnerGivenlnitial SurcnerpeFee)
AdverseDe�ermination �115 . �� 6-9-89
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(brmerty Plb�7�(R. 11/88) DISTRIBUTION: Original to Counry,One Copy To:Salety d 9uiltlings Division,Owner,Plumber
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