The URL can be used to link to this page

Home My WebLink About002-939-04-2303-LUP-1992-036 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 sha11 be done in compliance with the require- o � ments of the Sawyer County Zoning Ordinance and the laws and regu- M lations of the State of Wisconsin. PRINT - USE BLACK INK OR PENCIL � ' Fa D/f ►/ i'v D. /�No ��l j L ;,,� s, %/�s t�,fL�-,� _ %�; �� ,. Owner Builder � r �� -�� - �o �� X / �� Mailing Address Mailing Address ',� �/,a �� r � I,u.�' � 6 �/ ' ��` -;� .5-�-, x � it�e Zip City, State, Zip � r o � Building Land Use Zone District t�- � o E (�7 New ( ) Filling rt � O Addition O Dredging Lot size 3�`-��'>� x SLo�� N � ( ) Alteration ( ) Grading ,.. ( ) Moving On ( ) Acres - � ? ( ) ( ) � _, A�-� �,` New Construction � -i 1l-E�C�z ' �, Size ,j.: ft wide l� � ,� ft wide �rl ft long �� ft long Floor area sq ft (dl(p sq ft � rn � Tota1 htg / ;. to peak �� to peak x �� Stories j r ' Stories _�Z No. of Bedrooms � raar lnt lina �c_�atar-7-Tnr G� (year round) „o.r�4soese�aa-1) S� 1� � ..._._ C/1 rt Type of Bldg or Addition r• /, a o (� Dwe 11 ing k � r• ,� (r) Garage (1) (2) car 'r� < (�j Storage Building � m� l ( ) Boathouse � �' 0 ( ) Livingroom � ( ) Bedroom ' � o � ( ) Kitchen-Dining '� 3c �'�� ( ) Porch - enclosed/roofed � �1"� ( ) Deck - open , :r�*,� a. , �70=> ( ) F� 6�i, -. r� � �_ ,�'• '�� - � � - ��.i c7 ' � Type of Construction j� rj (�3 Frame O Block 1 '/b �';"� F--I 7 ��.��' �" r�. ( ) Log ( ) Concrete � (v) Po1e�� s�n O Steel s N (�'�" Meta1� ( ) �� o . � e.d - � Cost $ 5U,ouv c=�-' � ?�1 :N �,Oc�o tT F-.uY! � .m. M Vo1 y�; Pg ?� of deed y I CS Vo1 Pg --- I ro � Cer. Soil Test �=�`"j- (�'�"?j v �� n , m � Sanitary Permit �;7- IG� CL Road ~ '� -- --------------- z ' =�!�rA<!�� iti�. : �� , � � i•l. Flc-I ��-rt= ° z � Issued �i m�� (aC�2 Denied � _I �F�FL+DAVI� �� 16TlrJ�'-r�F�G �,J �� ,�1+�cr� .z os.A/_ f �( ��-il� �— l�L�� -� ni�r E Owner -' Zoning Administrat r � TC� WN � � �ASS SEC . 4 TWP. 39 N . � - --- - _ 3 3 � ; ---- --- i , � ; i � , 39 39� 39 3 . � "t� L.D �� <t ' ��: � �6,� • 6, I �. � � -- �._� �� • 2� � ( � 39 � .2, / f-"-''"` �,. , / ' i ; i - ------ � � � 7.3 ,r�, ' j ' ; � ; �. �9� _ 5 �_ v 51,��', �-� �" � � } ;� i ; 27 �39� 3�� '. ' f � . . . � _ . � �' `� �; ; � � � � 1 `�� 7, I _ - �� 3 9\ '� , � � w�' � i \';2, ��' �� 5 - - ' � _ , �,: 9, or /� ` 39. 312) �,, �_,% . v , �.o •. '!a ,2 3,� . • � �, � �� ,. - �, �� _� �� 39, � ' �� ,:� d ' ' /o, � ,,g, � z,i � /2 , _/ , �� 3`),`� / ,IL�i �� • 9, 2 ,f , �.� b .G / — � �T, � � � . /.J � t �� •�.'O � 39 -- — --- ---- ---- - ---- --- _ j' 1 �' . � ,> �,'�. I I 39 ��\�! �,—��'\ . � �_ . . � �' �U ,.4�� ' , �'� v �U � ' //. 2 3y , :4. 2•, d' ' ' : �' Y, � �,�. J/v --- � /� � t� _. � �� 3�� • a � . , �_ , . , � / . � �. \ 3h� �� ; . _�<.�� -` , , ' DOCUMENT NUMBER AFPIDAVIT � �2�Q�� EXISTING SEPTIC SYSTBM I ONE AND TWO FAMILY ��e�� Sewy�x C.amy }� )'� If the existing septic system does meet the minimum re- &e�ca.ad�o rcrrKd tba ! / �q a7 quirements for groundwater and bedrock depths and if it �9�1�,��n c 1��9 ,et�o'do.� is functioning, an addition to or replacement of a hab- ,�3d,:.d,:,o.r:�i.�i,vd..�'�.�,_ itable structare can be made in most instances without d �k�>��; �`'��ya.l��', � - updating the existing system. If the existing system �-c7�uw._�+��,.,,; is utilized for the addition, every attempt should be �� made to locate and reserve an area which is suitable i� .�.---� for a code complying replacement system for when the system fails. If the addition wi11 substantially in- crease the wastewater discharge, the existing system RLTORN TO will be replaced with a code complying private sewage Sawyer County Zoning Admin system. P.O. Box 668 Hayward WI 54843 • owner(s) Wi1ma and David D. Hostetler t�iailing address Route 6 Box 6657-A Hayward WI 54843 Property description SW4 of the NW% S 4, T 39N, R 9W. Parcel .7.3. Vol 480 Records Pg 3. Town of Bass Lake. 002-939-04-2303. _ (� (we) Wilma and David D. Hostetler plan to ( ) Add onto existing dwelling ( ) Add onto existing mobile home ( ) Replace existing dwelling � Replace existing mobile home with new dwelling The present private sewaqe system has been working satisfactorily as far as disposin; of wastes. If the present private sewage system does fai1, it will be replaced orith one that is code complyinq. /1/�IIY.fX H/ /v ('��-�-[/l,!2� %/��it�'� // � / .Z David D. Hostetler aate ��iJ.�J , � ' l �-,� Wilma Hostetler date Personally ca:ne before me this '�esos`eas:e��s�, . 17th ags�°°�'y�;ii i`t. �•ch 19 92 �° ` , �� ' � , Robyn haks , ;Notary Pub1Sc h ° SdWy2T�! �...�'� Ca�.inty, Wisconsin F k� �� , r" � f�: My Commission"'��:g��g��;e�Fc�""17 April 1994 �G��:..�>Gro.ieo. . - Existing septic system - Sanitary Permit $]-19� � Date system installed 23 OCtOb2T 19$7 � O -�*�--�, w" �� c��ChY Asst. Sanitarian Merton . Maki 17 March 1992 date This instrument was drafted by q�e David D. Hostetler `�0.91. 4_�a,�.+ � � �� SANITARY PERMIT APPLICATION COUNTV �DILHR In accord with ILHR 83.05, Wis. Adm. Code SAWYER � CST 85-073 STATESANITARYPEflMI`# , � 98412 � -Attach complete plans (to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBEFt V 8'h x 11 inches in size. � -See reverse side for instructions for completing this application. PETITION i. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR vnRinNCE �VES ❑ No PROPERTV OWNER P OPERTY LOCATION � w/a Ya� S T3 � N� R f E-�e�j W PROPERTVOWNER'SMAILINGADDRESS LOTNUMBER BLOCKNUMBER SUBDIVISIONNAME _ � .�1.3 CITY,STATE ZIP CODE PHONE NUMBER CF71`' : NEAREST ROAD,LAKE OR LANDMARK STo � " � o ��.ce : L � /f. II. TYPE OF BUIIDING OR USE SERVED: � Number of Bedrooms if t or 2 Family� � OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#Z,3 or 4, if applicable) 1. a. L�J 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. 0 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): � (� � Q - 3 U Feet Private ❑Joint ❑ Public CAPACITY VI. TANK in allons Total #o� Prefab. Site Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel ylass Plastic APP Tanks Tanks structed Se tic Tank or Holdin Tank 7-� 7J�� ❑ ❑ ❑ 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�: Plumber' ign re:(No Stamps) MP/MBR91MNo.: 8usiness Phone Number � l`! / l`G!tsz->�, a �.� 7/.� 6.1� �O 7�S Plumber's Addre s(Street,City,State,Zip Code ! Name of Designer: � i= � t S �r'S 7 1/ VIII. SOIL TEST INFORMATION Certifie0 Soil Tester(CST)Name CST}� ,4 .0 S q CST's AD RESS(Sireet,City,State,Zip Code) Phone Number: � / ' y IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved SanitarqPermitFee Groundwater ate Is u AgenlSignature(NbSiamps) �Approved ❑ Owner Given Initial Surcharge Fee AdverseDetermination $95 . 00 $Zr7 . 0� 1�-23-$� X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 Qormerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Piumbing;Owner,Plumber ,bAvE /�ds iCT � G � � �( <l �� , � < � ,� ; � � , � ; � � �.52� � � i � i ' � ' ( ' � i '��. �;:NT. -- /.% � � `/ ! l �� , 3 � , � � � � �f� � r ' h � � � ri /�� r_- � :�_._� I �� '� c s � 5 �� . � , � C�ti / ��v �ti p � s'-�