HomeMy WebLinkAbout010-941-16-4305-LUP-1990-113 _ �
Application for Land Use Ferm.it
County of Sawyer .a
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Tl�e undersigned hereby makes application for a Land Use Pezmit and ayrees � �
, that all work shall be done in accordance with the reqairements of the Sawyer °, t
County Zoning Ordinance and the laws and regulations of the State of Wisconsin.
�p�Tt G. H Barbara D, Gruehn PRIN�r - osL ONLY DI,ACK INK/PLNCIL �
nKQR2'f��. Rr.ID
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Owner Builder
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mailing address mailing address
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city, state, zip city, state, zip
8u�ding Land Use Zone District �—�
( New ( ) Filliny i '� �
(vr Addition ( ) Dredging Lot size _� l� � _ s �
( ) I+lteration ( ) Grading �• f a m n
( ) Moving on ( ) I�cres v
( ) ( )
';f;�f�-.� .
New Construction '
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Size .�./� �� ft wide � ft wide
� �.�� ft long --'� ft long �
Floor area ��-?� sq ft "'-- sq ft ' �
m
Total hgt /n � to peaic��'=1(� �.�� to peak K '��.�
� ��J.;/-{Q 5 — �'/'4 � .
Stories `�-'-� �
No. oE bedrooms rear lot line or waterline
(year round) or (seasonal) � — �
i 2�� i c�
Type of bldg or addition j"�. ; �� N �
( ) Dwelling � � � �
O Garage (1) (2) car j ,� � p's
O Storage building � � i � rt
� � i �
( ) Boathouse � �'I
( ) Livingeoom i� �-��� j y
( ) Bedroom � �
( ) Kitchen-dining j i
(�'!) Porch - enclosed/roofed � �
(v' Deck - open � j � '
i �
(� ' ._ - �>i�, i � i
( ) , r� , .� _ i _iz� �' i�_..�. �,
�� g �y,. � �V � ..-
Ty'p/e of construction .j\j ,--�--=��-�--�? i� �
(v� Frame ( ) Block \�i �., '2C� 1(V ��
O Lo9 (y Concrete � i8.'�'_(r i i 1 �
l ) Pole ( ) Steel � ' � ��� �
i i
( ) Metal (�-T- '--�� '� � ' ���� �
��`�- r � �� '!1��-� //o�_� 9:�Q -1� �i � m
Construction cost $ ���.�.�?�'0.%v�1- i _ �Z— i �
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Vol "� Pg �- -'/ of deed i � �1 i �
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CSM Vol L� Pg �r�% i �5� i w
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� Cer. Soil Test i � � ��j
----��-CL road ------------------- p�\
sanitary eermit ��j- �OZ
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Issued 3Q t�ia,� 199� Denied � I J
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�� Z� ��c �1__�\l__'�_ �ve�r�L2�SL�.T�1
owner. Zoni.ng Administrat{or 1
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EAST / 325, 44' s,
3' w 668, 44 ' g� , 220. 0' d2o. o ' 220. 0 '
`' o;.., 69 0 �u . 3 . �I 3
o� o T.,, o ''' o �n o �' `o y 2
a' / � 0 2 ya 3 0 4 ° ti3
� N 85 � ry O N O N � o, N p I�-
/6 9� 0 o �a 2 �) � 2 9 "1
c. 667. 25' 220. 0' 220, 0 220. 0 ' 'r• Wc.
� „ CZ� 30 RoAD EASEMENT _ _ 30 ' _ �ycoR�
2 / WEST / 32725,
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,�.�lSCONs'�,,'
4 /_9 SCALE /" = 20o fEET •`� � � '.
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O STAKE /N PLACE =� � �
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� STAKE PLACED ''��� ot,�.`�
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/�o-8a�-�� �. ,�,��-A-na d--n�
I , Robert tt . Swanaon, Vlisconcin Regictered LaL�d Surveyor , hereby certify
that in full compliat�ce vdth the provicious of Cliapter 236. 34 of tl�e l;�i.ccousia
Statutes And under the direetion of Fay and P",ich�el Sar,ycr , ownerc of caid
land , 7 have si�rvoyed , divided , and mapped thc laud lierein descriUed aud thut
cuch map correctly reprene»ts tlie cxterior boundaries and diviciou of' the
land curveyed and that thic land ic loczted io tlie south�sest } of the south-
oact � of :ection sixteeu ( 16) , Township forty one ( ii1 ) Ilorth, Range ni�a� ( 9)
Wert , Town of Hayward � Sawyer County� wYcconcin descriUed as followc :
Beginning at the soiith # corner of Section 16-41 -9: the�;ce north (3°08,5 '
wect 30,00 feet to an iroa pipe : thenco north 0°08,5 ' west 234.00 feet to
an iroa nipe ,
Thenco eact 1j28.44 feet to an iron pipe lyin� on the wQst liue oY the
Town Road.
Theace couth 0°08.5 ' wect ,P3�,00 ielt to an iroa pipo : theuce south
0°08,5 � west j0,00 feet to an iron pipe which ic the 1 /8 coruer.
Thence weat along tha couth line of the Sectiou 132'7,25 feet to the
eouth } corner of the Section which ic tho P.O .B .
All pareelc are cub�ect to a 30 foot ro�d eacerncnt as: choa�xi ov the map.
Parcals are alco cubject to eazemeutn and recervationc of record �
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SAW YER ROAD
SCALE: I INCH— 40o FEET FOR ASSESSMENT USE ONLY NOT
DRAWN BY: S.R.o. DATE� _ 3/27/84 INTENDED TO SHOW GONCLUSIVE
COLON G) INDIGATES GOVT. LOT BOIUNDARY LOGATIONS IP OR
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Plb 67 �-� �= '�
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� ', ' State of Wisconsin and County
�
'; r�� Uniform Permit Application
for Private Domestic Sewage Systems
State Permit '• County Permit
Number �` Number � � - � ��
, — -
A. LOCATION OF REMISE WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
LEGAL DESCRIPTION : Name One:
(Sec., Lot, Block)
--��� y�ITY _ _-- VILLAGE
^`�// d � S� .��G. � TS/� � C�G !1 lG'�l <tL _ TOWNSHIP
B. OWNER OF PROPERTY MAILING ADDRESS
N e (Street, City, Zip Code) i
/ � �1 �/5'0 �� ll�� !� Wl S�� S f�
C. SEPTIC TANK CAPACITY 7 �� Gallons NEW INSTALLATION �LACEMENT ADDITION
MATERIALS: Prefab Concrete Poured in Place Steel �Other ; No. of Tanks � ,
D. TYPE OF OCCUPANCY
One �r����^-Family Residence � No. of Bedrooms —�
Commercial Industrial Other No. of Persons to be Accommodated ��
(specify)
E. APPLIANCES, ETC. : Food Waste Grinder YES �0 Automatic Clothes Washer ��YES NO
�---�
Dishwasher YES �NO Other (Specify)
F. EFFLUENT DISPOSAL SYSTEM NEW �XTENSION ADDITION REPLACEMENT
Seepage Trenches: No. Lin. Feet Trench Width Depth Number of Lines
/ i �/ �/
Seepage Bed : Length 3Q Width � �- Depth ��' Tile Size � No. Lines �
Seepage Pit: Inside diameter _ Liquid Depth — _
G. Percent of slope of land ���� % direction
� i/
H. Indicate Slope of Land & direction of slope on sketch I. Tile Depth 2�
PERCOLATION TEST
Indicate Soil map number And Soil Type � � y1�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
/ ��T�'S� z�� l(1� � Z�
y , � , c ri ► � �' Q � � �.
3 l � ► , � ► ► � a � r �--
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALLED
S 0 I L B O 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
i/ �i i/ ,
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�l �/ � � .S� � �, ��� �
�f/ �f �� � / �� j � < < t � � � < <5 c� n aL
/ � � . p / � / � � r � , ir S �i L1U
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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)
.
�r � Gr'�
Name of Owner %'✓ ' ' '/� ' ` �' ��""'�'*"'�'�''�� County •• � �'� «J L� � � Permit No. � S `��
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 a,nd location of test holes are correct to the best of my knowledge and belief.
,�> .,.? „ i h ' i.r i%
NAME �- ;,c..,. c;:_:._- ,...,_: .� r F'pl'" TITLE i .
(Type or Print) � ,:,1 ,,i
REGISTRATION NO. or MASTER PLUMBER LICENSE No. ��
A D D R E SS /�e•;� ��--t:''..-.��, �/��f l,;�'-' ,�i-� �l�� .s c:. � -� ��='l Si�� .�-�
� /r �' ` �..�=y% ,J - "�''�-, �
DATE OF TEST ��� ,-�-� SIGNATUR�'� ` , - ' '-�.�'�-.�'� '=�F%���--%-�" i..�'�*"
-------------------------------�:�-t------------------- - ---------------------------------------------------------------------------,-------------------------------------...,
_ �MASTER PLUMB MAKING APPLIC DP}-�>�� MP Ic� .7�
'` '�2�=�,-�'`.�.`�-;;��'.:.�.• , %-'
Signatticer: — ,� License Number: MP RSW
For: "--s'y' ' �--'=--' Provide sketch below of system
(employer) (Include direction and percent of slope and all applicable distances)
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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 �����
Permit Issued/R�j�T�ti�(�1ate) �� �-" � ��� � Inspection ��?�0 73
�
Issuing Agent Name `��� I1� 1��r�Tl� Valid No. Date Rec'd
DIVISION OF HEALTH, P.O.BOX 309,MADISON,W1.53701 —Revised 4-1-73