HomeMy WebLinkAbout010-841-32-2105-LUP-1991-233 � • ' Application fo2- Land Use Permit �
County of Sawyer o
The undersigned hereby makes application for a Land Use Permit and � _
agrees that a11 work shall be done in compliance with the require- o
ments of the Sawyer County Zoning Ordinance and the laws and regu- � '
lations of the State of Wisconsin.
PRINT - USE BLACIC INK OR PENCIL
, �� . .__ h .-i� � �
t �r�� � m����_r� _sA,�,c � �
Owner Builder �
a �
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Mailing Address Mailing Address
l�Ayu'A2� � Le>i 5�1��3
City, State, ip City, State, Zip
Building Land Use Zone District R� 1 0 �
( ) New ( ) Filling rt
(�/) Addition ( ) Dredging Lot size �'j7�' Y �90`/2�0� � n
( ) Alteration ( ) Grading � •��
( ) Moving On l ) Acres
( ) ( ) r RJ
a �1
New Construction � (r�
Size /�� ft wide ft wide � N' �
�
e Cp,� %
4� ft long ft long „�
�i
Floor area FjriCi sq ft sq ft �
ta �
Total htg ►Z� to peak to peak � ,�
�
Stories / Stories �'
R
No. of Bedrooms � , ___ _ �
..2zrL � ' 'ne
(year round) or (seasonal) � � �,
Type of B1dg or Addition o' r
( ) Dwelling a: ,°Y
( ) Garage (1) (2) car �
( ) Storage Building N #
( ) Boathouse � o �
(/) Livingroom �
(<) Bedroom�
( ) Kitchen-Dining N ' �
( ) Porch - enclosed/roofed �
( ) Deck - open .
( ) � � _ �
( ) � D�
Type of Construction � II�,
(lj Frame ( ) B1ock
( ) Log ( ) Concrete , `�
( ) Pole ( ) Steel �L �
( ) Meta1 ( ) , � �
ti
Construction Cost $ 5flD � �,�� �7 O�i".[o�1 W
P5kpD,tD) N
Vol `1'i Pg _� of deed �' o Ncwqy
� ��-4,
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CS Vol _ � _ pg ,,.i � a'1Y- ExiSnuG �v �
� 6g`� T3�� Na�SE �
Cer. Soil Test ��o� _�, �
Sanitary Permit ---------- L Roa�d -- ~ r
co NUI� 6 sFPr'ic sY�'r�"T o
/NSTpU-ED �v90 • z
7y
Issued �2 N,p�l�cY11�R, `Q�� Denied � �
�-�,� �� � • �_ � ,,:;. _ V 8 —6 F-02 �V�[ �t
� ) .�J����'�'l-.,�t� _ �—� 6 N�K-� -�C�JJT4 �
Owner Zoning Adminis rat
TOWN OF HAYWARD
SEC. 32 TWP 41 N. R.8 W.
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Eo'" SURVEYING SERVICES
523 E. 06DEN ST. TELEPHONE 715-748-5597 sueoivis��Hs
o � � MEDFORD WIS. 54451 cer+nrieosuRveYs
7 7 PROPEAT" SVRVE�9
TOPOORp7HIC MAPGING
4TREETIYPROVENEHI�S
ROUTE IOLAT10N5
CERTIFIED SURVEY NO• P��TP�p��s
N �/4
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NW CORNER - N 89•07'00" W
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� ;. ' , I , C'r�arles Offerman , land surveyor of the State of YJisconsin ,
� do hereby certify that I have made the fello�^ring surveyof part of the
v ' � ��4 of the ncV; , of Section 32 , T. 41 N. , R. 8 '11. , Sawyer County , '�Visconsin,
_ ��! ' ^:ore particulG~ly described as follovrs : Commencing at the North � correr
m ef said secti�^ }2 ; thence N 89� 07 ' 00" V!, 429 . 00 ' ; ther.ce S 0' 34 ` 32" ,'��
=�7 . 40 ' ; therce S 88' 26 ' 36" VJ, 66 . 05 ' to the point oF real beginning•
`_her_ce S 0' 34 ' 3z" '.1, along the westerly right of way of a road easement
200. 00 � ; thence S 88' 26 ' 36 " 'dd� 570 . 90 � ; thence N 0' 22 � 51" E� 199 . 98 ' to
the southerly ^_ght of �•�ay of C. T. H . "B" ; thence N 88� 26 ' 36 " �, along
sa:� d southerly right of way 5']1. 58 ' to the said point of real begir.nin�.
Sz�d oarcel being subject to any znd all exceptions , reservations,
easements , and restrictions , either in use or of record.
� Regis!cr's Office � � J n � J `49.i�!f�i�:ySf;"j�p6
Saw��i�r Counly � `� �c��� �jG�1 i�ll�F�df
Fe2ived !a rewrd the � / day oI `4� .l� • ,. V�h „�f`
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h D ]9 3 at q��CodocY " �'� �O
,}1 m(.i�recorded i� �rol. tj P ;� Cr'F.RLES ^
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SCALE ��• IOO' � � LEOEND �F�t.�`� t ' •` � �''��i`:
—T-- IRONPIPE FOUN� ���+�G`�`Q
THi51n5TRUMENTDNnFTEDBYDEVON VANDENMEUVEL --0— �"% 24��IRONPiPESET� MIN.WT. 1.13L0/LIN.FT.
—o-- 2"%30� IRONPIPESET�NIN.W23.BSLB/LIN.FL
—�- STONE NONUMENT FOUND
—�5-- IRONPINSE� INpIL,R.R.SPIKC� ETC.)
-{�— ALUMINUM MON. W/D� CAP FOUND
I, CMARLES OFFERMAN ,IqND SURVCYOR OFTNE STATE OF W14CONSIN,DOMEREBY CERTIFY THATON MAY 17, 198J.
� SURVEYED THE �BOVE DESCRiBED PROPCRTY p��ORDiNp TO OFFICIAL RECORDS A�0 CHAPTER 2J6 OF THE REViSED STnTUTES O iME STATE OF
M'i.^.CONSIN�TNAT THE ACCONPANYINO tiAP IS A TRUE AND CORRECT REPRESENTpTiO � EXTERIOR BOUNDARIE$ OF TM �A SURVEYED� TMAT qLl
BVILDiNG3 ANDIMPROVENENTS LIC MHOIIY WITHiN THE BOUnDARY �INES, AND pT N N OnCHMENTS BY ADJACEN 0 RT'I OWNERS AP�:AR FRON
SCID SURVCY E%CEPT p5 INDICATCD,
�ELSER FOREST PRODUCTS
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CURVE DATA
CURVE NO. CNORD BEARINO CHORD D15T. CEN7RAL ANOLE RADIUS
� _ p N46' 53� 24rW 9�.34� 2T0°00� 00�� 6a.00�
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� RC)NALD L. .�y � FOUND MONUMENT ( t Vs ' i.R )
j p� • � �ON �^+ � SET I V4M x 30� IRON PIPE
ARINGS AR BASED ON � -0�
LAR OBSE TIONS, � DENOTES N V4 CORNER OF SEC. 32 ,
F'^ "�''� T41 N , RSW. (�uM. woH. w/�"ur )
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`�� SUR� MARCN 4 , 1983 .
� - - _�_ 14 �I�J
I, Ronald L. Peterson, Wisconsin Registered Land Surveyor, hereby certify
that in compliance with Chapter 236 .34 of the Wisconsin Statutes, and under
the direction of Patrick Hamblir� and Thomas VanRoy, owners, I have surveyed,
divided and mapped the land herein described, that said map is a correct
representation of the survey made, to the best of my knowledge and ability,
and that said land is located in the NE�-NW4i Section 32, T 41 N, R 8 W,
described as follows : ,
Commencing at the Northeast corner of said NE'�-NW4i Thence N 89°07 '00" W,
along the North line of said NE4-NL.T�, 429.00 feet, Thence S 0°34'32" W,
117.40 feet to the actual point of beginning and the South line of the right
of way of C.T.H. "B", Thence continue S 0°34'32" j,i, 620.00 feet, Thence
S 72°47'20" T,', 244.60 feet, Thence S 88�26 '36" W, 134.00 feet to the point of
curve of a cul-de-sac to the left, the tangent of said cul-de-sac being at
right angles to the last described line, Thence along the arc of a curve to
right, 311 .0? feet, ( said curve having a radius of 66.00 feet, a central
angle of 270°00' 00", and a chord bearing N 46°33'24" L�', 93.34 feet ), T`hence
S 88°26'36" T�, 200.00 feet, Thence N 0°22 'S1" E, 619.93 feet, to the South
rijht of �.a�� line of C.T.H. "B", Tl�ence N 88°26 '36" E, 637.62 feet to the
point ot be�intlin`.
Subject to all esisting easements and reservations.
�15C�NSj�/�.�
� �.�Y
- , . � .
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This irstrument draft�d b}� �� :;� %�
Ronald L. Petersoi� � � ;
March 4, 19S3 , '1 ' "��`�D �
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Approved this ���� d:ay of �1`r�(��_ �-� , 1983, by �=�_�.;� � ���.- �_, ,����'`� ',-t�
Sawyer �ounty Zoning Admin.
18 � .cs93
R����e ors�b �. _
sawycr County
c�ceevod far nxvxd t10 �day e�
��u/�A D lfl�,�� 3 4'cl.xk
�, r� o nt�or�i.d irs�1�1. Pa�,e 2 of 2 pages.
� �:� ��.�..�,11 alJ.
_J.�y--��-��"`''.____�- }i�y;��i�i
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fl'DlLHR SANITARY PERMIT APPLICATION COUNTY
� In accord with ILHR 83.05,Wis.Adm.Code
� SAWYER .o
p��•�_� CST H3—OO6 � STATESANITARYPERMIT �
-Attach complete plans(to the county copy only)for the system,on paper not less than 137 95 2� o
8i4 x 11 inches in size. �"
Check if revision ro previous applicetion Oo
zSBB fOVBfSO SIdB f01'If1StIl1CtIOI1S�Of COfIlplOtll19 thlS BPPIiCdtlOfl. STATE PLAN I.D.NUMBER
1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION.
PROPERTV OWNER PROPERTY LOCATION
� � ,/ Ye/G!c/'�a,S ,� T`l�,N,R E(or
PROPERN OWNER'S MAILING AD�RESS LOT# BLOCK/�
y .�-
CI ,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR GSM NUMBER
��:�
� I—
II. TYPE OF BUILAING: (L:�eck one CITY ����� NEAREST ROAD
1 ❑State Owned ❑VILLAGE (,�,
r,?u�lic L�1 or 2 Fam.Dwelling-#ot bedr�oms �_ PARCFL TA.�IJUASB �s) � -"7
�III. BUILDING USE: Qf building rype is pvblic,check all that appiy) ;?10-841-32=2105 �
�ApUCondo �
2 ❑Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑Outdoor Recreational Facility
3 ❑Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑Church/School 8 ❑ Mobile Home Park 12 ❑Service Station/Car Wash
5 ❑Hotel/Motel 9 ❑ OHice/Factory 13 ❑Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B i(applicable)
A) 1.�New 2. ❑Replacement 3. ❑Replacement of 4.�Reconnection of 5.❑Repair of an
System System Tank Only Existing System Existing System
8) ❑A Sanitary Permit was previously issued. Permit#— Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 �Seepage Bed 21 ❑Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑In-Ground 42 ❑ PitPrivy
13 ❑Seepage Pit Pressure 43 � Vault Privy
14 ❑System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4.LOADING RATE 5.PERC.RATE 6.SYSTEM ELEV. 7.FINAL GRADE
REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) GG����j ELEVATION
���(� �SQ /Q Feet Feet
CAPACITY
VII. TANK Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manutacturer's Name oncrete Con- Steel 91ass Plastic APP
Tanks Tanks structed
Se ticTankorHoldin Tank � d /
LiriPum Tank/Si honChamber
VIII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibiliry for installation of the onsite sewage system shown on the attached plans.
Plumber's Name(Print): Plum er's Signat e:(No S amps) MP/MP�o.: Business Phone Number:
'N i
Plumber's Address(Street,Ci , tate,Zip Code):
! l J� � � �c
IX. COUNTY/DEPA TMENT US ONLY
�Disapproved Sanitary Permit Fee(Includes Groundwa�er a e ssue Iss � g Agent Signature(No Stamps)
Surcherpe Fee)
�Approved ❑OwnerGivenlni�ial $llr).�� 5-1-90
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(lormerty PIbf7)(R�.11/BB) DISTFIBUTION:Original to County,One Copy To:Safety 8 Buildings Division,Owner,Plumber
iU� -.v�v- ��c .���yiu � T� �3c.�� — a�'qwr� �- � ��'�wa �-�
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DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY 8 BUII D'NG .
LABOR 8 HUMAN RELATIONS DIVISION
P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATIOf�
MADISON,WI 53707 State Plan I.D.Number:
�CONVENTIONAL ❑ ALTERATIVE (flassignedj ��
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADORESS OF PERMIT HOLDER: INSPECTION DATE:
P- ��1,6 f��- �l $�X R 43S wA�-RD 1� S-�'`�D
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST FEF.PT.ELEV.:
s�D�r�U Dw. 1ao '
Name of Plumber: J{tj/MPRSW No.' County: Sanitary Permit Number:
t�o�,��� �P�,� a 6 S w o --o a-�
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET EI.EV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
�O O � �(S . �I.T�.�8 ES ❑NO ❑YES ❑NO
BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: � PROPEHTY WELL: BUILDING: VENT TO FRESH
I �l ALARM: FEETFROM r I LWE: � I f AIRINLEL
C]YES ❑Nn � �-T ❑YES ❑NO NEAREST—► � b SO 30 a-S
DOSING CHAMBER:
MANUFA;TURER. BEDDING: LIOUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED�
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AiR iNLET:
PUMP ON AND OFF ❑YES ❑NO NEAREST—♦
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
1NIDTH: LENGTH� � NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: {�PITS: LIQUID
DIMENS ONS �Q1 2� TREN�CH.E�: �t `T'ErR1AL: t„ P�T DEPTH
v J �� i rtw
GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PAOPERTY WELL: BUILDING: VENT TO FRESH
BELOW P S: ABOVE COVER: E/L�EV.WLET: ELQEV.END: PIPES' LINE: t 1 1 AIR WLEL �
�1 �}' �! •� 1��3� � C NEARESOT—� �SO S� �3O � S�
MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑YES ❑NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE PERMANENT MARKERS: OBSERVATION WELLS;
❑YES ❑NO ❑YES ❑NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES:
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BEDITRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING' GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. OISTR.PIPE DISTRIBUTION PIPE MATERIAL 8 MARKING:
ELEVATION AND ELEV. ELEV.: DIA. ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICA�LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑YES ❑NO ❑YES ❑NO
PERMANENT MARKERS: OBSERVATION WELLS� NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEETFROM LINE:
❑YES ❑NO ❑YES ❑NO NEAREST—►
��� P �v �.��--s P�oT Q�t
�-�S�C����ro �S p��
Sketch System on Retain in county(ile for audit.
Reverse Side. uae ry� r-. --�
\
SBD-6710(R 06;88) __