HomeMy WebLinkAbout010-841-35-5102-LUP-1991-068 �,3y �_S� y .
1lppiicaLion for Land Use Fcrtnit x
County of S�wyer y
0
1'he unclersigned hereby makes application for_ a Land [l5e Per�nit anc3 ayrees '� �
i:he.t a11 work shall be done in accordance witli the requ.irements of the Sawyer �
Cout�ty 7,oni.ng Ordinat�ce and the laws and regulat:ions oL t:lie StaLe c�f S^lisc«nsin. �
PRINT - USL OA]LY I3LT3Ct; I.NK/1'1�ilCIL �
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Owner Builder. �
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maili.ng adc]ress mailing acldress
�/�Sh`l'�%��` .'�// `����_��' -----------
czty, s�.ate, zi� ci�y, �L-ate, zi.p
Duilding Land Use 7one nistrict ___ R �"_�
� New ( ) Filling �' c��
{ ) 1ldditio�i ( ) Dredging Lot s�_ze _ _ ct "
----- - .-. a
( ) 111Ler�tion ( ) Grading N �'
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t ) t-toving on ( ) Ilcres `� • !r �o _--
( ) ( ) I�;
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flew Constrt�cticn ' �'1
Si�e _ ��-• ' .`.l. wide it or�c'� IC�
;'�;'� f l- long ' Lt lonc; I�
Floor area /-/-r��'-;� sq f L- _ sq f t r;'
b: `.
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'i'oL-a1_ �tgt j(� � to peak to peak �' �.�
-- ��
Stories ' -'�
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tao. of beciroorns ���e oz waterli:ie �
(ye��_ rouficl) or (seasonal; i,— _� �—_-- --Q
. i� \_ ------- i ci
'Iype o� blclg or addilion i \ � ---- _ __ _ __ _ _ � � o
i 1 .�- -,s-. ._ � tr �
O C1we17 ing � __' 3�: ' j --
( i Garage (1) (2) car � �.\ 1' ' � F,, �•
(�"; Stor_age building � ( _� � i � rr
( ) I3oatliouse � � ' � N
( ) I,ivingroom � '� � _� �� i c �
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; ) i3edroom � ; ,� ; �
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( ) Kitcher.-dining � � � �,
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( ) Fo�ctti - eiiciasedjroofed � �,f , -``---�� �
( ) DecE: - opeii i ��"� � � i �
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Type of cons��ruct�_o�i j'� � '� �� �
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( ) Frame ( ) Ui.ock i ` � �
( ) Log ( ) Concrete � � �
Pole ( ) Sl-eel ! i � �'�'�
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Cor�struction cost $ �G'C-'�� �"' � �'S����� �` i n
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N 26 CFR7 !'rlc0 SURVcY MAP
0 PA�?T L'F GOV7 LOr I SEC 35, T1/N R3W,
� N% Co� S�q33, TR/NRBW LOCATED IN SAWYER COUiVTY WISCOPJSIN.
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I , Ronald L. Peterson, Wisconsin Registered Lend Surveyor hereby
state that in compliance with Chapter 236.39 uf the Wisconsin Statutes
I have surveyed, divided and mapped the land herein described, and
that to the best of my knowledge and abilit.y tLis mup is a correct
representation of the survey made. I Furttier st�yte that ttiis survey
, has been made under tlie direction of MR. KURT KRE'I'SCHMER, owner .
This land is located in Govt. Lot 1 , SecLion 35 , T 91 N, R 8 W,
Sawyer Cowzt.y, Wisconsin described as folluws :
Commencing at Northwest corner of said Guvt . Lot 1 , Thence
S 0°O1 ' 31" W, along ttie West line of Govt . Loi: 1 , 51.9 . 66 fee't , Thence
S 89°43 ' 56" E, 593 .86 feet to the actual point. of beginning, Thence
continue S 89°43 ' 56" E, 246. 75 feet to a meandcr corner on t.he Westerly
shore of Round Lake, Thence S 19°OS ' 22" W, a1un�� tC�e meander line of
Round I.ake, 105 . 68 feet to the end of said meanc3er l.inr. , Thence
N 89°43 ' 56" W, 256. 15 feet , Thence N 23°49 ' 09" F_, 109 . 09 feet to the
point of heginning, and including all ttie l.and t�etween the meander
line and the waters edge of Round Lake, betwer.�, thr parcel lines
extendrd to said waters edge .
Subjec�t to end togetPier with joint use of a 30 Fool, wi�e driveway
easement as shown herein.
Subject to d11 existing easements and reserv,�ti��r�5 .
a�"�'� 1 2� 588 �
sa.�ca�n�
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A D�IB�at�_o'alock s�
d recorded in vol.��___ �� �
of �P°9eJ�-=-i-��. R��P � ��i
x �s�� � PETENSc)N
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HAV W Anl>
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ThiS insti��ument i�rafted by � " $UR����� �
Ronald L. Pelerson
Auyust 19 , 198
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/��.�,� � ��l�
A�,pi�uved Ct��is ��day of �j�f/ , 1987 , t��Y ��,�� _
S�iwyur Ccnuity Zoning Admin .
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UN� �A
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FAGE I OF 2 PAGES '����Mi���3S
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Plb 67
� �` State of Wisconsin and County
j Uniform Permit Application
,
for Private Domestic Sewage Systems
State Permit '' County Permit �
Number Number
A. LOCATION 0 • PR MISE WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
LEGAL DESc�RIPTION : Name One:
(Sec., LotJBlock) CITY VILL,�GE
i� . :v . 02' t,22� i•• .-,• y ��C _{j l . 41 xu� :i, fj :r' :iesYt:. .`w TOWNSHIP
B. OWNER OF PROPERTY PJIAILING ADDRESS ` �;�}ii � 1
Name bULll �1e �ai4Jl'�.v1li'.L'it (Street, CItY, Zip Code) j�r�yrjVay,jj� ��J,�;VtJ�wll�
5��SG
C. SEPTIC TANK CAPACITY S�— Gallons NEW INSTALLATION � REPLACEMENT — ADDITION _
MATERIALS: Prefab Concrete Poured in Place __ Steel � Other ; No. of Tanks _�
D. TYPE OF OCCUPANCY
One or Two Family Residence '-'u�`�"�+^�� ��"j'� No. of Bedrooms3
Commercial Industrial Other No. of Persons to be Accommodated _�—
(specify)
E. APPLIANCES, ETC.: Food Waste Grinder YES � NO Automatic Clothes Washer YES � NO
Dishwasher YES �_n0 Other (Specify)
F. EFFLUENT DISPOSAL SYSTEM NEW �`X EXTENSION ADDITION REPLACEMENT
Seepage Trenches: No. Lin. Feet Trench Width Depth Number of Lines
Seepage Bed: Length �E) � Width 1C s Depth �.�.21Q Tile Size �y�� No. Lines
Seepage Pit: Inside diameter Liquid Depth
G. Percent of slope of land ��—% }�}g��— direction
3�n
H. Indicate Slope of Land & direction o` slope on sketch I. Tile Depth
PERCOLATION TEST
Indicate Soil map number And Soil Type
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 1st Wetted Overnight in Minutes Last Period Last Period Period One Inch
1 �2" no tUr.�oii. 4�2"s� 16 I�U - ,
2 42" no to soil 42"s�;r� � 3.�, �yU 10 6 b ' 4 �
n , �. • n
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
S O I L B 0 R 4 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
Z �l° �rU ��? ° LO i5 ' - u �,.-
�' �` u r�0 ' �z�rl nff �� "Ls�r•�d
3 ��G" ;.0 I� ' to�sail d�zad off �A" sand
RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
(COMPLETc OTHER SIDE)
Name of Owner nURT 0. ii1Zr;Tj�HI��ri County JXw�� Permit No.T��
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 (3); Wisconsin Administrative Code, and that the data
recorded and location of test holes are correct to the best of my knowledge and belief.
NAME �l"uRr:lu�;r. i�':h;PCu i F TITLE —��C.IiuTR:,�",Tni-2
(Type or Print)
REGISTRATION NO. or MASTER PLUMBER LICENSE No. �l.�aR
ADDRESS OU, , � �-v, ,; _, - _ ,.— . , . ._..
DATE OF TEST i ]T�` ��,� �7� SIGNATURE ��'�'"� '"
�y.
MASTER PLUMBER MAKING APPLICATION MP
Signature: — License Number: MP RSW
For: _ Provide sketch below of system
(employer) (lnciude direction and percent of slope and all applicable distances)
. ; & 5oii Bore Holes� - � � -- t -
I � PLAN VIEW (Locate Percolation Test i t-
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PROFI LE (Indicate Groundwater or bedrock where'applica I , � ;
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Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid.
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Do not write in space below— FOR DEPARTMENT USE ONLY
Date of Application Fees Paid State ,—•�� County �V��—
Permit Issued/R'L�2C[2[F'(date) ��.�T �s �3 Inspection Yes -��-'�`�=�No
Issuing Agent Name Valid No. Date Rec'd
DIVISION OF HEALTH,P.O.BOX 309,MAD!SON,WI.53701 —Revised 4-1-73
D�.partr.ient .of 2onibg and Sanitation .
&awyer County
Inspection Report
Name of Property
Description
/�Cr�r`f.0• rC�'S �i-cr• }7�' �_ �/A�S h a��•w`�•
Owner /�r�,�✓' Address � �T
Builder 5��� Address
Master Plumber G•�P/c"�'�7 Address 1�1f�/G���"�
Violation Inspection - Check box
( ) Sanitary ( ) Zoning (x) House (�) Sanitary Tnstallation
( ) Garage (X-) Setback -� Lake
( ) Privy ( ) Setback - Road
( ) ( ) Setback - Lot line
(K) Private ( ) Public
Comments
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Gf�'�
1
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Discussed with Builder (,(,) Yes ( ) No
piscussed with Plumber (�C) Yes ( ) No
Date of Inspection __j�_2_-
—�T—
Signature of Officer