HomeMy WebLinkAbout014-942-25-3405-LUP-1992-070 ^ Application for Land Use Permit y k�
County of Sawyer � A a
The undersigned hereby makes application for a Land Use Permit and tv
agrees that all work shall be done in compliance with the require- 0 1
ments of the Sawyer County Zoning Ordinance and the laws and regu- �
lations of the State of Wisconsin. � /�
PRINT - USE BLACK INK OR PENCIL v
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Owner Builder �
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Mailing Address Mailing Address
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City, Srate, 7.ip �'�5'Ja 7 Ci_ty, State; Zip
Building Land Use Zone District R R-�- o �
(-(� New ( ) Filling rt �
( ) Addition ( ) Dredging Lot size m n
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres /, SZ � �
( ) (_ � \ Z
Y-
New Construction ' �
' �1
Size �G ft wide ft wide '
� �5 ft long ft long -- �
_ �
Floor area �/ sq ft sq ft ��� J7
Total ht � � „ �
g /�, to peak to peak 'J
x
Stories / Stories
No, of Bedroomc — kJe lso� L«�e
rear lot line or waterline c�
0
(year round) or (seasonal) s--- //�� — � rt
Type of B1dg or Addition o• r
( ) Dwelling a o
(d-) Garage .(:� (2) car � ��� C rt
( ) Storage Building � , N'
O Boathouse SS -- �3' �� 38— o I
( ) Livingroom � �u , p
( ) Bedroom \ t, p,., _
( ) Kitchen-Dining � '� , ��
( ) Porch - enclosed/roofed ___�Y' ���'-�, 7
( ) Deck - open
( ) _ p I ' � �
( ) ' }3s _ �
� j
Type of ConstYuction � �� � �
(t) Frame ( ) I31ock
( ) Log ( ) Concrete � � i r` �'
( ) Pole ( ) Steel
( ) Meta1 ( ) U'
m
_ �
Construction Cost $ p00,� ' �' 'I �''
Vol 3,� Pg 4iY of deed , I 'I�
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CS VO1 8 pg 136 - i3� � ���� y
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Cer. Soil Test B 1 - o(�y i�f`�- °'
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Sanitary Permit 8� _US� --------_ L Road - '-' N
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Issued � /�_IC�C�Z Denied — �
N
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wner I £
Zoning Administ ator
N, \SCALE /" _ /oo FEET �
O ZRoN STAKE /N PLACE ��sa
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o,p4. 3� ¢o' EASEMENT �• � 2S
- - �3 �:Sa.zo y/� 4�8�� _ � 208'. 00' . %�oR
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�'age 1 of 2 pa�es �" N�_ ;r-..� «<'
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I , hobert h . Swanso:; , ldisconsin iiegistered Land Surveycr ,
do 'nereby certify under tne provi �ions o` Chapter 236 . 34 of t::e
r,;sconsir. Sta�utes , and under the direction of Harold uma11 ,
owr;er o±' said land , I nave survcyed , divided , and mappen �r.e la.;d
he:ei:, descri'oed , and tnat saic land lies in the soutneas� or:e-
fou_^th of the scu�hvresi one-,ourth (S. E.4 of S .l�J .4 ) of Section
� twenty-five (25) , Township fert,-two (42) North, kange nine (9)
- l•dest , To�m of Lenroot , Sawyer County, 6Jisconsin described as
follows:
Commencing at the south 4 corner of Section 25-42-9 : thence
South 85°35 '42 " 6dest along the south line of the Section 208. 00
feet to an iron pipe which is the point-of-beginning;
Thence Soutn 85°35 '42" 'rvest ?49. 86 feet to an iron stake on
the northeasterly right-of-k�ay of the Tar.r.ings Point Road;
Thence soutn 85°35 � 42 " lVest 58. 20 feet to a P-K spike in the
center of the road;
Thence North 60°21 � 18" �'Jest along the center of said Road
322. 06 feet to a P-K spike;
Thence North 32°52 '42" East 501 . 56 feet to an iron pipe on
the meander line of Nelson Lalce - said iron pipe lies 60 feet from
the water ' s edge;
Thence South 57°16 ' 18" r.asi along the meander line of said
Lake 300. 00 feet to an iron pipe lyin� 22 feet from the vra�er ' s
edse;
Pnence South 47°05 ' �? " East along tne meander line of said �
�ake 11�. 48 feet to an iron pipe iying 37 feet from the wa�er ' s
ed�e ;
"_'hence South 20°i9 ' 03" ':iest ?46. 76 feet to the i:on pipe
w:nich is the point-of-'oe;;innin,c-,.
�he land lying between tne cneande: line and the water ' s edge
betvreen the lot lines extended is to be considered a part of �he
lot.
I.ot 9 is su'oject to the joint use of a 40 foot drive easement as
show�n or. the map.
All lots are subject to ease,:;er.ts and reservations of reco:d.
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FORMERLY — —' ,\�_____ �— _ —
SOUTH LINEGOF SEC. 2 ✓ —
.12. �� .
�, 36
REFERENCES: SAWYER CO. DEED RECORDS �
AER1/►l. PHOTO D3 — 1970 '
U.S.G.S. — HAYWARD SCALE: I INCH = 400 FEET FOR ASSESSMENT USE ONLY Nfi
ORAWN BY: KM DATE � g-23-7g INTENDED TO SHOW CONCLUSf�
COLON (:) INDICATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
• BOUNDARY LOCATIONS
—°--�1 �� SANITARY PERMIT APPLICATION � �OUNTY r
�U ��m�� In accord with ILHR 83.05, Wis. Adm. Code SAWYER °�,°
'�"'"""'�"""""�""°"' STATE SANITARY PERMIT# •, �
CST 87 - 064 86136 " �
—Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER O0
8%2 x 11 inches iri size.
—See reverse side for instructions for completing this appiication. PEriTioN
I. AP�LECAfdT I�VFORMATIOM — PLEASE PRINT ALL INFORMATION. FOR vARiatvcE ❑ YES ❑X No
rPROPERTY ONJNER PROPERTY LOCATION
������� A �) i n Y S�� '�4 � [c� '�4, S T 1f�, N, R �ar) w
PRCPERTI' OWNF_R'S MAILI�G ADDRESS LOT N�BER BLOCK NUMBER SUBDIVISION NAME
r �,
t.�� � ��. _� �
CITY, STATE ZIP CODE PHONE NUMBER ❑ CITY : NEAREST ROAD, LAKE OR LANDMARK
t��� �l �S �- �r �Y • �f D� ❑ VILLAGE � Q r C� Y) Y1 1 �'! �
I I:. TYP� OF BUILDING (3R USE SERVED:
I
' \�;mo�� of Bed�ooms if 1 or 2 Family � OR ❑ Public (Specify):
Ill. PURPOSE OF APPLIC�4710N: (Check only one in #1. Check # 2, 3 or 4, if applicable)
I1 . a.�New b. �� Replucement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary �ermit was previously issued. Permit # Date Issued
� 3. L� 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. ABSUF�PTION SYSTEM lNFORMATION: (Check one)
1 . a. See a e t3ed b. ❑ See a e Trench c. ❑ See a e Pit
2. FER OLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY:
(�linutes p�r inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
p��j� � o Feet � Private ❑ Joint ❑ Public
CAPACITY
VI. TAMK Site
in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- p�astic Exper.
INFORMATION New xisting Gallons Tanks Concrete glass App.
Tanks Tanks structed
Septic Tank or Helding Tank C 6 � e � ❑ ❑ ❑ ❑ ❑
Lift Fum Tank/Si hon Chamber U � � � � ❑ ❑ ❑ ❑ ❑
VIf. RESPONSIBILITY STATEMENT
I, the undersigned, assurne responsibility for installation of the private sewage system shown on the attached plans.
Plumber's Name (Print): P ber's Signature: (No Stamps) MPRSW No.: Business Phone Number:
��� . �' � �C3;S' 7 � 3 '-8'�.rs
i Plumber's ddress ( treet, l,ity, State, Zip Code : Name of Designer:
' �- � e y � �'�-l3 S cc y,, �
VIII. SQIL TES7 INFORMATION
Ce tified Soil Tester (CST) Name CST #
� � c� .e �s 3��?
CST's ADDR SS (Street, City, State, Zip Code) Phone Number.
� c� Yr�.:� G� s Q � 0 � � —
I)(. COUNTY/DEPARTMENT USE ONLY
� � Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature (No Stamps)
�.b! Approved ❑ Owner Given Initial Surcharge Fee
AdverseDetermination 125 . �� 25 . �0 6- 2— $7
X. CQNMEMTS/REASONS FOR DISAPPROVAL:
i
Sf3D-6398 (formerly Plb-67) (H. 03/861 DISTRIBUTION: Griyinal to County, One Copy To: Bureau of Plumbing, Owner, Flumber
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