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HomeMy WebLinkAbout002-145-12-1200-LUP-1991-030 Application Eor Land Use FermiC x � County of Sawyer y _ o � The undersigned hereby makes application for a I.and Use Permit and ayrees � tliat all work sliall be done in accordance witli the requirements of tlie Sawyer M County 2oning Ordinance and the laws and regulations of the State of Wisconsin. ,?c-,_ -- ' .. . ` PRIN'P - USE ONLY UWCK 1NK/PL:tJCIL ' O ��c�r��r 7'"�u-� �c� 5-��- ow�►��. - �Owner Builder � 8 2 � �,2s� � �alling ac res mailing address O ity, ta e, zir city, state, zir Building Land Use Zone District (�'4�. ` (w New ( ) Filling � s O Addition O Dredging Lot size 2..,(�� X ? �Q n � ( ) Alteration ( ) Grading --� in ti ( ) Moving on ( ) Acres Z� ll O L New Construction � ' � Q � Size �_ fC wide ft wide �� ft long • ft long � Floot area 7dC�J sq ft sq ft ro r Total hgt � to peak to peak x' --t�— Stories � No. oE bedrooms —�' rear lot line or waterline (year round) or (scasonal) � ��, � Type of bldg or addition � � , � N � ( ) Dwelling i. ��jD � �y � ( ) Garage (1) (2) car � I � a S' (vM'Storage building i � � C n ( ) [3oatl�ouse �� ! ��/'�"��� � N O Livingroom � i G� � j � 7 I O E3edroom O � �G�S � � �(P Q I I ( ) Kitchen-dining �� , �� K ��� il � ( ) Porch - enclosed/roofed i • �� ( ) Deck - open i ,�uj ( ) �i � C ' I� � � � h�. � Type of construction � j ' T� �` (� Prame ( ) Ulock �_�03�� � / � °y� I ( ) i,og ( ) Concrete ' t�3 i ) C. (�y'Pole ` ; Steel �i�yv J� i ( ) Metal _ ; �0� I w ��n i i� �� � fn 3�'Q,�. ' o '� ��" � " construction cost $ . � � 3�a �i� �o vol �.� ' Pg S�9 of deed , j i• � Pla}�� ; ; '� CSM Vol — Pg _. � i ��i � j ro i i i w i Cer. Soil Test �1 -Q�8 j I i � � �a _______'__CL road ____'r.Y_'�_"____' z�� Sanitary Pecmit '77_J�J_ o - K�..,11�.G 3�i 1'1'���...�`; v � z; Issued �T'��� �� I v1� I Denied � \ � �� �� � i f: X - r19-�-�" �-��+1�1 � � --��"�L;� owner Zonin ndministra or N � DOQ�O � I " ¢o, � �v � � , �;��. 1 , � . � � ------ �- _--- - - - _ ______. z.00� f � �1 � � � 7 q � . 3 , � ; E � G[ J ;+ � � ^ J , � �Ito.s . Ila�s I �I S. 5 ' �'--' � � � � i � '41 � r-: � N! (� i i — 83� �- � , w� '0 5 � � �� � T L,,. 9 ! I� Ia, "__. . �G+O� i ! 3 � i � � �_ � � �(n3 µ�`r'� - i � ; � � � `L�� i i i i � i � ' � I I � �bs� � 1 �3, 9 ` I � h z�� - � _ F�1 R c.�i �a't R-�"T � - I � I o � ao � m u� ;• w m - o � m r e cn -P W �v - I I i � O � � � D � O - � B OC K 5 � � � � � N N I 5 - ro � � �N„ m � a n � W ro w � ��„ m w w w � ti o m o e — — AVE. — — — � a a �o m � s u �, u ,o � o � a � s �n �►. �,+ ro - I � � � V/ � � � rn m B 0 K 14 m n � rn m � � � W ? p N p N N N N ro N p � N W + N� 6� V 4 1� O I � < N YD �. t71 � .� � tD � - - — AVE . — — — � B CK - - - 21 � T� � IQ ,p m �1 6, v, ,i, m ro = o �o m � s v� i• w ro - AV � `�' � � W � � � l i � r - — - - AVE. — — — — 1 ip ao �I 6� N ♦ y� p � e, I o �o o .� o` u� � w re = 'o I � � � � � = BL C K 7 z � m _. I I� I Em N N n 4/ W U {y U7 In W � � p w a tA � +1 �Y O � Ir W # f� f� �) N� tO O Lr�s'— --�„Up— - AVE . — — — — — I � I o �n � .� a+ ,r a w ro = 'o m a .r s+ u� � �,,i ro - ,3 � � 0 � - 0 � � I m 3"� B C K 12 � m rn � m � N � I,F o � N N W N N b N N q w W � tJ W d W uf W W �. I I — —i� � � �I 4 'p � p W # ul P ^� m �C O �7� �l h� 1 B OCK - - 23 � N O w GO �I � en i� W „ - O u w �1 6� �n � W p � � State and County State Permit # 20�26 _ � � � r ,, � Permit Application County Permit # --�1�— for Private Domestic Sewage Systems County Saw,yer _ _ csT 7-058 *DENOTES STATE APPROVAL REQUIRED Date Approval Receivecl from State if Required State Plan I.D. ,# A. OWNER OF PROPERTY Norbert G . F�uard Mailing Address: ROUte 2 BOX 286 A 1 � � � � �^• '4J r i � J ,/ �Lois�.�3�u�.`t' �:�. • I-� l) 4� �•.'_-� ``- � =-- 1'� � l� t') bC' l� ; a�`I- �'t '.z B. LOCATION: _ Y4 '/4, Section ' �`� , T N, R `",i� � (ar) Lot# _ �City _ __ Subdivision Name, nearest road, lake or landmark Blk# Village �..07 • L(c> "µ��„ � • y���y c�_• :� �,~,( tq Township �-j;��3 � �� 'VY h �� "�I�N� .� �I�f� l r� ��y5._ . F,3 tZ�V7 C. TYPE OF ' OCCUPANCY: *Commercial * Industrial_ 'Other (specify) *Variance Single family _�_ Duplex No. of Bedrooms r No. of Persons �� D. TYPE OF APPLIANCES: Dishwasher YES _�_ NO Food Waste Grinder _ YES�NO # of Bathrooms_� Automatic Washer �_YES NO Other (specify) E. SEPTIC TANK CAPACITY ��� Total gallons No. of tanks � *Holding tank capacity Total gallons No. of tanks New Installation �_Addition_ _ Replacement _ Prefab Concrete *Poured in Place Steel X ____ Other (specify) _ _ F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1 ) �,��� 2) �;_j� 3) �_Si_Total Absorb Area � I� sq. ft. New� Addition Replacement *Fill System __ Seepage Trench: No. Lin . Feet ,`� � Width � Depth__��Tile Depth 4' No. of Trenches _�_ Seepage Bed: Length Width Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth _ Tile Size _ Percent slope of land �L�3�' = Distance from critical slope _ 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 t�ave sized the effluent disposal system from the EH-115 prepared by the ified Soil Te�ster,,� „� . NAME iY;�rw�Z,� '� • �-}�sjh]ty�, �� IZ. C.S.T. # ��" � ���� and other information obtained from =� (owner/builder). Plumber 's Signature ti.- � ��t '� ` MP/fo4p.R�M.# �74� Phone #���` — � -d � � ____ Plumber's Address t � - " ��� PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). .__- _�,_�___._---_-- _,-- � � ,,.,. , � 'l V � �-,.,__r�s 1�l il � �,. —t_-�--- • .;� (,�%` � ti ,�� �,�- � 4� '� �w� , � � `' �_, � � � . , � � '�� '~. . �, ��� 7 , ; ; �' �4�''' � �' 1 �^C� � , , I I -„ � ,,.; __.: __ .J ' I y� �, ' _ _ _ I It,r� :� � I I ;:;; � _ . � � .� ___. _ . , � - � .,� . r � �„ ; .. --- - : , , , . _ . �� . � r � ' .. , , � . __._ ��s•� ,• � _ - � ,� . c _ - , ,� _ � �. _ `� -:� . J : _ _ __ �, ; � _ ; _ . __ _ _ ;_. . :. . , � �- � Do Not Write in Space Below - FOR DEPARTMENT USE ONLY Date of Application ca�� —'� Fees Paid: State 10 0 00 County 1F . 00 Date l� September 19'7'7 Permit Issued��¢$� (date) �-1F -77 Issuing Agent Name Lori Ca rr�,� Inspection Yes�_�II= �q Septerr�ber I977 Valid# Date Rec'd 1 . county (white copy)�„� �� 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 i Depar::::ent of Zoning and Sanitation ` � Sawyer County Inspection Re�crt Oumer �Git�'�i�� lr �IU/}2CL Address � �. /�,'/�•/+2c� C�JZ� Description ��T /2 ��k !Z �e c 30 7�ia nr � R :Y �� Narne of business Builder Address Plumber /�U�e�i� �/+/J/+RRE Address �T� �iL1 l��/f/Zo� 4�-Z. Inspection ([�}�Private ( ) Public Property Sanitary installation � ellin� Privy Violation Mobile home Setback - lake Garage Setback - road ( ) Sanitary ( ) Zoni.ng Setback - lot line - o w< � _ _ I �n�!U�2 -� / �. �� 5�� �V uasT ��S�a � �yf \ �-- i �I I � i h i � M ' i � i J i , -- � � �O v . � � F-� Discussed with owner ( ) yes � ) no Discussed with builder I 5 yes S no Discussed with plumber t j yes j no Date - � - � Signature of Officer �,,,,� ,�1z,�1 i