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HomeMy WebLinkAbout010-941-26-4311-LUP-1991-110 . �; ��`'�� 1lpplication for Land Use Fermit �_ N�4'"�V�� ,� �'�ll�,�`:1-- County of Sawyer �'�_ , ,.!.!C.. o � The undersig�ied hereby makes application for a Land Use Permit anc] ayrees -! � tliat all work s}�all be done in accordance witli the requirements of tiie Sawyer °, County Zoning Ordinance and the laws and regulations of the State oE Wisc�nsin. ��O�w � � • � PRIN�r — usL ONLY ULd1CK 1NK/F`liNCIL C/�.� a �� ��N�► �� �v1��s z. ��� a%�� E�15��-� � ��► Owner Builder �)�--�- �--�,� L-� � '`, �� � /�c�X ��� 5` mailing address mailing address _ 1� A 4�u.� w i��i t� � S�1 s��l� l-�►s 4�w,��' � tiv� ���� city, state, zip city, state, zip �uilding Land Use Zone District �,�-+ ( ) P�w ( ) P'illing S $q (I�nddition ( ) Dredging Lot size rr � ( ) niteration ( ) Grading N �+ ( ) ttoving on ( ) Acres �� �p� , t � c � � r: _ , tt- � � �_�;C:-� �r`�.�;=4>d �_:,�., d t�;�'� New Construction ' ( � ci�T �..�,c.;E ,, �,_��', Size � f l wide �"'"�'''` �`�= f t wide �!, V; / �-- f t long ( � f t lony � Floor area I� sq ft �1�_� sq ft {'� i � �? l Total ligt � � to peak I �- to peak %�' r -,. Stories � I � No. oE,bedrooms �� ' r rear lot line or waterline �ear. round) or (seasonal) � � � ( i i o 'I'ype of bldy or addil-ion i ; C ( ) [lwel l ing � .,�, �� .':� � � rt ( ) Garage (1) (2) car � � - _ _ � � � � �' ( ) Storage building �, � � � ` �'� � � � ( ) E3oatliouse � � � � �G � i N ( ) Livingroom �y�/' � i o rY � � I ( ) F3edroom � G ,. ,� � � r �i 7 � ( ) Kitclien-dining j \� i ( ) Forch - enclosed/roofed � � ��� �24 +� i � ( ) Deck - open I�v � " " � (�" _t�C-� �'X��f�.� �Sc'/�', i � 20� D � - ( �"����C �r�s r�E�� ,���� Qc�m r '��,�; � ,, �,� ; � C ► , w. �' �- , . ,�� 1 °►3_`° f-1 � G TYPe f construction '� �� p8, � ,�_ i � ( [�rame ( ) 131ock � � � _1_�_� �` �0 1 CA 2� ; � � � ( ) ►,og ( ) ConcreL-e � � � � _��I2° 1 o i � ( ) Pole ( ) Steel y� ��c._�` ' 1�, c�'�r,k,r hi �...- ( ) t•f e t a 1 ( ) r '1�o Y �j )�a'' ,�,.�`��,,r t � ' � I VO . `�=' -��\�- °' I (ND Construction cost $ � pb j �,'`I � ,I ►Z2' � � �-- --�-ai I Vol 31�/ Pg 173 oF deed � ` _ � ' �o i � r= i i; �p a � r* CSM Vol � Pg �,� j. � �3" ° � "•_ i ro i o� � 22� r- � � � Cer. Soil 1'est 7� -�7a � � � �Il•(fl� _ � m d j ���� — =------- C ro -----------------0- z Sanitary Perrnit �� ��Qd L o �" — � �1..+� � 1 z Issued ��j JU�� ��� � Denied � " ` '� i � � ' ��N J�- { In�k� — �C ��'. �z- 7oni_ng ndminist� t " �?z'��° _ a ,Z- ' --, � ���� �. - - . .^,nwVnr Crwnh' J ifl �Y.oE .,..,� r„r recad tE6� �'l r`�... , . p iSo ebnk I� 1,� A D IB��U. , ,r �I �cK.ctdFd{A�OI._�___ �� ����-yy ' �'� � �,��- - ,;�,,.,.. ,y2-• w. . �Zbs.s� E� .v�, b r"� � °�' N� �' � R� � � O p� mp Q' `I A'►�t :o � � �. o � � 0 r � ioo' ioo' S. O6�88yz �E. 1 �� N° ��. e�r I �'S-_ P O �_ � � Z � O � y � n � � rntv Z � EF °` y, �,n � �� �'. � �M ��. � ��,' ' 56.5 ,� p5 27'OO..E. �� • � n � 2 D (n ln �� � S� o � � r (n � Y m R� m 0 � � ' n ,Vo �� p k 2 rn n � � � � � � � � � � p � 1 � � p \ m u = � � � ln y � Z Z O � �c� � ,,, � � � � �l :' .�1 , � D �*l b �I � , ; cn„ � m y � � {� � ' . � � � �' " � � � ff E - . � � N � � , � _ q �. _ _ � � � ,� E' �'� n �� � N �'�.� �'�� - - � � � 1 � � �` . " � ro _ � � � - � � i�;��;� 1 �, ,�„ ti � :,.,,i�ed S�uve9 N��3<4 . y.3 R � TOWN OF SE '/� . SEC. 26 T� lµ. 9 .14. 8 .14�. S LA K E 13� .'3.6 HAYWARD �y2 . ,�.6 .vo 14�.3 /' .13.7 / l4.1 14. � . .1�.I6 � �� 73 O �� c .14.11 Z''z _i4.zi �, �C��T ..,,—Z l�{.I � 1`t.l .I4.1 �Ay �'Pp 14�1 .l�f. 1 � .1µ.17 - Iy.20 ✓ 1418 .13.8 /� .�s „ r ► � � 511 5. 6 .15. 4 .16. / I 5. � � �.,� , =x� H W Y .I,C' 3 9t � 15. 1 '���,° � 15.10 15. 2 .15. 8 � � . � P L B 6 7 State and County State Permit # 10 36 0 - , � - �q Permit Application County Permit # � for Private Domestic Sewage Systems County Sawyer "DENOTES STATE APPROVAL REQUIRED CST 79 - 372 Date Approval Received from State if Required 12- 08 - 8 � State Plan I .D. # g0 - 50789 A. OWNER OF PROPERTY Hayward Animal C11ri1C Mailiny Address: �o � N � , ki,Lt� lSz �QT � � /} i� a � T, i�c. , � c� �/ ;3 `� B. LOCATION: �L' }�'�'a �S � Ya , Section � , T� N, R � (or►� W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village C� -r � `�� '� Township l�f� �/r.t,',q2� C. TYPE OF OCCUPANCY: *Commercial "Industrial "Other (specify) 'Variance Single family Duplex No. of Bedrooms No. of Persons �• SEPTIC TANK CAPACITY � 0 � �1 Total gallons No. of tanks � HOLDIIVG TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) _ New Instailation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate � � -- Total Absorb Area �"' `� sq. ft. New � Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenchf�s Seepage Bed:._.�—Length •�_Width�—Depth�Tile depth (top)_.�..�—No. of Lines � Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land t '�� Distance from critical slope 1�1� WATER SUPPLY: Private� Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: �"���_ � V �2 � �,� �; I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I tiave sized the efftuent disposal system from the EH-115 prepared by the Certified Soil Tester, O ; NAME + -+i.i C' Y. 2 � G G .3 C.S.T. # � . � — `I �f / and other information E obtained from 'p [" ".! ' n ., (owner/builder�. � Plumber 's Signature�Y- , '�'-z- �y L--=� I�1 p�Mp�g 6 .- ' - /� Phone # 7�,�j —��� 5 �ylj'�j , Plumber's F.ddress � 2 Stone Lake 1'1T1 5 � � PLAN VIEW: Provide ske,�{;h below of system (include direction of slope and all distances in accord with H62.20. Well loca- ition shall 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. I I � f s . . � � _ .�__ ..�.. ._ �;. _ .::,..e _.� .�. __ _:_.__�.�._� . ._,_._ . � : k I � ; 1 . . I .. . _ . . . , I l�R�� ��r� T ..__ T_ I .� � I,t_Z��� — --- , ._w...a.�.�,..�W��. _,p__..�.� __�_ _;,_._ � ��� � � .�I ; r ' ; � f � � € � , � � ; , _,-__ ,Z ` ` _._a � ._- .., �._ � _ .�. - _� , � � '—• � , 1 ; ; ' � � ..��� . _.� ' .. : �. ���_���� � ,� � ��-�' _. J C c O -�_ _ ._ _+�__ � �T-iY.�c , ; � , : � ____�_.__- � __ , __ _�__� ;__«_ �RoPosGo � �- � �_� _._.i _ —�� _i____�-_._-r-...... ; r�� i M.��l. a �.z:�:�L _ _+._ ._.i _� .�___. ,.�_ _ _. � . � � � i ; : � , , _��. ._ ....___�__.�---� --:, C t� +� t� �--- � -- � � -- � , � i , � ; - -_ , _3 . .�_ . ; � � i � , s � ; i , � , � � s ! � � , , ._._.. . _.. . I,. y_...._.i _... .t. _i.,..._....t _..�....._ . . �...,._ .:_ __ _. . I ' f , �_. , , � ' �__v _e_.�___.� ____.� _�, _ _ � � . �. , ...3 _ T � 4 � i _. . _.. ._ . � . . . . ( ���... ` _ � 1 4 i i i ��� � � � 7 � � � E ! � � ---�----I-.--;_- . - -�.__ _�-.__�___-�.. � __-�____..;_,_ _�---�—�- �----f-�- ; , , , � , � __ � . : , � � ' � ' ! . � _ _ � � i ` _.,�_� .tm.__ _ �__�� . . .�_ T� , , 'GT � ��� �� Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 11 - 10 - 80 Fees Paid: State 14 . 00 County 36 . 00 Date 11 November 1980 Permit Issuedl��aCt3� (date) 01 - 08 - 81 Issuing Agent Name Elaine I��ling Inspection Yes x No State Valid# Date Rec'd 1 . county (white copy) 3, owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 4 Department of Zoning and Sanitation Sawyer County 0 Inspection Report � � � Owner Address Name of business Builder Address Plumber � Address Inspection H ( � Private ( � Public Property Sanitary-instal � � Dwelling Setback - lake Violation Mobile HM Setback - �road o� Garage Setback lot lin ( � Sanitary ( � Zoning Privy tz� N � x � B.N1 tc��� �`' �..T. �i F. 5 , � D• �. G�� i � � " � tsc; u;�_L�- �. � Im � �, I '7� ��� '\ �, ^� �� � � ' i ���" U F\ ; '� ` I \: , ,, � , ---�- -- " ��r _ -----_ __��' � y 5' �5 -- I ( �� � ' �: �—OO— --- U] Ul Dr-w��y a-F�r�;i��5 � �i"�. �sf Cvr4t ��.�' ______— �� � cD ; � � — 6' � ; _ _ _ tz i ------ - N. L N, I I ��-- �- �,, ! ��.oF���� � � � �3 � � E I � , � � Discussed with owner yes no � Discussed with builder yes no Discus5ed with plumber yes no Discussed with ' yes no Dat e �%- /�- �G� Signature of Officer ��� j����--�' D � 1 - � O' p_ N N O 1 O Z � � � � � . � � H \ � � . .._..�. 1 . � W p _ � c . -, � � � Plb. # 60 1/78 PROJECT DETAIL DATA SHEET `� NAME OF BUSINESS �-�Fjy�uARo A NI Nr� L/N 1 LEGAL DESCRIPTION ,t) %2 � S L� %v ��G �6 TtuN �ll N R 9 GU OWNER �ToFJF� � ku�is� _ P1AILING ADDRESS RT oZ Mout�.ILt ZIP �0�1�9 ARCHITECT, ENGINEER, ,,C�il l F�(!r.5 ����'J��� ADDRESS �� � S f�'1 IY F ��� PLUMBER OR DESIGNER � ZIP Jc��f�� TELEPHONE NUMBER %/3!- ,��S' C /�/`� 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building New building ��S Addition _ ( ) Apartments and condominiums . . . . Number of bedrooms _ ( ) Assembly hall . . . . . . . . . . . Seatinq capacity _ ( ) Bar . . . . . . . . . . . . . Seating capacity _ # of ineals served _ ( ) Bowling alley . . . . . . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number of sites ( ) Camps . . . . . . . . . . . . . . . ( ) Day use only Number of persons ( ) Day and night Number of persons _ ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Church . . . . . . . . . . . . . . . ( ) No kitchen Number of persons _ ( ) With kitchen Number of persons _ ( ) Dance hall . . . . . . . . . . . . . Number of persons ( ) Dining hall . . . . . . . . . . . . Number of ineals served daily ( ) Doq kennels . . . . . . . . . . . . Number of enclosures ( ) Drive-in restaurant . . . . . . . . Inside seating capacity _ Car-service -- Number of car spaces ( ) Dump station . . . . . . . . . Number of dump stations _ ( ) Employees ( total of all shifts) . . Number of employees • O Hotel O Motel O Cottaqes . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit (� Medical and dental office bldas. • • Number of doctors, nurses, medical staff j Number of office personnel � Number of patients ,3 ( ) Mobile home parks . . . . . . . . . Number of sites _ ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . . Number of persons_ ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . . Seating capacity _ ( ) Dishwasher and/or disposal? ( ) 24-Hour service ( ) Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . . . . . . . . . . . . . . Number of classrooms � Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . . . . . . . . Number of cars served daily ( ) Swimming pool bathhouse . . . . . . Number of persons _ ( ) OTHER . . . (Specify) . . . . . . . �_ _ COMPLETE OTHER SIDE � - . t, ; � i� ,; ; ' ; � , � ��� �:� Indicate whether the following facilities are present. Floor drain yes x no Number of drains � Food waste gr;n,�+ar yes no ,,,,� Dishwasher yes _ no � Automatic clothe_� washer yes _ no Number of clothes washers _ 3. Septic tank cap=,city � DOC� Holding tank ca�;�=_city Septic or holdir�g tank man!ifacturer 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches depth number of trenches SEEPAGE BEDS : total square feet �j(� � width �� � l ength of bed �/� " depth � y " SEEPAGE PITS : total square feet outside diameter depth below inlet total depth from top to bottom of pit Sigr�a�ture ofi p�rso� completing form: FOR DEPARTMENTAL USE ONLY � � �� ! �� '� __�,, �_ :��.._ i � � ..� � , .� Address ���/1; ���� � �lt � „� �--��� Zip 5'0" � %'� Telephone Number �� j�. S� C S � � �'°�5`� Date � � � �� � „ ,., , . . �. � . . ,_ b . . .-I ..�ei � - 3SCOi1G127 - ::t�'Y'C:�� l:'�.1!1 :;l.l] l'Cy'07"'� [�O �"lP7 F�i:�: (,�,�� �11� .., __. i'] O�'].S10i1�' O!� �;�]lt'.�)�tCY' _Jr,, �,IL O.F ��1p' Wiscori^i.ti ..��.�� l.�� c . ��r; ��i ',>i� i;li^ d_i _��,c�tion of' Ua �ius Ja;i,� IrtOl'��711� OA',-I-1!`1' C;1 � I.'Y J.�� ,'i � ] 11�1<!t'. ❑111.'VB,yECI. � (.11V7.(!E?C) � 7Y1(] '.I:fi�.)fiF(� th� 1:�_ri�l h<>> c;_n ,' �.,c'r f L���+ , rui�l that :��i�J la.nd lir�:� in pa�� L oi' thF� rior�t��a�ae� b n� � :�n�,i, ���, . �, r ;iic �o;ztliea�i o:�c-fourtli (., . , � or ;; .E. � ) ` anrl t}ie ��o,� tir,���rL .,i;�_ 1�„�,� L„ o.i' Uhe -�ou�:'-ieae:L on��-tvur�tli (:; .��.d . ; � oI :� ,. 4 ) ol ,, � ! ,;i L�: , �, � ,;-':i ;_ (2u) , letrrts�i:if; .Corty-oii��� (��.1 ) i�OY.'�f:; � }��i'll�� i].Lll'. (: i .-, ,. L � lOIVIl O� i1.1'V'vJ0.YC1 , :�'dl'!yC)� .:OUll�y" � (.1S— con�in �l�sc� iLcd � .; f�ill oris : � o�n�ucn� l�� �� �� l lii�. ��1 � ;�12ier. ��+'esb of tiie souti'ieast ,ction corncr o � . _ � � , I �_uu . . �,i;ence l;olti� OS°27 '00" �.e;� t 10��). G:`; i'eet to ari ii -�ii j�i f�� � �'�'-�,�; oi: tiie no��tii i�i�i,t-ol-v�ay oY _ . 'i' .i�. "li" vrtlicYi i;; tlic l��r���1 -,; f -��:���;i��iiitih. i'ii��ic� Uoi� ��;��. '. ' j,.� " .�rc, � G17. . uy f'eet aloii�; tlie not:��l�i rigiit- of-��aay oJ� U . 'i� . i�. "�_ ' t-� �:�i i,oii pipe; 1��1r�i1C(` l.�)I ��� _ ���.�..ir �� ..�� . _ ,3-� �vj. j� .��C'.(: � t0 'dYl 1Z'OI1 �.11})l.'� . � i'Yieiice ��o�_itu .. �1 " ;;;isi: v31. . b1 i'ent to an iroii pil�c; „ "_7 ' ' asb 183 . 9c fec t to an iro:i �ip�; rriiicti 'ihoncc ����, I;li 1�; " , ls the �,oint-of�-I;��>;,;_�.ini.�i,�.. Sa.i�� r,r,r�c�J •�,�� t�"�; i�=� 1. 1 �� acr_es ;�ioxe-or-less. S�_�d i>ai c:� l ���'o ; �� L to easemerrts and re;,ert��a.tions o�" record . .,,,,u�i�n,q .� ��.' ���1� �`� � C ''. . . -� � - f�`' _ �R��.,� ., ., ��'• L�: OiJ � - tt;; ..;,;:�. , i t��... 1 ;��:,e �: �,�,(^-'r1Y•�"�'-' //-/L - 79 9y