HomeMy WebLinkAbout008-938-34-5401-LUP-1991-115 II��''� M'�C'<�'";c�T> �IK'�� �
��-1-��F �' �L �D��r"r Application for Land Use Fermit
Cow�ty of Sawyer a�
0
1'he undecsigned hereby makes application for a Land Use Permit aud ayrees �
that all work shall be done in accordance with the requirements of the Sawyer � �
County Zoniug Ordinance and tlie laws and regulptione of the St�te oE WL!)CO11R10.
PRIN'P - US� ONLY 6L7�CK 1NK/PIiNCIL �
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�i��c� 1> b�t %%- .i � �.�/l1���1. }'
Owner �'' Builder �
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-731 ���_� ��c�e"G�,��� �,
mailing address mailing address
�1�Y\Lf._x.�Ci�, � ti�_Zi rll��1
city, state, zip city, state, zip
building Land Use Zone District ��"'
(�y. New ( ) Filling / ,9'-'"` r�S �q
( ) Addition ( ) Dredging Lol size [A� �(p,�,(.�Z, �.,ZQ �i' r* �
( ) Alteration ( ) Grading � . � �
( 1 Moving on ( ) �� ��7f' /�1 i Jt}� �� 7 v�
( 1 ( ) � .��-`Z. f, r, -
n
New Construction ' -
Size � fC wide ft wide
�7 ('j ft long ft long t,� . `�
�y
Floor area �{�' �� sq ft sq ft � ""�
U/
N
Total hgt �� to peak to peak � i x'
>
C�,
Stories 7)/�L� � , fj��
No. oE bedcooms �� rear lot 1' . or. waterline
(year cound) or (seasonal) �`,� .. �
i c�
Type oE bldg or addition ��� � o
i �N � tn C
( ) Uwelling li �, !�p' i C .t
� Gazage (1)�(2j ar i� � U S'
i N
O Storage buil ing �..j n �D i �.rt
( ) Doathouse '� �� � �
( ) Living[oom � /I� I �� �`�N i � ��
( ) Bedroom _''\ �i i �� -- � I
( ) Kitchen-dining ��
( ) Porch - enclosed/iooLed - �� �
i —
( ) DecY. - open ry I . ' �O _ � �
i �
�
( ) :� , �i---ca°-- i. . . . itV
( ) C I j �-+� ��,•-.i , �
� `J� I YJ ':)I �.
I
Type of construction v j ��,��'�, �
�'j Frame ( ) Block n.�i ��-> I
( ) Log ( ) Concrete ��� � l� J�
( ) Pole ( ) Steel (j �Z,'
i �' µ
( ) Metal ( I �� '��1 ��
.� � I� N
i. m
Construction cost $,= ,.-7 . ��.�`� �
Vol 4�� Pg (p°� of deed � !'; (L
/ ���J J'?.
csM vol _SIL_— �'q <.��' � _ ' i t' N
I H �
Cer. Soil 7'est —'' � ��`���� i m d
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/I Aucu --` ----CL road ------------------ z �u
Sanita=y Permit �'('I o3 Nf��,pl-� o I��
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I
Issued � � �}V N� �q C(� ' ��
Denied � ..,
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P���- ��,� _
owner Zoning Adminis rato
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N�RT�Ca�TE AS��CI�TES, INC. RICE L�K�� WISCC)NSIP! 5�868
G'ER TIFIED ,SUR VE' � MAP N0.
. . �
I�CATED IId GGV' T . LCiT 4, SECTIG;1 34 , T38N , R9v7,
`IC;�'T' GF EDGE`rJATEf?� SAT�dYER CCUPJTY� Z�TI �2v'SIPv'
`� .
� � � � � 0
R��e �� � SE CORN�R
. LAT 0�
Sawyer Cou�S' W QO D H AVE N
Rcoeived fa re� ti°1° �� � �
' AD lfl %`I dt � ocbck. N85QO7��E P.0.8.
�-�G'�l.c u-�ti ' _ . -
�M � �d in val C��_, � 27+ i��o 'i 12.1 I � k� � � 66
ct ('�;,.� �-�-�� mD°W��L � �p'`�
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L �<<...� '� � _
Reqistet �
"' LOT 4 � BEARIN � S REF-
a ��
Deputy �� ._ ERENGED �'0 TNE
� � 175° 38� �G� SOUTH LINE OF
0 3 7H� PLAT O F
,� o � WUOD HfiVEN AS
0 0 � BEARING N85°07�£.
� N86°0009`E � � �
63'+_ � 162.20 ,� o �
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a ca tn
co �n
� t 73°25'57"
ro 3
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1 c�o o �
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,�6 `�`''6'� �° 68'
+` � �,x� . 0 0°� N84°45 29�� �
6 �� 3 l
V 2� �.�2 �.� �
56 �
Q } �iso 02�
�' `�°�' �O� rn � 4/
. . tu � �'`'"' N Q'I
ti . 170°46`I4" °' ��
EXISTIN ` ��' j 2 � ry� L E G � N D
_ HOUS �p ��~ � Q 2" PIPE � FOUND
-� �L O 3I4 X24 IRQN RE-BAR SET
�y 1?9° II � 54�� °� N1lN, 1A'T. J.50 LBS/L{K. FT,
N
N� '� y� d 3/4'�X30� lROt� RE-HAR SE'C
�% g � c� ! �� MIN_ WT. 1.50 LBS/U�l. FT.
�;' 2 n+ � ' :'�.o .� � ---_R.�NT� OF- X�AY
Q�1 'l� F•s� $ (Rj RECORDED AS
� 660� o ' , F ,,.,�� �� �~j ��l
� 1� PIPE FDUtvD
32� �� Iv0. �t3 ..
1
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r �•�o °j � � 5-1063 j � ` . ,
.p� `��, � � = � �i10E LAKE, i (r :.
�°� �' 6� �,,.9 ` Y�iSCONSIN '� � �
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S 86° 36 57� w 4g �j�o •'•• ,� �,'b•�
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(R) S 8T�W -J i'ss�, � � �� ��o�o
CSN1 VOL.�4 PS � tQo��`•a'�
e I � ���g
REGtSTERED t, t�ND SURVEYOR
I hereby certify that ? have surveyed the property �� '
shown on this plat and that this plat is a correct t` ay_ �� �
representn�i:;n of said survey to the best of my knowledge and belief� . _ _ � �� �/�
' '��,�,�,".�, c�c�'io�,
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S�� � 1�= J00� . '�� PROJECT NO . : 1452 .
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Plb 67 ` �
! ' State of Wisconsin and County
Uniform Permit Application
� _ J �" for Private Domestic Sewage Systems
State Permit '� County Permiy�r �O�
Number f f s O � Number �1
-- —
A. LOCATION OF R�MISE WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
LEGAL DESC IPTION : Name One:
(Sec., Lot, Block)
o CITY VI LLAGE=
�.� C� � " 1'j S G,L,'a ( . � ' /V _ C G-c!� �" ��=�—Cc���`�'NTOWNSHIP
B. OWNER OF PROPERTY MAILING ADDRESS
Name (Street, City, Zip Code)
� ^� O . .� /� d / - � r ' GtJ . -E'' t�--+ `' ( �
C. SEPTIC TANK CAPACITY �7� � Gallons NEW INSTALLATION 'L� REPLACEMENT _ ADDITION --_
MATERIALS: Prefab Concrete Poured in Place Steel �� Other ; No. of Tanks —
D. TYPE OF OCCUPANCY �
One or Two Family Residence � �✓ _ No. of Bedrooms —
Commercial _ ___ Industrial ___ Other __-- —_ No. of Persons to be Accommodated � —
(specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES �'�NO Automatic Clothes Washer YES �
Dishwasher YES NO Other (Specify) —
F. EFFLUENT DISPOSAL SYSTEM NEW � EXTENSION ADDITION REPLACEMENT
Seepage Trenches: No. Lin. Feet — Trench Width _ Depth Number of Lines —
� ,� .i . P
Seepage Bed: Length � �' Width �L' Depth ��_ Tile Size _�_ No. Lines �
Seepage Pit: Inside diameter Liquid Depth
G. Percent of slope of land % direction
H. Indicate Slope of Land & direction of slope on sketch I. Tile Depth � � � �
PERCOLATION TEST
Indicate Soil map number `�— And Soil Type �G�i'` ��
Hours Water Test Time Drop in Water Level Inches Minutes
Test Depth Character of Soil Since Hole in Hole Interval Second to Next to Last To Fall
Number Inches Thickness in Inches lst Wetted Overnight in Minutes Last Period Last Period Period One Inch
`� � � - C� � � �' � ��,
� � � S lt N O �L��� G� k' � !�
� �- ti � t.� ) Ca �� .
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
S 0 I L B 0 R I N G S — Minimum 36" Below Proposed Absorption System
Boring Total Depth Depth to Ground Water Depth to Bedrock
Number Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches
� / . .
� �' , ��7 �f C ��� a. � L�/,� ��''
� �� �� r� ,� � � � � �
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RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
(COMPLETE OTHER SIDE)
Name of Owner �.�� ��.S.S�� County ��J��i�.. Permit No. �� I
PERCOLATION TESTS
I, the undersigned, hereby certify that the Percolation Tests reported on this form were made by me or under my supervision
in accord with the procedures and method specified in Section H 62.20 (31, Wisconsin Administrative Code, and that the data
recorded and location of test holes are correct to the best of my knowledge and belief.
NAME � _,.�i -C J�, �,�f � TITLE —_����
� � (Type or Print)
REGISTRATION N0. -- — — or MASTER PLUMBER LICENSE No.—���
, ; t.._ � -
ADD R ESS -��—�.� r� � '".�/' ' " ``'.
.. , Jj � � �
, , �
DATE OF TEST �� � � "� SIGNATURE ��� 6' ��� %'�-"
� � .
. ; ,
,� :.. ,
--------------------------- -
MASTER PLUMg�R MAKING APPLICATION MP � I,�
� �� / �
S i g n a t u r e: :,,/ �t� ?�� v'`�• ,�'t �� License Number: MP RSW
For: ��_�� � � � -�- Provide sketch below of system
�-_�� �..
(empl ye � �' (Include direction and percent of slope and all applicable distances)
20' '. \ �LAN VIEW (Locate Percolation Test & Soii Bore Holes) _ E 4.._...-_f '--.
1 �
15' � _ � , _
, . �
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10' j ! ' ' � , . _ : _ _ �
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;_-, � 7` / � %�' � ,?a ' /t'f / i�✓ r- /� S�.D� .s`
PROFI LE (Indicate Groundwater or bedrock where applicable) ;_ _ ; j
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Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid.
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Do not write in space below - FOR DEPARTMENT USE ONLY
Date of Application Fees Paid State 1• Q� County ��.��
Permit Issued/Reg�ed (date) vUL�� I���- Inspection Yes � � No
Issuing Agent Name K� �'►�1 ����T� 'D�P��rY Valid No. Date Rec'd
DIVISION OF HEALTH,P.O. BOX 309,MADISON,WI.53701 — Revised 4-1-73
Department of Zonin� and Sanitation
Sawyer County
Inspection Aeport
Name of property ���c,J /U��So,�
Description ���y� , ��%y ��� �� i,��,v �qW
----r -r------ ,' --7--
Owner Address
Suilder Address
Master Plumber G,v�c�,E-���,E Address
Inspection
(� Private ( ) Public Property Sanitary Installation
Dwelling Privy
Violation Mobile home Setback - Lake
Garage Setback - Road
( ) Sanitary ( ) Zoning Setback - Lot line
7fi1' I
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.) �.
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/-i�4K� CbF+ETHC
Discussed with Suilder ( � Yes ( ) No
Discussed with Plumber � Yes �J� No
Date of Inspection �-� - 7�
Signature of Officer ���� �p,�,�.:D
r
� IEEP 1 GF 1
SU`P.VEYGR'S C�I'IFICATE PAGE 2 GP 2
' I� :,es� A. Jesse, :e�is�ered Land Susveyor, nereby certify .hat ' have survey�-,
divide� and -.a��,� a parcel e: land located in Govern..ent Lot � Section 34, T38?',, ,
R9:d, '_''com o= F,�gewater, Sai•ryer Co�nty, `.�7isconsin, said parcel is bow�3e3 by a 1ir.e
describeci as iollows:
5e�irninc at an existinc 2" iron pipe at t'r.e Soutneast corner of the Plat of
��7ood =iava-�;t=:�:ce S3 Sc'4a"'�, ll1.01 `eet; t'�ence S00 25'02"id, 96.53 feet; tnence
S5 5°'OS"ti, 90.10 feet; thence S20 23' 36"'t�, °1.63 feet; thence S29 37'22"u�I, 9?.4C _`ee`.;
tk;a�ce S30 25'28"'.•;, 101.06 feet; tha-�ce S24 27'49"?�7, 180. 28 feet to a point on �'re
:�orth liae ef Lot 1 of the CertiPied Survey i•:ap recorde3 in Vol,ime 4 on page 85 c�
Certified Survey 'laps for Sawyer County, ,�Tisconsin; th��ce S85 36'S7"id, (recor3e�
as S27 ;d) 147.70 feet to a :�e=.nder point 20 feet more or less r-a;. t'.,,e wate*s e�?ge o`
Lake Chetac; tnence along a ireander liae i;2C SC'S0"=', 190.64 �ee�; �hence :d20 22'21"�,
265.42 fe�t; t:�e.lce i:16 40' 33"�, 318,Fi6 ieet to a :ieanaer corner a� tne Soutnwest
s_.--corner o` tne Plat of �-?ood :'_ave^,, said *neander corner being 27 `ee: rr;ore or ].ess froc.
't;lE Wdt�ZS E.':02 Of I,d1.C' �'fiG'�dC� ir.2a'iCC.' i��i� �i��� �12.�]. L2At �C T_"i? "'i Oi
'1J0_u�
be?irainq: .
, - Said narcel incl;;des that 1 and l ying bet:aeen tne r::eander line and tn,e side 1�`
lines extP*�ce3 to tne watars e:ige of Lalce Cnetac.
Said :arcel is suhject to ease-rAnts of record.
'_"ha� suc'si olat is a correct representation o€ all the ex�e-i�r � �-�caries of
the 1�1d s�rveyc�: and the subdivision thereof r^.ade;
� 1;�a+ I ;,ave :�:ade such s���e}�, i�'�n divison and certified �ar:ey s�y t;,e
directicn of ';r. Allen �leison.
"�:at I ;Eve fully conpli� w_t: t:,e provisions o� Cnapter 236. 34 0; tb.e
,. i•Tisconsin Statutes a-�d tne s,ilxiivision re?ulations of tne To:an of F�i.�ewater and
the County of Sarryer, in surveyina, d'zvidina and rnapping the sas,�,
�1t`���Oi9Eii:gt�0,�'' . .
a�`4``�/\ ��O���'''� � �
� f DEAN A. ' �
� (, I 9 � 9 �� ` sEoosE � ,�, �-2-c%� �. -z-�
Date ��� RiCE �nrcE, _� � Dean A. Jesse
�� � wisCONSiN . O= Rc�i stere3 Land Sur yor
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