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HomeMy WebLinkAbout002-940-23-5307-LUP-1991-322 Application for Land Use Permit X County of Sawyer o ' 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- M �L.� lations of the State of Wisconsin. � PRINT - USE BLACK INK OR PENCIL � f �.y�.l'�'c1�0.s. � � �1 ��N,�,�c! /�IC'��v�s�j - �z'c� � Owner uilder � /cc�� �E�/nl� c�y ���3 i3d��io�3 �� Mailing Address ' Mailing Address �i� ��'/�-S ,�;c�;A� S8o%� /f/�✓cc�/-��=C�'� Cz� �s � Sy�y3 � City, State, Zip Ci y, State;' Zip �� r � Building Land Use Zone District R a o (�—New ( ) Filling rt ( ) Addition ( ) Dredging Lot size 4� n ( ) Alteration ( ) Grading ( ) Moving On ( ) Acres - �p� ( ) ( ) � New Construction \ Size �� ft wide ft wide ` f � ft long ft long Floor area /,��'j� sq ft sq ft � � � Total htg /�' to peak to peak � ^ 1 \ Stories / Stories '� No. of Bedrooms 3 rear 1ot line or waterline c� 0 (year round) or (seasonal) �, rt Type of Bldg or Addition 8c' a o (l�} Dwe 11 ing r• rt (�1 Garage (1) �L} car � O Storage Building m� k A, ( ) Boathouse o' I��� ( ) Livingroom � ( ) Bedroom ( ) Kitchen-Dining ���� � � ( ) Porch - enclosed/roofed d O � ( ) Deck - open Z5� � ) � yL-� •Z Z G' � r\" � ) i Z �flh � C � � � Type of Construction rJ `a � r� (�[1 Frame O Block f,J 37--�� t ( ) Log ( ) Concrete �7' 'z N `� ( ) Pole ( ) Steel / �5� ( ) Metal ( ) � ���� • � m � �� - v � Construction Cost $/,�� - - , _ � � �s- - . � Vo1 4(pP�j Pg � of deed li,v� ' — CS Vol _� Pg /�,3 £ ro Cer. Soi1 Test � �"��5'�cti _ n a 9�-iaa �.�_ � o � Sanitary Permit J-� C Road 'J q 37 ---------- L _ ----------- z .� Jy1qC,(c Cc�rc, o z Issued 23 Dece ber 1991 � Denied 1 ���1 � � ��t ti� �'�� � � Owner Zoning Administrator �DiL�R sANITARY PERMIT APPLICA7'ION � _ v In accord with ILHR 83.05,Wis.Adm.Code couNrr ' r� CST 91-122 Saw er �� V STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than 151172 8h x 11 inches in size. ❑Check if revision to previous application �ee reverse side for instructions for completing this application. sTnrE P�nN i.o.NUMaEa I. APPLICANT INFORMATtON-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION O/(J G ,Ii - '/a '/a,S � T O,N,R �E-(6f�)W PROPERN OWNER'S MAI!I.'JG ADDRESS LOT� BLOCK# DIt� �� CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER �'ot� S�l o C5m 8 3 II. TYPE OF BUILDING: Check one CITY � NEAREST ROAD ( 1 State Owned �VILLAGE ❑PUbI1C .�1 or 2 Fam.Dwelling-#of bedrooms� PARCEL TAX NUMBER( ) III. BUILDINGUSE: (Itbuildingtypeispublic,checkallthatapply) 002-940-23-5307 1 ❑ApUCondo 2 ❑Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑Outdoor Recreational Facility 3 ❑Campgroun� 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestaursnUBar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑Other: Specify IV. TYPE OF PERMIT: (Check only one in line A.Check line B if applicable) A) 1.�New 2. �1 Replacement 3. �Replacement of 4.0 Reconnection of 5.❑Repair of an System System Tank Only Existing System Existing System B) ❑A Sanitary Permit was previously issued. Permit#— Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 �.Seepage Bed 21 ❑Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑Seepage Trench 22 ❑In-Ground 42 ❑ PitPrivy 13 ❑Seepage Pit Pressure 43 ❑Vault Privy 14 ❑System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4.LOADING RATE 5.PERC.RATE 6.SYSTEM ELEV. 7.FINAL GRADE REQUIRED(sq.R.) PROPO5SED(sq.ft.) (Gals/�daJy/sq.ft.) (Min./inch) �/ ELEVATION S � �p/�j �J 0 �� / � �. 7 Feet Feet VII. 7ANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATIOti New xistin Gallons Tanks Manufacturer's Name Concret Con- Steel ylass Plastic APP Tanks Tanks structed Se ticTankorHoldin�?ank E'GQ � �iftPum Tank/Si honChamber VIII. RESPONSIBILITIf STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(PrinQ: Plumber's Signature:(No Stamps) MP/MPR9tlPFld.: Business Phone Number: �.12� � /_J, �� 5��� ��J O�.S'5�.3� Plumber's}Address(Street,City,State,Zip Code): �o �/�/^�/ X._7 S�O dLJ IG �/� �� .5 7 O I"(O IX. COUNTY/DEPARTMENT USE ONLY �-7 ❑Disapproved Sanitary Permit Fee(�SurcnergerFee water ate ssue Issu'ng Agent Signature(No Stamps) }JApproved ❑OwnerGivenlnilial $115.�� 7-30-91 �1��""" -�/,` Adverse Determination -�-�M,Q'�' X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD�398(tormerty PIb�67)(R.11/88j DISTRIBUTION:Original lo County,Gne Copy To:Safety 8 Buildings Division,Owner,Plumber � l)�PA� i�L1EfJT0F . � � *�, rt ;� � � � • n , , �"�� �.� "� � � � � ` , � ;. r ,,.�,r L-iY �„ tiUlLUlivt;5 INUUSTf�Y, f . <. ���... . \.. j . Yf . � :.� L a3 3 U� '�r? La 5. U�U �J�0�4 _�, _. _�_ ... . " '�'�_ �.�Ro� �.�!� t , ��= t _ ^� ,, .aNa: , , �. �^'' r�-� �� � .� .� � ` P.O. BOX 79G9 ..:. ��4 ��� ti �i i ' i I xjl� � �"° g'"�y s vw,_ �� •"e . HUh1AN RELATIONS ` � � " ' ` ° ` ' '� ~ / f.4ADISON, WI 53707 �iLi-i�i �3.�)(�i!ii �?� C:.;apter 1i.r.�.l L(r)CATICIN: $ECTIOtV. � U�:'NS ��P/fv1t717TC??`Y�-;`-hrY; LOT N✓. f3LK. iJO.: SUSDtVISION NAME: . I�,c �� <:� �, ;--�� i�� y�� �� � r � 1�� �- � _� �: ;� � » �._�� ` CUUNIY: IOMJiV �'S;BUYLE?' iJF+` ,�: ' . i �iriILING A^DR��J'S:� L� `a+r�' /,Y `� +r IZ I �L� 1�/�' . � J\/1 ."ni-��.... �� . " �J f f''�'I �. � "� �.t n ;> ��D l' � �. .�r�'l C��� � �'� O C) � U ;--� - - - -_ <:T�, ,_; .. - -- +-= USE � G,;T�S vEc;Er�Vi,TiONS P�t DE (�/ I�:C:. BcDf;IVtS. : CO��I�bAE.^,�IAL � � .FiiF�;:;N. �l � IPROf-T�D�S�i' t �G�JS f'E� A IONTESTS: � Residence � � � i ; Nrw ❑Replace I � �a -% P ..� � �/' / -__�3 i // fj� i ` ' -� i f/ /� � ----- J l b � - . - -- _ . , T� R:1 i �NG: S= �i;a :W1dL`Ic: for 5`:5�8!". �J= .Cil:B l:"IjUlia::�� 'i0! ;'f5;9R� COM\ �NTIONAL� MOU'V��IN CRC"" �PRc��' .'Rc. ;>Y ^' i;' r� !L;r� � 7 NG i r.':� cCv'vif,".�'JDED S �'STEA4:ioptional) � � ❑�; � ��'� �!�� � C%<,�'� � �`,= i � , ,� '��j � � ` ' 1 §�° �i ,� ___, �-�:,:. � � : � :� �_ . ,,.�.. - - - _ . _ �..- _ ._�_- ._, If Percolation Tests are NOT :;ra�;ired ,��"''� '""�' � � �{ < <. ;..-� a��y poriicn o� th . . � area is in the _� imder s. ILHR £33.091511b1, indicate_ � _f�j ��;' '� ;odp�a n�'c•;e Floodpla�n elevation: `;�l h� . ;,�oi=� +I_ Yf�v''�;: ���T�on�s BORING TOTAL� , v.- , � i i ': y ? � - „��T - ; . , �- � � � C-r_ � �,h ".( ,:,TcR GF SOIL � � ri . - t,Ki��a , .:LO�,, TtXTI�f�E, „ND CEPTH NUMBER p�f'TH IN. 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V i . � � � � � L ' . . � � � , �.,r ..i . �•.��'�.� : I . . .� .� � � . -�. . .� -. . _.. . 1 � /� � I ' I I I 1' � r � � .wr._.....:..�r,�" . _.o I � i �'2r' v I , Y�\ i� i �� � t r�� I � _' . . o"�'p;'��_. _,_ � � ��� I� ' � .�.r�{� I ` `I .. � ' f ,.1 U� J m 1 �.' t ✓^ r ,p i "' i ' '1 . .� . �Jf rrt� i ,�_�,�_�. �J I � ,��� � �� � ' ; _ • ' ' � I . ` ' __ .,..... _ _ _ _ � ✓ ✓ {\ \ • ' ' � ` ' -..-.� = � , � 2 ,� � _ � � . _.I -- f ' I __. 1 __1__�. � -. , �, ► �, , � . , , � _, � _ i . i _.i----;. . _�._ ... - -�--- �--- .l.- --, . i . . __ ._�_. . � • � ' .� I, the undersigned, hercoy certiiy chat tl�a ;c:i :�;;s reponc;; o�: 'hi; ;orr„ a��;2 made by me in acco:d ���i[ti ;I�z proced:.�re; and methods specified in the V'Jisc sin A�RiiniSlr�iivC CO��, ?n;i (hJi thC (;�;"d fCCO(dE(� afld i�ti 1.�;7,fI0i^ C` '�1� :^S2: :�iQ CGff0C1 (C the ba;t cf my knowledae and belf8f, , �.AME (linntl: — ----- � ---- !�i�S�rc •.,����E i;G'.�,:''���cG u�l: - �.�-. . � � /; t • < � .� C� :,�1 r� t'-.� Pt �. '" :�t' � ; . "'" i': .� --x' .. , .. : . ADUR�SS: . -- -- '~: IC, RT„ aT�';^' NU\1�EF: , PtiONE NUfr18ERloptionalJ: . � . / -. , - J h - �( ; ! . n ::� s �' �_ / `i �'�� f� � 1� � f� /.-! 'iL. ...., i'(.. .dt� ; . .iJ .: /. Cl� � �j -� .� - �( Q ` �� � �.� / ,_" _' ___. .._'_��"_"— `. '__'_' � : J I C,i r i �i:l '.—_'_._ _ ° �'..`'�. �r / � —/ �/'.+Y'�.._!J _l._.��1 � ... �—�_ ;�-..�:.,�c_. .. .._�.� / l��• ^ISTRIF�UT!Oh: (' � �g:nal cr.donec �. . :o L�.ral ,,;nori:. . ':o,n�_ . O:.n.�, snd Soii Tes:a. . i" -- -_ _ _ — � • GOV�T,�OTE3 � � E . SEC. 23-40-9 EAST—`t`�E g4o 05 E•� c N. r ,� �9�0 OS j � ii 2�� L�. I.� FD. ` , 21�'l'l�o, m 738.00 , � ab `ti o� 0 35' E. 746.5� 45.32 4� 50 E. 825.3) ` 0 5� a� �N• 83 264.63 � �'' �V � `� �S� h1 a� ,� � 35 �� E. 5�° 0� o � ` 0 2 0 35 �� E. N, 83 �� � � � � ,� ��� N' 83 �� E, 428.05 0 ��30 �,� � , � I.D. I.P. FD 830 35 �� O 3�, � t N� � LOT I o° " �' � � 0 33-, � � � 0 0� ,,� . �o� � 29,200 SQ. FT. � � � � --� , 3 '� � a \ O � �6 S. 86° 43� 51�� E. ;,� 211.71 63.25 M „ 6 ro \`Z �� O O 600 �` �4 \ �\ N ; � LOT 2 � r � „ 3� a - ----- - \ � 9�0 30 3� 29,186 SQ. FT. op�;` cv _ \ N ', 4-, � � 7�0 �� � � j� b ---- .- �3 ,, �'o `v h �-�' � � > 57 �(! � S`�� '*�ti � (� a� a 6842s�'' � _ � � r� 5 ,`� a� c�n 9 68 O � w , �� o Q`\� �, � � �~ I o � � ',�� i i �' ,b � ' ; �}" 4' ,,,,, SCALE • I = 60 FEET � ��� _;C ' �-`'�• `°o 1�' '� �� �� �`+� �i . � .�r - , .. �_;f, ,; � , - ' �. �� O 1.25 I.D. X 30 IRON PIPE PLACED �� � C ° U , , , > � r(, .RO';I:;�'(' '', O �c`� � �� � � • ' 1.5 0�� L D. X 2 4�� I R O N P I P E P L A C E D �„ � .� rn � � - .� �^-. �, :.l�j .` S�J;. �.��_j - � T, � v � �.. � tt„�,��,..;;L�, • IRO1�J PIPE IN PLACE � � , � '''� � �` ^ �,i� w ,� � 'i� � n=;�� , , ( ) ED GOBLER�S JUNE, 1958 SURVEY � �; " � �: �•i � ., -�, . , _ -�j�-�, . J�-.�`„ .. -,:';, ,� ���� . , ; �, r �''���„�,1�t��•' NOTE ACCESS TO LOTS TO BE PROVIDED 9'f OWN R �� ► ��' � J � I ° �� ,e, �',�-�-e-� � �� ��'�� � `� � .�-.�0-8/ r - .. I , Robert R. Swanson, �Jisconsin Registered Land Surveyor, do hereby certify under the provisions of Chapter 236. 34 of the Wisconsin Statutes and under the direction of �gnes and Lowell A. Bashor � owners of said land � I have surveyed , divided , ar.d mapped the parcel herein described and that said parcel lies in Gov' t � Zot 3 of Section 23 , Township 40 North, Range 9 �Jest , Tovm of Bass Lake , Sawyer County, ���isconsin described as follows : Commencing at the northwest corner of Gov' t Lot 3 of Section 23-40-9 ; thence South 4°50 ' East , along the west line of Gov't Lot 3 , 82�. 3 feet to an iron pipe; thence North 83°35 ' 00 " East 428. 05 feet to an iror. pipe which is the point-of-beginning; , Thence con�inuing i��orth 83°35 � 00" East 264. 63 feet to an iron pipe which is on a meander line along Grindstone Lake� Thence South 32°29 � 57�� �`�est , along said meander lir.e , 280. 00 feet to an ir•on pipe; Thence North 71°23 � 57 �� '��est 168.42 feet to an iron pipe; Thence North 17°05 ' 3j" East 160. 00 feet to the P. O . B. Said parcel also contains the land lying between the meander line and the water ' s edge between the lot lines extended. Said parcel contains 58 , 386 square feet more-or-less and is subject to easements and reservations of record. Owner is �o furnish access road to lots. �'�,. , ;�.1. . ; � pr��-,�.,, .. _. �J1:Lat 1 '. . . �v SS�11� i"��.�.r � . ' - '�.� J 'IU;, ' � r ��Y.:n::17. ' y' T11J. ^, z� �1 i������.. ff�• F �` �ij f —Sr`�T'Y� �LDY`: �'�,,� UurV��.;. ��r:�i��i��„ �C�� ,Q �,�-�".� 3-�30-8/ Page 2 HI�HLINE ROAD O O B F�� � ��y � � , 0 -P O , °-� � , p o . D � � C ) � I r^` a ° � V � 0� � 1 9 7 1 �A 0 N o � 0 w N CN 0 � W ' � r 1 • � W Crl 1 � � w� 0 0 N I � � N i Z '��j � ,NO� � � � � j D O W m m O N W p N — ��