Loading...
HomeMy WebLinkAbout002-939-01-5225-LUP-1991-310 •• ' - Application for Land Use Fermit �� - County of Sawyer 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- � t lations of the State of Wisconsin. �, PRINT - USE BLACR INK OR PENCIL U'e.(�OtJiCO� � / � �JJ�IPYL2� WdI��'�S Mo�t�n L��..� I�ilIGSZnC� ~ '�! Owne Builder r r, �.o. (�i n u �o � R+.5 - 3 o x y�z . 1-1�i� �a�-1 N. t� Mailing Address Mailing Add s ��r��l�a MIJ S�3o� C�,�„»P.�,�� . �'alls�wz City, Sta e, Zip Ci y�tate, Zip 54'7�q-88o8 Building Land Use Zone District Rk'- �„i o � (� New ( ) Filling rt O Addition O Dredging Lot size �rj0� x ��04����� � n ( ) Alteration ( ) Grading ( ) Moving On ( ) Acres �j_13 ( ) ( ) o New Construction '�5� Size �_ ft wide ft wide � 10 ft long ` ft 1 ng � i � Floor area �I�I 1 O sq ft �-'--{0� sq ft �� �o� � �� Total htg /a� to peak (to�_�a�c-� � <'; � � � Stories ( Stories �� vm �a No. of Bedrooms o i _ ,_.- �:�.. ar""wa erline c� 9" � �_ o (year round) or (seasonal) " � � n Type of Bldg or Addition � a o ( ) Dwelling r• ,� O Garage (1) (2) car 2��� � OC) Storage Building � ��� m� �9 ( ) Boathouse � ��0� c,, c�C��'���,' - � � ( ) Livingroom i C\�t G� ( ) Bedroom — d' ( ) Kitchen-Dining �`� ; �1 � ( ) Porch - enclosed/roofed � �v-- ( ) Deck - open �'�` �Lc« �� � f � C�� �.�'lo�b 1: �2 I-k�. 4- �r\ � � � 1 - W - � �' ' g' � Type of Construction —' � ,� G ( ) Frame ( ) Block � q ,A,r�, ( ) Log ( ) Concrete f (� Po1e ( ) Steel �L Metal ( ) � � � �Z� � � � Construction Cost $ y3�9S6.00 �6 6 Vol �-�� Pg a3(pof deed � / CS Vo1 i Pg � �'� ro � m Cer. Soil Test ?+._ �- �``� 15�� � n m I�1�1 (a1 Sanitary Permit �,(�;- �=`I � -----I�---�-Road ------ ~ -fl .p <�% --------- z W �T.- �,��� ,�_�. ��, , o �t: z z Issued Z3 ����,� I��� Denied �� �`e (� TC�%1-C�'�1C_./ �-^��-�C L��P1 '% � �L� �� b er Zoning Administrator TOWN OF BASS LAKE SEC.I TWP 39 N. R. 9 W GOVT LOTS 2 a 3 �---- � � ,� 3.9 �.19 ' ' � � - � :3.7 3.�0 � 3.3 v.i, :2.1 3.1 I .eY :3.8 � 3.6 34 :3.2 :2.18 Fo � 2. �3 3.5 � �2.i re VOL 3 PG 2 20 2 2� Z y 3 3 1.13 j�3 ,2.15 � 2.5 � .3.1 i� � I 60 r Z `�•, .2.� � :2.22 0 .2.1 . �A C :2.�4 � Z.Z ��s � :12. ' :2J2 3 COURT � r� r i i i r r """''' e�a.e��.si ._ : ae a - � is o�< �. . si sa�veR co �,er_o�o F . ea � ` t ' Repis!ork C:fico � (� � � � ry foaM Iw. sos-A , . Scnycr Co�ar,ty }� � wc+,,.c.....� Acccivrd fc; rc<ord the � / �+�y �! - ' Q+ A D 19 �:� .�3�oc:l.�r.t $tM�C NO. �627.3 �_�ir.d revrded In wl.J�___ «�QLX� en POJo..�..2p.�.�n}_ '�G:J ' _ � .�'�C�—�i�./�t.l'�.:._ . Ao�{x�cr r �JUIY �.�_ � . � Z � � � W � OY Z03 m � o � � s � � � i � ao 1 *� f10 � JV � w"� � N � � > � _ " 1 Z �,o �, . �s; _� , � -'`__' _ `� �-�z � � m � W � ' ^' „�o�oci _ � asnor�z Soci/'froe - ww o M W � 3 M L 2 '.8 2 'e I 0 i ' __' .�. _— _Y- �' S�Qj.� �z �� . � F � � M .. bi '.L>'�Cip g -�1-- F^ �L. NN � / f•/ � �t J N �..b�-.�s •nios w � i _ � Q � ' , F,. � J �- (n}- B � � � ^ � � w N h�I �F — fn N a � p � Z� � 9 � v / � > N ,� a a� wQ . zmz $ ° I . � h �o Ng� . � w= UZoa�--� c�' n' �, � � � �° a zWN� � ; ;NOaZ ��cn +' �� - �� � � � 8oaU/� Q - ffZ3 N y ��''�-+ � �� JQ . W W W W ��1.: ^��' 'p� Q yZ� \ 1-�J < ZQC � I— ZF-Z O I > Y \ \ Q � � �� } amv� ° g' o < � � m OND � � �WO o ~ \ � � we� ZQ JF-�U � k- Z � (/� o I a 4 � � W � 'T�J " w 1 � t_ � � ��,5 � _ � � , � � 9 g M _ ' z� — -- - asnoN � — — — �— — e — — _ � � 2 l 9 �� °' i i x � g � \ � � � � o � . � u�l ; ! i �f i � w( - \� %rb y ' � , i m W� � ' z � z� ,� ,,� � �� � bd' � ,� ! �' ti �.�� a c� h r. �il- 1 ` � �� � li- � +i � �I � p i � _ i c� I � o� � I� ,� 1 i�. I � ���i � , , � - m z a r (� �/,� � !M i '� ' P � -� �` � O � m` r. _'�!o, . � �, o a 3 a iq Q \ � p c� �y � « :Q al " �� o F � I � c u _ � c N W I � i; ^ M i � �D .o � Q ZI Q . > - � � � a ;n . 1 �� � � m �n -r„ 3 -' w o _ � �, ol � ' � Q 3�._ i`' - M � � N �' w O ni : � n z � O � m wl N � _ �, t � w W n o � _ n � � � � .� ? 1 � � �'I � ._ - ti ww � ` � � oi � W � . Z� o y � o� N �i r 8o Z zI O , w ~ � O 3 O `Z� w � JI `o mLL � Q J I 3 � � J ,_J JI z o ii N �� � Ji t`tto��l;aiur r.� @o i i O� ? c I �� 3 ? w� ,�fi°��• �";.k.�.... C/vJ'�^�,,.Pd p 1 - W� n I s � � i o ,� n x I-� n ��.'� L� '.��� e �� F'' �' t p Q � q�� � ��j �'� ��a. �R � � 4' � t 1I O J� w �1 : G M 'n % � e � i . J� N c U ,� ZI Q� Ll'. p � n i � j� e x � zl � � � �� .' ��'•,. � J ;�� � � � � �I : ';••. r I �� p O o'+ .� ', ,� t � cr u' o � + 'ti .. .. ' . i z " w t u�° I � F- ~ c�i � ° �ta �.x�� __' "' a � � g� � �a � � I • 0 � � a O� � Y.� �.i�Q a Z �.� p Q (n - o. I ` - . LL1 ,�- O O J . o � � , � ,00-OOS � a 00'OSI � Op 'C £ Z ,06 ' IZ � �� ^ J � ,c � � O t,00s �� � H1f10S �."e7 ,OE ' tOS .` : „ bb - ,GO - 0 0 N � t� — � � � Nz g � V Z (—� _�_S � �- V W O ( GdOt� ! rvi0d 831ni ,`�^. ; adCJ � NtA01 � s x � x � m • � — -- — — — — — — — -- -- — — —�6'►� — � V � O O . 2y `� _ � � � 2 �/ �f��U..:��-�' . �y ` ° ° m� 1 ;'i'':u �l.i, :1 ,'e � . . r<.<.<-«f^r_ C.` '.�i"^'�, � �� w�scons!n APPLICATION FOR SANITARY �ERnAIT • � ' � ��4cJ y �2 C� NTY o l (PLB 67) � '_ aara<casm oePraarmenroF UNIFORM SANITARY PER 'T -1Lr �v ' �-'�+?�ID IflDUSTRV,IRBOR 6 HUTRfIRELRTiOf15� �^m �� _ O � � � �O � � _:i�..; . J 1 —Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Yzx 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT ; PROPERTY OWNER MAILING ADDRESS ; . ES l,� r� N � E /oo �. i rcci`EL •�-��. �9P /T"�� Wi , �� � PROFEI'�TY LOCATION /. p �pU� C..OT �Y: � `�—,=cvt: ! /V[cI1 /4 N�1/4, S (n , T,3� N, R 8 �) W TOWN OF: � �SS [_�� C ' LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER I � � l�CTE��S 1�0/� TJ �,'OHD ', TYpE OF BUILDING OR USE SERVED Ii�l os�E�nil� Number of Bedro�ms: � [� Pul,lic (Specify) : �THIS PERMIT IS FOR A: �. New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Altemate System L�� Reconnection ❑ Petition for Modification � IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. �. Seepaye Bed ❑ Seepage Trench � Seepage Pit ❑ Holdiny Tank �� System-in-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # _ issued _ ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. ITotal -;='of Prefab. Site Steel Fiberglass Plastic I Gallons Tanks Concrete Constructed � Seotic Tank Caparity Qd� � Lift Pump Tank%Siphon Chamber i Holding Tank capacity � Manufacturer. �_. � IF TtiIS IS AN ALTERNATIVE SYSTEPJI CO.VIPLETE THIS BLOCK: ❑ Mound � In-Ground Pressure Total m of Prefab. Site Steel Fiberglass Plas; ic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber i Manufacturer: PERCOLATION RATE ' ABSORPTION AREA ABSORPTION AREA VUATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet�: PROPOSED ISquare Feet): S �p � 5 �jZ � Private ❑ Joint ❑ Public i, the undersigned, hereby assume responsibilit stallation of the private sewage system shown on the attached plans. a e of Plumber (Print): (� ignat �_ MP/�do.: Phone Number: I, �ta�yZ�' � � ���3 ►°+ t'Zt'�`r� �� `�' _ C-- c� �'s�tL.'�s�_ S7S<Z (7iJ" 1 �3� - 4�c�76 , �Pluniber's Addresr. Name of Designer. �T<o Nf'---�-I u� F-2 ,C , �1 S�/c3'�� ��c rL! G 2�i"��=r= i COUNTY/DEPARTMENT USE ONLY Signa re of Issuing Agent: Fee: Date: ❑ Disapproved r L� Owner Given Initial � � 5 . � 0 7 - 21 - 8 6 '� APP�oved A�iverse Determination Rzason for Dis p roval: Altemate course(s) of Action Available: �!LHR SBD-639£3 (R. 5/82) CISTRIBUTION: Original to Coumy, One Copy To; Eiureau of Plumbing, Owner, Plumber ^ _1.- A K c L o�.v� r�j __ � J . � ✓ � �J� �'" • � + � � i. �P• � ,�Q . � L � \ `` ��4 r�c�5 ,2. w��r� I c� �ou•�or � SQ c � � r�9�'�, �' 8'-�-� 'f��� �C��s: �f-r�,�, gr,u.yan . , � � � -- ; Zo _ _ � �� �� — h1 � �� < �0 9 � --? fQ � � r------ — T 1 I � � �� `! �� �, �. � o ��'. . . c �� ^ , I� ,,. - 7% �� , ' ' �«�y � � - �----- _ --- - � ; � - -- -- y I I �� � { � I �-r U I i � Z o' � i � ' � � � ---- 3 0 -- — 1 --- — I v���� c1�r� 3 sF`����c��. -- , - — �, l; �� ��gs��.t�'�' 1�(oTE � �- �, 6� F�p � � g �� � Q� CiP- (�a�� w' r I ��� �.-f� � �L „` F „ , .,� ---- ,;' � —r--- . ,� / c l ��� . ; 0 0 -O � Sy S.�'��' �I cStJ n." �^.� � ' ��r � � . ' � � � � � '' --- ;� � ; I . ,,. , _ � I �U , �-.� I ►�. � -rU Nw y K i,v i ,�-rc 2S p o r � r t2o �-9 sc� � � � "� zo � _.'_.._—_-..�„ _._'._'_—___. . _ f-� r : i .. . ' , , . ' , , �/LL� 1 l�w GEPARTMENT OF RE�O�� �� v�O�L E�3��I��J P1ND SAFETY & BUILGINC� I N D U ST R Y, .__...._�_�_— ..__-_----__---�._,r� D I V;S I 0 ' LABOR AND PERCOLAT80� T'ESTS (�.15) P,�ADISON WI ��IJg HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: $ECTION: TOWNSHIP/M ' i.TY L0�.: BLK. NO.: SUBDIVISIONNAME: w�/ N w�/ � /T39N/R E � � W As.s 1. � � COUNTY: 01Mtd'EFi�5/BUYER'S NAME: , MAILING ADDRESS: S fJ +-✓ �' � � ni � o �' . N� � rc h �l.� v P �e Zo :� W � USE DATES OBSERVATIONS MADE ,S'� �J NO. BEDRMS. : COMMERCIAL DESCRIPTION: v PROFILE DESCRIPTIONS: PER(,0 AL TION TESTS: I�Residence + � �� i �� New ❑Replace _ / _ " / �/S`� t/ � / (. O RATING: S= Site suitable for system U= Site unsuitable for system CO V NTIONAL: M UND: IN-GRO aPRESSURE: SYSTEM-IN-FILLHOLDING TA K: RECOMMENDED SYSTEM:loptional) �S ❑U �S oU �"'S �U o S �U ❑ S .�`"U Y �:�' DESIGN RATE: If Percolation Tests are NOT required �f any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: /�J/� Floodplain, indicate Floodplain elevation: �� I � PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AfJD DEPTH NUMBER DEPrH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) � � i �. � > � � �, 0 _ G " Q,c' �'j'ir15.t 7`S (o `' 3 (�� �i Q ��/ MYaC.s / ' Q ,_ 7 .. �.� �O� .S.;t_. TS ' '� � ,� `'�� O>��� B- � �� D C►i .�-��--� � . � � • �, .. _ ,� , „ , , �,,� y�,`�., � � G " l�,c" 6•vS� TS � �, yo '� �M � �l S B- „3 `'D f� /� /� -� � o " ,. �, .. � d �s � B- �� `� 7i c� ./rl�tr-` � �f' r�i r� Jr ..' C� �� B h/ 5 ,C TS (�, 'r 5f � , �� r' !3. N.p d Sd j� .i B- ,,S gy " 9 �, „ o-�- " !3 � s.c, rs s- - �3�� �' ti c.. Q na �s .� � �5� .� o "— � �f " � �8.� .� r�a/ s o�- r i B- (� �� " � � „ C� — G " 3�� 5 � T'S �' '=� ]: J,� �`Z' ^'c Y d � , � .. �.n r� d ,�'�`:�� PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE NINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD i PERIOD 2 PERI � 3 PER INCH P- .3c� ' '� 3 P- P- 3 � P- ---- P_ 3��.� - S �" P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the ho: zontal and verticai elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the directi�n and percer of land slope. SYSTEM E�..EVATIO 7� � f � �� r� o �� � � 7 � � , � 7S' � � f}� �c:��'cc1 � � � t J� _ , 1 � '�_a.Gra�•�2. �1 . � � � ��. � o IQ�v� _ �=,1. J /c��' � � ' � � - ��� � � __ , 'i/ .. .. r �l d� �l IP PZ� . _ , . : � �y Q � �, � � `i _ _ _ -- - . :_ , _ + p v�. � �� � x ,/� , ...}./� .... . � ho. ._ Q� � � � ' , i . ' � ,: � . ` � ' \ 1 7 � �. _ : ___._ _ , _ , � _ � �. � � :_ _ . ' . _. � , . �.. � '� ._ � 00, `3 � 3 3 " � _ � , _ . _ --. ., Q o Q ,. � _ - _ 3 _ ; : _ : _ . . � , s„�� � . _ �, • � o �- �"r / t� �o � I � � r�, . 1 ` . � . _ ___ . � � _ __ 4 4 �-- -- - �j.. � hn �p5 � �o ' � , � ��� R� ��� -- � _ � - o_ �,�. �� __ _ _ - . , � - _ . ____ v?' ^ 6 ` � � ��„�_ , �'� �' � (2 r �sl ` _ / � .� S�T�° A � r�� �3 '°' fl I, the undersigned, hereby certify tha the soil tests reported on this form were made by me in accord with the procedures and methods specified �n the Wis or Administrative Code, and that the data recorded and the location of tl�e tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETEC ON: � ' � � .z� ' /� — S�'� ADDRESS: -. CERTIFICAT O NUMBER: PHONE NUN'BER (opcior 1 � 3 � Cc.�.,�.,��. Cti�� '� `i � <o �` �lc-�-�;�G CST SIGNA E: � �� ��� r.�n�-n�n� iTin��• ll�ln�nsl anci one copv to Lor_�I Authority, Property Owner and Soil Tester. /