HomeMy WebLinkAbout010-941-30-1204-LUP-1990-198 1lpplication for Land Use Fer►nit �`
County of Sawyer ,a
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1'lie undersigned hereby makes application for a Land Use T'ermit anc3 aqrees 'j
tliat all work shall be done in accordance witli tlie requirements of the Sawyer �
County Zoning Ordinance and the laws and regulations of the State of Wi>cc�nsin. '
PRINT - USL ONLY I3L11CK 1NY./PLNCIL
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mailing address mailing ,aaress
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city, state, zip city, state, zip
Building Land Use Zone District A^ �
(y�f New ( ) P'illing
( ) 1lddition ( ) Dredging Lot size ��� D � � ��� � � �
( ) Alteration ( ) Grading �n n
( ) Moving on ( ) Acres � ,L' �
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New Construction ' �
Size �� `/ fL- wide ft wide 2
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y G f t long f t long "
Floor area 9�O sq ft sq f t ��
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Total hgt /;� to peak to peak � r/� ,4,� %;" �;
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Stories r„ �� �,_ �`
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No. of bedrooms ------ �; rear lot line or wat� liiie �
(year row�d) or (seasonal) ��✓ / r
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i ar i o
Type of bldg or addition i h � � �
( ) Dwelling � i , y � i � `�
(6� Garage (1) (2)�car � a JD �o '���7� �'
�_� � � +��W. � c rt
O Storage building i f 4�
t::;axr�c� � N�
( ) Boatliouse � � � �'
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( ) Livingroom 6� —� i �
( ) Bedroom �— ` y�' �3� —`�'i
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( ) Kitchen-dining i � r
O Porch - enclosed/roofed � � . �il�'.G i� C
c,•� �
' ( ) Deck - open � �� �
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Type of construction i . i
( ) Frame ( ) Block -
( ) Log ( ) Concrete i ��o � � jF'
( ) Pole ( ) Steel � w �
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(X) Metal ( ) � � � i � �
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Construction cost $ QU Ufl•O v i r � �S � i �
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CSM Vol / �� pg � v v i � a
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Cer. Soil 7'est i 'f ►J
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Sanitary Permit 73 � .?,�3 �
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Issued 31 Julv 1990 Denied
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Andy ocik, agent
owner Zoning Adminis rato
P .O. Box 864
Hayward WI 54843
P I b 6 7 =����•;» .
,� �.
State of Wisconsin and County
� � � ! Uniform Permit Application T
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� for Private Domestic Sewage Systems
State Permit County Permit
Number � Number l� �d�,�
A. LOCATION O P EMISE WHERE SYSTEM WILL BE CONSTRUCTED,ALTERED OR EXTENDED
LEGAL DES� TION: Name One:
(Sec., Lot, loc ) CITY VILLAGE
N.W. aF T BI.�. ��C �.� T lil N R 9 W• HtiYieihRU TOWNSHIP
B. OWNER OF PROPERTY MAILING ADDRESS ' �
Name (Street,City, Zip Code)
_ L�.�hiARD JOHItiSJN R+OUT"L+' � Hl�WARU, �nfl.a{: ' `TIV
C. SEPTIC TANK CAPACITY �__Gallons NEW INSTALLATION REPLACEMENT x ADDITION
MATERIALS: Prefab Concrete Poured in Place Steel x Other ; No.of Tanks 0�
D. TYPE OF OCCUPANCY
One or Two Family Residence H� No.of Bedrooms �
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 Y NO Other (Specify)
F. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION ADDITION REPLACEMENT Y
Seepage Trenches: No. Lin. Feet Trench tNidth Depth Number of Lines
Seepage Bed: Length_���_ Width ]„(1! Depth __�__ Tile Size l�n No. Lines --�
Seepage Pit: Inside diameter �iquid Depth
G. Percent of slope of land �i�`P % direction
H. Indicate Slope of Land &direction of slope on sketch I. Tile Depth $t�,M
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 lst Wetted Overnight in Minutes Last Period Last Period Period One Inch
1 96" 10" t.g. 62"c 'l,k s� ;d2 i� Zp � 1 t� �-
n u n n
3 96" iapt.s 62"c z4"s z� �a lo � �
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM ISTO BE INSTALLED
S O 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
1 2� . � � -- '� #�71Rr�ii�-C].a�t-6D-"-sant� --
2— -�2" NO _� f -- -- " --al.r-- Rl A�60" sa� --
3 — --7�2''-_-- �— -�4'--- ------------- �A"�eF�3�-�-"-e}�---�6"--s��-----
- - - ---------------- ---------- -- -- ------------ --- --
RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE ARE:A IN WHICH THE SYSTEM IS TO BE INSTALLED
�CO�.�FLF:TE OTHER SIDE)
, Name of Owner L��QNHt�l� JOH�QA1 County ShYIN�t Permit No.�'.
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 a
recorded and location of test holes are correct to the best of my knowledge and belief.
NAME C�►�� ��L�� TITLE CC�11.�Z'1?B.TOR
(Type or Print)
REGISTRATION NO. or MASTER PLUMBER LICENSE No. ]l�y��
ADDRESS B�T�� � I�CAI.F HDan �iAY`tARD, ytI.S(;n1�L57N—�4�t�
...� . .
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DATE OF TEST _ QCT. �a �e� SIGNATURE �`�� _
MASTER PLUMBER jVl NG APPLICATIO MP �fj
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Signature: � � '" � cense Number: MP RSW
FOf: ��T ADLrLTG� �r-�,�__ Provide sketch below of system
(employer) (Inciude direction and percent of slope and all applicable distances)
20' PLAN VIEW (Locate Percolation Test & Soil Bore Holesl
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Note_ The application cannot be considered for filing until all of the above questions are answered and the fee paid.
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Do not write in space below — FOR DEPARTMENT USE ONLY
Date of Application Fees Paid State County �1�=__�_
Permit Issued/-ReJe�tei9 (date) �T 1� �� _ Inspection Yes No _
Issuing Agent Name _]��11_���-j� �_ Valid No. Date Rec'd
DIVISION OF HEALTH, P.O. BOX 309,MADISON,WI. 53701 — Revised 4-1-73
/
Dcpartment .of Zoning and Sanitation .
- Sawyer County
Inspectio� Report
Name of Property
Deacription
Owner _ � e/iJ �6/ThSew Address _ ,c�f`�Ywk:-r�/ Gv/S�.
BuildeY Address
Master Plumber b � /ii'e�G'��� Address �-l�yu//�f"� w��5�.
Violation Inspection - Check box
( ) sanitary { ) zoning (X) House (x) Sanitary Installation
/ 'fo� �o �L �, C/�/ _ �. �n� ( ) Garage ( ) Setback - Lake
( ) Privy ( ) Setback - Road
D�� ,s?,y�efY, ( ) � ) Setback - Lot line
()() Private ( ) Public
Comments
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Discussed with Builder ( ) Yes ( ) No
Discussed with Plumber (X) Yes ( ) No
Date of Inspection ie f° �3
Signature of Officer ' �
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I , Robert R. Swansun, Wisconsin Registered Land Surveyor ,
do hereby certify under the provisions of Chapter 236 . 34 of the
Wisconsin Statutes , and under the direction of Thomas VJ. Duffy,
owner of said land , I have surveyed , divided , and mapped the land
herein described and that said land lies in the northwest one-
quarter of the north east one-quarter (N.W .4 of N.E.4 ) of Section
� thirty (30) , Township forty-one (41 ) North, Hange nine ( 9) West ,
Town of Hayward , Sawyer County, Wisconsin described as followsa
Commencing at th� north 4 corner of Section 30-41-9: (1 "x24"
IP. ) ; thence North 87 19 � East along the nor�h line of the Section
6�+9• 33 feet to an iron rebar: thence South 1 40 ' 00" East 663. 88
feet to an iron rebar which is the point-of-beginning.
Thence North 87°19 � East 230. 00 feet to an iron rebar;
Thence South 1°�0 ' 00" East 660. 16 feet to an iron rebar on
the south line of the forty;
Thence South 87°02 ' 20" West along the south line of the forty
330. 04 feet to an iron rebar;
Thence North 1�40 ' 00" West 661 . 76 feet to an iron rebar;
Thence North 87°19 � 00" East 100. 00 feet to the iron rebar
which is the point-of-beginning.
Said parcel of land contains 218 , 130 square feet or 5. 01
acres.
Said parcel of land is subject to easements and reservations
of record.
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Registei s O(fice ��
Sawy, r County ) �"�
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