HomeMy WebLinkAbout002-940-36-5212-LUP-1991-342 Application for Land Use Permit �
� County a�f Sawyer o ,
The undersigned hereby makes application for a Land Use Permit and �
agrees that all work sha11 be done in compliance with the require- �
ments of the Sawyer County Zoning Ordinance and the laws and regu-
lations of the State of Wisconsin.
PRINT - USE BLACR INK OR PENCIL ��
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Owner Builder �W
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Mailing Address Mailing Address (Q�
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City, State, Zip City, State, Zip
Building Land Use Zone District � �R 1 0 �
(k) New ( ) Filling , 63;�2(,y
( ) Addition ( ) Dredging Lot size Z SO X �`c � n
( ) Alteration ( ) Grading v
O Moving On O Acres 1 d'.l �
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New Construction y .
Size Z 6 ft wide ft wide �
,�z ft long ft long �
F1oor area ��2 sq ft sq ft
td \�
Total htg (.3� to peak to peak x �
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Stories � Stories �
No. of Bedrooms (� "�;_ , •_ZSo '.---�
- or waterline c�
.J ON�So�/ LAK� O
(year round) or (seasonal) �, rt
Type of Bldg or Addition Q' r'
( ) Dwelling � a o
C• rt
(X) Garage (1) (2) car
( ) Storage Bui ing �o ~ 1�
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( ) Boathouse o
( ) Livingroom � �
( ) Bedroom
( ) Kitchen-Dining i--- g
( ) Porch - enclosed/roofed .__! �ti�" N
( ) Deck - open }�ous< . , i
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Type of Construction �. �nv w
(x) Frame ( ) B1ock � ,�S` 6� r�.
( ) Log ( ) Concrete ( �H �
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O Po1e O Stee1 � � 4 m
( ) Metal ( ) �' �ix ;I��----i9/---,, o� �D
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32' �
Constru�tion Co��`$ ,Soo.00
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Vo1 62Z Pg 63 of deed �
CS Vol /2 Pg /!� ��8 ro �
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Cer. Soi1 Test '��D"oL3 �
Sanitary Permit ��—'��o --"------ L
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�AKE t?D. EX?E..rsio.✓ p
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Issued 23 December 1991 Denied N
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Owner Zoning A ministrator
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SAWYER COU(VTY CERTIFIED SURVEY MAP
F0. II/2"I.F NW Cw A part of G.L. 2� Sec. 36, T. !y0 N. � R. 9 W.
Sac. 36
N 90"00'00'•E
1678. I' NORTH IINE SEC. 36
BASE OF BEARINGS
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o � i9�ies�t. h� 32°�239�W
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SIIRVEYOR'S CER^1IFICATE
I� LYLE L. ELLIOTT� regiatered land surveyor hereby certify that by the direction of
ALEXANDER SCHIRG�'R, I have susveyed and mapped the land parcel which ie represented by
this Certi£ied Survey 14ap:
That the exterior boundaries of the land parcel surveyd and mapped are described as Sollow;
A part of Government Lot 2, Section 36, Township 40 North, Range 9 41est, Town of Bass L2ke,
County of Sawyer, State o£ Wisconein, and more particularly described ae follows:
Commencing at the h'orthwest corner of eaid Section 36, thence N 90°00'00" E along the
North line of Section j6, 1678.21 feet; theace S 9°15'20" W 800.4� feet to an iron pipe
being the point of beginning:
thence N 89�1,K�43" F 4�4•OS feet to an iron pipe on the shore of Johnson Lake;
thence S 32°12'39" �d on a meander line of eaid Lake ']9.99 feet to an iron pipe;
thence S 1°30'24" W on said meander line 162.35 feet to an iron pipe;
thence s 23�46'36" W on said m��n3er line 101 .33 £eet to an iron pipe;
thence N 75°32'36" W 39l1.Ej feet to an an�le iron;
thence N 9°o3'j1 " F 230.3R feet to the point of be�innir.g, said Far^el contains 2.62
acres more or le�s, includins all land from said meander to the waters edse, and aub�eot
to any easer�ents or restrictions of record.
I have fully cecplied w�ith the provisions of Section 236.3�j o£ the 4lisconsin revised
Statutes and the eubdivision o.dinahce of Sawyer County,.in suz�;eying and mapping sam�.
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Hc�+,,,�;l���s ) 2 � S J 3 ✓ o;;` L L. ELLIi�{'r, land surveyor
FOAY`l�Oi�' j� � " Wi consin Regiatration S-1 j00
Rxen•od fnr tea+rd me ,S 2at 01 .�� � 4 , _ D3 e: hiareh 30, 1988
� � < <` � '��' I hereb certif that thie survey ie
�t7-k�l A D 19).i at �''�o'clack t c. 1,. � Y Y
M. and recorded Ln vd.y/.: " :; j:';,;};,,�, E�� i = correct to the best of �y Imowledge
o� viF'.�:ll�„ onpaqe /� _ ,• und belief.
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�'� � � � � State and County State Permit # 15 4 3 � �.`
� � Permit Application County Permit # gl - 1 ] O
� for Private Domestic Sewage Systems County SaWyE r
' DENOTES STATE APPROVAL REQUIRED CST 80 -� Ob�
Date Approval Received from State if Required S2ate Plan I .D. #
A. OWNER OF PROPERTY '�j � � U,} , ���� �J�t7lailiny Address:
�� � � E����%r✓C-e��=id � Y�� �y d � �' �
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B. LOCATION : YQ Y4 , Sec ion _ , T N , R (or) W Lot # City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township �� "6r
C. TYPE OF OCCUPANCY *Commercial " Industrial 'Other (specify) "Variance
Single - family � Duplex No. of Bedrooms � No. of Persons_�
�• SEPTIC TANK CAPACITY. �S�' Total gailons No. of tanks _�
HOLDING TANK CAPACIT'�' Total gallons No. of tanks
Prefab concrete Pcured-in-Place Steel �_ Fiberglass Other (specify) _
New Instailation �V Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E, EFFLUENT DISPOSAL SYS7 EM : Percolation Rate � Totaf Absorb Area �-- sq. ft
New Replacement Alternate (Specify)
Seepage Trench : No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed : ��F Length�Width �� Depth_�/�Tile depth (top) `_�.No. of Lines—.�
Seepage Pit: Inside�mete Liquid Depth No. of Seepage Pits
Percent slope of land � „/� - Distance from critical slope /1�l��ffl,� . �j�
WATER SUPPLY: PYiva+e Joint ❑ Cammunity ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I , the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin tldministrative Code, and that I fiave sized the effluent disposal system from the EH- 115 prepared
by the Certi � Soil Tester,
NAME �� ���,����r� C.S.T. # J�� � �7 and other information
obtained from (owner/builder} . �/
Plumber 's Signature Mp���g{�p / ;l� �D Phone #��� �� �- �'��-�
Plumber's Address r � � s�` �
PLAN V I EW: Provide sketch below of system ( include direction of slope and all distances in accord with H62.20. Well loca-
tion shalf be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
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Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY ;
Date of Application 0 6 - 2 9 - 81 Fees Paid: State 14 . 0 0 County 36 . 0 0 Date 2 9 June 19 81
Permit Issued/�dgqr� (date) Ob - 29 - 81 Issuing Agent Name Gayle Jorczak
Inspection l�"es li' Ne __ State Valid# Date Rec'd
1 . county (white cop°,�j 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
� ctatP. ( Dink CODV) . 4 n�umher (ranary cn�vl