HomeMy WebLinkAbout002-940-05-1217-LUP-1991-124 �
' � 1lpplication for Land Use Fermit ,
Couni�y of Sawyer y �
0
�
1'I�e undersigned hereby makes application for a Land Use Permit auc] ayrees '
that all work shall be done in accordance with the requirements of l-he Sawyer M
County Zoning Ordinance and the laws and re9ulations of the State of Wisc�nsin.
PRINT - [15E ONLY 13L11CK 1NK/l'lifJCIL
�1a•nc.�.�, m � '�
��n;r 'r� rn, r ; �_; 4.�,�� ��,c E .�,�t�+�'
Owner Builder
�
i _:_�; �� , :
mailing address mailing address ,�
E
�
���; fi � � _ ...� °�f,, :��
� -
city-, state,' zip city, stat-e, zip
E3uilding Land Use Zone District `�. `w �
( ) New ( ) Filling
(�f,T nddition ( ) Uredging Lot size 2��� `�( � ��,5� � S �
(�711terztion ( ) Grading v� n
( ) Moving on ( ) Acres �,,,��:,1_:
� ) � ) H
C�J
New Construction ' � CH=i
�
Size ' � fL wide ft wide �
` ft long ' ft lony �
. Z
Floor area � sq ft sq ft �
�
Total ligt to peak to peak Y �
Stories
No. of bedrooms rear lol line or wat�erline
l , .
(ye��r round) or (seasonal) � � i
Type of bldg or addition j i � °
( ) [lwell.ing � � � � �
( ) Garage (1) (2) car 1 � � �'' pr
( ) Storage building � � � `' '�
� N�
( ) Doatl�ouse � � �"
i � N
( ) Livingroom i � �'�� • i �
�
( ) Bedroom �
� I :^�_
O Kitchen-dining i r r�` i
� Forch - enclosed/roofed � '`�� �
i
l 1 Deck - open . i + i �
( ) i j7 � i
( ) ' ' t � i '
� '-
� . _ _ _� � .�
i �� ! ii
Type oE construction � ' � �
i , � ; i �
��r Prame ( ) 131ock • i '.{c ,�- N jw- -� �
( ) I.og ( ) Concrete i ; `"�� I Q� �? i _ ,y,
( ) Pole ( ) Steel i , ( � "i i
( ) t4etal ( ) i �2� w �
}r4—� —�r- s '9�� i tn
� i �— -�i 2� i �
Construction cost $ ,=�� � , i -_ " i
i � i
Vol � Pg ' of deed i I i
i ; i
csM vol �_ Pg �5 i �D7 � �� i a
I I �1 �j
I ' I t] �
Cer. Soil Test 1Q -��l,p � p - � �
,_,
�/- 1� -----CL ro d ------------------ o ..�
Sani tary Permit �q - �lJ� __ G
L � __ J .--- _. �'' z
' Tw T.� ��
- :d
Issued �(� JU(��, ��� � Denied �
F
l � �,� .� LI �. ,Y�^\�����t ����
/ ,�� �, .:_ i.` . i 44. - �'�'`„', _ - 1L2( i I\! �---� 1 V�lT�-_�L��(
f ' 1`:
owner Zoning 1ldminist ator l
� . G � ,c�___. -- -
;
�„
�, �,rz
ia n ^ °
0 y o A
�
� � �
� A
��
�
b
b
N z•,59'W. ¢00.�3�
2 49.73' g S. 2'S9'E. .
lOs � l �i A �2_ p� ?
a `''s. � n, �
� �" � � m
O � �
Reyis�_r�s Oftice 1 � y � (y
$avey_a County j � � O Y �
/ Q O
`15 day oE O .
Rec=i:ed for reccrd [he o.
.}- ���o c1o�Y
�,q,� _ T D 19 at / 249.�3�
P ':'. c^.d 2cc;ded in vol.�C�� Q�
of = �cN�°nDc�'-17=_= Ln
-���^�"�-�`'—='Q�-_ N o
Reqiste[ � �
!� ti� a M
= Depury p p � a A
� 0 Cr
Z
24 73,
N�
ti � �N
ti S t.� ��
� � r"� 00
� p D O�
N�'
A
0
A za9.�3� b
0
D
O
�
» 4
� � N
��
66' n' D
V� 2.
p. vu.
` 249.73' _
S. Z.J9' E.
ft o�a D
AuBART
� O G,
� � n
k A �
�, a �-
������,,,,,, o �+ �
,.•` ,� ,, = �,
�� ;�^ ••••,•~ `L': A \
,: � N„ 0 3
� � `�r ��ti�m �i n"s Z Z ii
� � �`�7M �= C
�v v �� �p� 2': e Z o
y� s � , m z7� `Gii �,, '^ o
� � 'y • � ' � 1 �
. r. � ,+` y
,',����h��rn���U��`,,,, a A T - ?
� D
n Z ~ u
Page 1 of 3 PaSee p � 3
n
> b
n
Q .._ ����� 1`I Cl.
TOWN OF BASS LAKE
SEC. S TWP 40 N . R� 9 W� .
I.10 1.8 1 .6 1 .4 12
223 I.II .I .9 I .7 .I .5 .I .3 I. I
SOMMERS RD.
5.3 `� u .J r�
6•3 .5.9 2J '� ,. .... , .. ` ' .0 .I.I
2.1 u
5.4 5.6 31 i 2 .2.� ,.r
1,13
32 .5. O3 O4 O O 6 .1.18
62 2.9 2.17 2.11 2.8 �.I
5.2 5.8 33 �
� J� 35 .2.12 2.13 .23 ia 1.15 .121 � .1.20 .1.19 i
` 24 �q I 2 3i 4 5 6
.5.1 36 � .2.19 8 11 2.5 I.I
15
.6. 1 d� - 2.16 --9 22 Is
� �� 2. i7
cL .5.5 2 2z
io z.2 ia
9.3 2.io ioe
z.�
.2.14 � .2.6 2 �9
10.5
.10.4 9.4 A RIN� � �E 14.1
. .
� L � 6 7 State and County State Permit # 2 2 � 8 � __
� Permit Application County Permit # _ 9 ' 0G6 , �
for Private Domestic Sewage Systems County Sawyer _
` DENOTES STATE APPROVAL REQUIRED CST 9 - 01C
Date A�proval Received from State if Required — State Plan I .D. #
A. OWNER OF PROPERTY Mailing Address: P . 0 . BOX 6 �
1
.�� � � � G%� I � , {! / . � ���
B. LOCATION : Jf/ Ya��' Y4 , Section �` , T�1N, R _ � E—� Lot# City _ _
Subdivision Name, nearest road, lake or landmark Blk # Village
Township ��SsL�li��
-- �u�� r � �' a � _ _ --
C. TYPE OF OCCU�PANCY-�Commercial * Industrial "Other (specify) _ *Variance _
Single family fi� Duplex No. of Bedrooms "� No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food �Vaste Grinder YES O # of Bathrooms�"
Automatic Washer ES fv0 Other (specify)
E. SEPTIC TANK CAPACITY Total gailons No. of tanks
*Holding tank capacity Total galions No. of tanks
New installation Addition _ Replacement _ Prefab Concrete __
*Poured in Place Steel Other (specify) __
F. EFFLUENT DISPOSAL SYSTEM : Percolation Rate 1 ) d� 2) � 3) � ` Totai Absorb Area ' sq. ft.
New_��ddition __ Replacement " Fili System _
Seepage Trench : No. Lin . � Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: i�ength �_Width � r� � Depth� Tile Depth �-� �� No. of Lines �
i/
Seepage Pit: Inside diameter Liquid Depth Tile Size � _
Percent slope of land 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 tiave sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester, ,
NAME l�'e � 2�'.r/ C.S.T. # ,�'�� — � and other information
obtained from (owner/b�ilder}.
Plumber 's Signatur MPRSW# � � Phone # 7/S (�� �/ �/�3 �
Plumber's Address — � -` - � . S �''�
PLAN VIEW: Provide sketch below of system ( include direction of slope and all distances in accord with
H62.20, including well) .
���'. / �
� �`
\
��� (,� � 1 ! Z � �� , �r � i
�v � � -.
��
�
j ,
,
�7 .
! .�
r � �a
� .
� . _
� � , :
� � � _ �
. . .�
,
; � .
� �
_ r _ . . _ ;_ o
,
��- S.s ��
Do fVot Write in Space Below - FOR DEPARTMENT USE ONLY
Date of Application 6 - 2 5 - 7 9 Fees Pafd: State 1 � _ � (1 County _�5_�_0_ Date � C 7„r o i Q 7 9____
Permit Issued/�t�a� (date) 6 - 25 - 79 _Issuing Ayent NameFlairie Nehrling
Va!id# Date Rec'd
Inspection Yes , '� • No —
1 . county (whi �e copyl 3. owner (green copy) DIVIS�ON OF HEALTH, P.O. BOX 309, MADISON, WI 53701
R , _ � . . ��, ,...�."1 E. nl� imti,�r l: , ,art! cC,� ,) _ -.
,�
�
Department of Zoning and Sanitation o
Sawyer County �
�
�
Inspection Report
y
N•
�
Owner Timberline Land � Development Ltd . �
�
Address � •0 . Box 60 Hayward, Wisconsin 54843 �
�
�
Name of business r
w
Builder �
a
Address
Plumber Lawrence Lamphear
Address Route 8 Box 163 Hayward, Wisconsin 54843
�3
O
Inspection �
(�) Private ( ) Public Property Sanitary-�nstal ,°.�
Dwe�ling Setback -- lake
Violation Mobile Hm Setback - road
Gar�,ge Setback-lot ].ine �
w
( ) Sanitary ( } Zoning Privy N
r., r
U �
7��L� � �
� ��r
�
��� U��t �
S,��P� �5 �
j�`�.;i �I.�� � �
� � x ��
���;��
,j`G,i. �i'r z
\ �` y`Ip �T"lytti� m
�- I �'I�
'� �Io c�1��� �
p%,y��.�.r N�, oo�l a•
�y; a �n
� N rn
c �
�.
�
N•
0
� �
� !
° N y
� Lt-�
�"� '-+
�� _ �
R�;L�ss Rn �
Discussed w�th owne r yes no �
Discussed with builder yes no �
Discussed with plumber � yes no
Discussed with yes no �
Dat e _�`� �.0 f�` ��
Signature of Officer ����'"rn �.�r�.rr� ;?