HomeMy WebLinkAbout010-941-25-2218-LUP-1991-111 . �
npplicaL-ion for Land Use Permit
County of Sawyer y
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1'I�e undersig►�ed hereby makes application for a Land Use Permit ancl ayrees � �
that all work shall be done in accordance with the requirements of the Sawyer �, �
County Zoning Ordinance and the laws and regulations of the State oE Wisc�nsin.
PRIN'P - U5L ONLY I3L11CK 1NK/E�LNCIL
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1�-�'I IG r '� A-�12 �GIS� �� r� �-V>1 � ��
Owner Builder
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mailing address mailing address
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city, s�tate, zip city, state, zip
IIuilding Land Use Zone Di.sL-rict 71 I
( ) New ( ) Filling ��
� 1lddition ( ) Dredging Lot size l:�f� X � �`{ /�S7 r+ �
( ) 111ter�tion ( ) Grading �n H
( ) Moving on ( ) ncres �. �f'7 ���s
t ) O �
New ConsLruction ' �
�
Size � fl wide ft wide -
a.
� f l: long ' f t lony
' Tz�T.��
Floor area �3� . sq ft 5+2 � sq ft
m
Total l�gt �5 � to peak to peak x T'
Stories � "�
. �
No, of bedrooms --�� rear lot line -vr-wa-� te�r�-i�re
__ __�-�,.
�(ye�r round� or (seasoi�al} � � � � i
� • i i �
Type of bldg or addition � � � �
i i � �
( ) Uwelling � ( �
i
( ) Garage (1) (2) car j i � � �' �'
( ) Storage building � r' � `� rt
( ) E3oatliouse � '��, � �
� m
� i r�
(� Livingroom i � o
( ) [3edroom � � -
�
( ) Kitchen-dining ,...j `�� � � �
� �
( ) Forch - enclosed/roofed (�i ,j �
i � � �
( ) Deck - open -� ' �'�
i
( ) �� �� d �v_..ra�_�._--��� �(Yl s.
� ) ���� iv 11 � _ ��� p�y� �� I
� ' . -r_ �� �n�-
� 3�' I
Type of construction �i ,r �
(� ['rame ( ) Block � � � � �
( ) �,og ( ) Concrete i d� � � ��
( ) Pole ( ) Steel j �� � '� "`"
( ) t•1eta1 ( ) � I a'
\ '
i �' -' I m
Construction cost $ /QGY�'(�. ��i,. � ` � �
— i � o � a�
Vol ��'U Pg �3 � of deed � ��� Q � ��
9 � . V!� '`(�"~'�' �� i ro
csr� vol f'g � S-�lv �,�, ;` � �;D-s �2�' i " �
Cer. Soil '1'est go� - d� ! � 4� i � d
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� -D�� ,CL road o �.
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Sanitary Pcrmitf `
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Sav�rycr County 1 S 2 8 `7 3 .
R�•cerved fo: rc�ord the �� daY °t
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NE COR. NWI/4 —NW I/4 , SEC. 25 ,T41N , R9W.
RONAi.D L 3/4�� Iron Rod
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MONUMENTS � SET I !/4 X 30 (0. D.) IRON PIPE o
� FOUND 3/4�� IRON ROD � N
BEARINGS BASED ON SOLAR OBSERVATIONS.
JANUARY 26 , 1977 � '' '"' ��' �' ��'
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S89° 11�58��E Recorded
�� ' 3/4�� Ir�n Rod
SCALE I = 100 6, � S89° 13� 18��E , 457.21�
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I , Ronald L. Peterson , Wisconsin Registered Land Surveyor , hereby certify
that in corr,pliance with Chapter 236 : 34 of the Wisconsin Statutes and under
the direction of Donald Winnie , owner , I Y;ave surveyed , divided and rrapped
tY:e land r.erein cescribed , thGt said map is a correct representdtion of
the survey mace and that said land is loc� ;,ec in the I�'ti•�i�-Pd',J';� , Section 25 ,
� T. �+1 N, R. � W . Gescribed as follows ;
Ccr±mmencing at the I�ortheast corner of saic :��1'/4-I�i�'h , Thence S . 0 ° 15 ' O8 " E ,
along the �ast line of said Id',J;�-;;Wy4, 589 . 37 feet to the actual point of
beginning , Thence continue S . C° 15 ' O8" � , along afore said forty line
677 . 35 feet , Thence N . 89° 17 ' 00" W , �54 . 68 feet , Thence N . 0° 15 ' C8 " W,
54� • 93 feet , Thence S . 89 ° 13 ' 18 " r. , 1� . 61 feet , Thence I; . 31 ° 28 ' Oc " E,
15C . 00 feet , Trence S . 89 ° 13 ' 18 " E , 45'] . 21 feet to tre point of
beginning .
Subject to all existin� easements �nc res�-r�,�ati��ns .
This instrument cirafted by-
�onald L, reterson Y
March 17 , 1977
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hp�roved t�:is �'�� cay of t�ar �h , 1977 oy ti�j;;;i . ,� ����� l r
Saw�•�r County � Zonino Administrator �:
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Fa�e 2 of 2 :dges
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,� RONALD L
PETERSON � . I
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�DEPARTMENT OF � APPLICATION �' SAFETY&BUILDINGS
irvousTRv, FOR SANITARY civisioN�
LABOR AND PERMIT P.O.BOX 7969`;'
HUMAN RELATIONS (PLB 67) MADISON,WI 53707 0
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Attach plans for the system on paper not less than 8%x 11 inches in size.Include a plot plan that is dimensioned or drawn to scale.Horizontal
and vertical elevation reference points must be shown.All appropriate separating distances and physical characteristics as specified in chapter
H-63,Wis.Adm.Code,must be shown.An index page or each page must be signed,sealed and dated by the designer.If designed by a Master
Plumber, the date, signature and license number must be shown.A legible reproduction of the soil test report or the owner's copy must be
included.
Jane and
Properry Owner � Mailing Address:
..Dar��c� Fas�� R�d S' �1.aYw.F,eo cJ/ sst�s�3
Property Location: �,..��Township: County:
'/o /�/ Y<S.25 iT / NiR 9 (o W /�AS/�it/A�irLD .S'�6 Y
Lot Number: Blk No:: Subdivision Name: Nearesi Road,Lake or Landmark: State Plan I.D.Number:
S � � (If assignedl
TVPE OF BUILDING
Number of
❑ Public� ❑ Variance' ❑ Other(specify)' Bedrooms:
C}�1 or 2 Family 'State Approvai Required. —3
� TOTAL NUMBER PREFAB POURED-IN STEEL FBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY QO� JC X
HOLDING TANK CAPACITV
�IFTPUMPTANK/SIPHONCHAMBER Q X
MANUFACTURER: �
EFFLUENT DISPOSAL SYSTEM �
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch)� PROPOSED(Square feetl: � NeW ❑ Replacement ❑ Experimental �Seepage Bed ❑ Seepage Pit
L/ ��'t9 ❑ Alternative(specify) ❑ Seepage Trench
IS Nd.
Water Supply: Owner's Name as Listed on Soil Test Repor[(If other than present owner):
�Private ❑Joint ❑ Public
I,the undersigned,hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber: Signatu � MP/MPRSW No.: Phone Num6er:
N f�.S/`1GlSS�7✓ .�93� ���Si 799-3 S
Plumber's Address: Name of Designer:
, o. BoX GG C���- Gt] S`�f8.� r�vntis �,4sMuss
COUNTY/DEPARTMENT USE ONLY CST 82-067
Sign t Issuin A Fee: Date: �qppROVED Sanitary Permit Number:
�6�.�� 6-24-82 ❑DISAPPROVED Z94Z�
Feason for Disap r val:
- . �'�/ ��� � '�\
Alternate coursels)of.Action Available:
Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T)to be submitted to the county pr���.or to in-
stallation.Failure to comply will void the sanitary permit.
DISTRIBUTION:White-County,Canary-Bureau of Plumbing,Pink-Owner,Goldenrod-Plumber
DI LHR-SBD-6398(R.07/81)
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hlaster Plur� r � 3938 .
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