HomeMy WebLinkAbout004-738-07-2404-LUP-1989-069 . • k
�pplication for Land Use Permit
� County of Sawyer y �
0
7'tie undersigned hereby makes application for a Land Use Permit and agrees �
t}�at all work shall be done in accordance witti the requirements of the Sawyer � ,
�+,
County Zoning Ordinance and the laws and regulations of the State of Wisconsin.
PRINT - USE ONLY BLACK INK/P�NCIL (�
Madal n V. Mockler Olson ,
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�"'���'r � Builder
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mailing address mailicig address
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city, state, zi city, state, zip
Building Land Use Zone District RR-2
( ) New ( ) Filling
(�Addition g' g 2 p �j' / x �'o � l.f' / rt �
( ) Dred in Lot size
( ) Alteration ( ) Grading �, �
( ) Moving on ( ) Acres � . 00
O O C,
New Construction
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Size � ft wide _ ft wide �
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��•• ft long ft long
Floor area 7 n �. sq ft sq ft
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Total }lgt ' Z� to peak to eak x
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Stories �_ ��
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No. of bedrooms ------- rear lot line •�-- ---`---"---' , �
(year round) -- — � �� � C-
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'I�pe of bldg or addition � � o
( ) Dwelling � � °' rt
( �Garage '�► (2) car i i � r
( ) Storage building i i �� �
( ) Boat}�ouse � � ~'
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( ) Livingroom � i o
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( ) Bedroom � i
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( ) Kitc}ien-dining i i
( ) Porch - enclosed/roofed i ► O
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Type f construction -� i ro i^°� �'
( Frame ( ) Block � � i � Z
( ) Log ( ) Concrete � . i -.G.i �
( ) Pole ( ) Steel � �, i � �•-
' � N
( ) Metal ( ) i
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Construction cost $ (� � �' i c�i
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Sanitary Permit 73-198 0
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Issued 11 May 1989 Denied �' �
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Madalyn , . Olson owner Zoning Ildminis rato
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� II I STATE BAR OF W�SCONSW--FORM I
� � DOCUMEyNyT NOA. II ,. �pAnT�AT1TT DR$D
1 • 0 V S � T��14 ep/�pE PESERYCD fOR RCCORDINO C�T�
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Michae.l..John_Mockler, an adult man __.._................... ,Sen�arCumty
...
...
.... ...... �: Pea+Necl ler}recrord the de1 d
,... _....... ...-_'-- '--' .. .... ---' '-"'-' � ��-�')(f4?A A D 19 7 e1�o'alod
.__'..._......__......_._ _..__.' .._. ..".._..."._"___....' ._.'_. .....__.'."._ .._ . .. II_�`7.1 end recvrdod lu S3LV—
_
.. -. .-
conveys and wnrrante to ._Maclalyn. Vi_rginia_Mockler, .an adult o� `������ /
—`-�r--,--
.. .......wnman . -- -- .....
....... -----... . ' c��-�
_ - -- -__.. .... I
-----------------��-----�--�-----------------------------------------------�---�-�-- '� Fed.ler
..__..'..."'......................'.'..._....--.._'. . �1
, . �__,.___..__. .
for _a__.v2_luabl.e consideration of one .dollar and _otl�er..__.. pE,�a� .o
-- - .. . . . �'
valuable consideration -� �- 1 /I p°�,"�
. - - -
. . Sawyer-.............. .... CountY� .� C V.�91__ ��- .. . . . .. .
tha following descr�bed renl estate in ...--_-..-�.�-
State of Nisconsin:
� Tax KeY No. .............•"--"'..-....._........
Starting at the Southwest corner ooCtsec[1onhSeven4(7)CeTownship Thirty-eight (38) North,
oE the Northwest Quarter (SE'�NW'�)
✓Range Seven (7) West o[ Town of Goiideray, Sawyer County , Wisconsin, thence East Eor a
distance oL 208 feet along the town road, thence Nol'eoceoWest�208afeetoatbrighteanglesllel
to [he West line of said Southeast Quarter (SE'�) ,
thence 624 feet south to the point of Ueginning. Being [hree (3) acres more or less.
Subject to all easements , reservations , and exceptions oE record.
This Deed is given in compliance with that cer[ain divorce judgment between [he above-
named parties dated August 6, 1979•
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This ..__.._.15..._..__.... homestend property.
(I5� ��9 110t�
� Yxception to �vnrrantics:
� nu usc - ....._., �s.79. •
Dated this ..-__-......... daY o[ ....._..._ _ ----.....__....
- -- - -- --
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_._...._. _-�--�-�--'-�...............�-�--��---..._.........._(SF.AL) /.Y-.---.._-�---- �
•�fichae_1 Jo n.Mockler ____________________
�----�---'�-----..............--'----"---'-----............. - -
� .(SLAL) (SEAI.)
..._-----�----'------'-------'---------'------�--��- --...-----'-----'----'-------
1 .
" ..._.........._._..-._--"----------�-"---------'�----�- -----------'--...-----'
AUTHENTICATION ACKNOWLEDGMENT
Sigu:�tures nuthenticnted this .._-_.--------. dnY of STATP OP �VISCONSIN
...__.._..__""'_'"""'""_....."'"'"'___""�
1J_"..._ ``�Naaltv��p�p�� s�.
*p,$ • j'fJ,f. Sawye_r .__ __..Gountp.
� �l>' .•�"" �Q�+s- -�--� 6[h.. ..dna� of
............. . {�
- ..._'_.' ' ..__._.
. _-:A.j... __.-...-�`. Q '!? I`ersounlh cmne before me, tlus ...
" � 4�{��,�l� �,ti --`:ligust__1979 bo��e »nmcd . ... ... .... . .
' --- --�------�- -'- P, ohn Mock_ler .--........_.
.._..__._....
..._._.....---- �Iichael .J...
. . . -'--.._....---
1'1'CL�: D1LhI13ER S"fATE BAR OF �'1SC�ONSIN.�i. , �
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(I( not � '� ..---.....--........__....--'--'--...__..
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auLhorv.ed by § . _.-.._......
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`. 'd , "•......�' � J_.__.............�--------
1His INSTRUMENT WAS OHAFTED �V �O�t 0/ '�f��S����P��to ine kn �vn to Ue tLe e o� .... who executed the
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'��������������`� ;oregoin �rrstrun t nnd ac owledge the snme.
Thomas E. Van Roy, Attorney at Law �_ ��
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� State of Wisconsin and County
r f Uniform Permit Application
for Private Domestic Sewage Systems
State Permit � County Permit� � ' Q p
Number ------- ---- - - -- Number _.___._._ l O
--- -
A. LOCATION F PREMISE WHERE SYSTEM WILL BE CONSTRUCTED, A�TERED.OR EXTENDED _ __ __
LEGALDESCRIPTION:� �_ NameOne:
(Sec., Lot, Block) ___ CITY (��i_r--c�jNILLAGE
TOWNSHIP
._�1-5-��1! �' L•��n��c,J .—___ _=_---
B. OWNER OF PROPERTY , MAILING ADDRESS
Name (Street,City, Zip Code) �
' � , /� / .� r L' � � � � r c '•� �.� i
Y � �_�---�-��<-1-�"S.e_"_ __- _ti1.."-_ _- �-_.J--_..-`_. --
C. SEPTICTANKCAPACITY _���7' Gallons NEW INSTALLATION -_-� REPLACEMENT _-_- ADDITION __
MATERIALS: Prefab Concrete _._—Poured in Place __.--.- Steel___-L_Other -_...-; No, of Tanks -__-
D. TYPE OF OCCUPANCY �� ^
�
One or Two Family Residence __ __-i.----- No. of Bedrooms _. -=. - �
Commercial _ _ Industrial Other _--— No.of Persons to be Accommodated -�-
(specify)
-�-- - -- ------
E. APPLIANCES, ETC.: Food Waste Grinder __-YES __��(JO Automatic Clothes Washer __XYES __- NO
Dishwasher _._-YES _'NO Other (Specify) .---�-----
F. EFFLUENTDISPOSALSYSTEM NEW__.�-_ EXTENSION __-._ ADDITION ._-REPLACEMENT_
Seepage Trenches: No. Lin. Feet _.--.-_-- Trench Width _ _- --- Depth ____ .- Number of Lines _--
,. i � � � ---y�_. No. Lines a"
Seepage Bed: Length__�-- W�dth .__,La- Depth -...:._ _- Tile Size
$eepage Pit: Inside diameter _-___._- Liquid Depth_.-._—.
G. Percent of slope of land -- -% ----- direction �
���/ .
H. Indicate Slope of Land &directlon of slope on sketch _ I. Tile Depth ____- _ __
� PERCOLATIONTEST
,�n�. . r�_�-_Q
And Soil Type _.-1_-���'
Indicate Soil map number _. . _---- � - -- - �-----
� Hours Water Test Time Drop in Water Level Inches_ Minutes
Test Depth Charac[er of Soil Since Hole in Hole Interval Second to Next to Last To Fall
Thickness in Inches ist Wetted Overni9ht in Minutes_ Last Period �Last Period Penod One Inch
Number Inches . _ __ __._ .___ _- � •
_ --
-- � .�..���--r"---�-* --� •� -.�� -�(1 . --� �` - _
.�� � - ; � � „?'! hl (, _�r' ��__�_ (n _.. -•�`
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�'! � - �� � �—.�22�- - ' --'^f-`� - �- -_
_-__--_�-L1-- _-.. _.____-__ _. -_ "
. ___ _ _ - ..- __—.-- _
_ __ .
_ _
_. _—__ __- _ _
RECORD DATA FROM MINIMUM OF 3 TEST HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE INSTALL_ __
----_—..___
- ----
------_.._
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 ,
Character of Soil with Thickness in Inches
Number Inches Observed Estimated Observed Estimated / ______ --
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1 �. � � � � <<.�' _-r__r�_=.-=�� � � —;—� .
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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)
_...__... _. � � ' i
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R W,�
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Name of Owner ���I � 1 �- /YI l5��\� � �"' County �1 CI �k E�r Permit No. 4�17
-----�------- - � -
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 Sec[ion H 62.20 (3�, Wisconsin Adminlstrative Code, and that the data
recorded and location of test holes are correct to the best of my knowledge and belief.
NAME �(J�.��y���>l���,TO�___ TITLE _ ---
(Type r in
REGISTRATION N0. _-_..��� — __ or MASTER PLUMBER LICENSE No.
ADDRESS _ — 7 - —
DATE OF TEST -"- ---��-r,--��-' - ---SIGNATURE--_,,f.E�'?������--- - ---�-�
.__. __...------------- - - LL,t�---------
MASTER PLUMBER f)A�.KING�I�ON MP . _
// c q �
Signature: _.�Y�d � ���c__- License Number. MP RSW �tZ�_
For: .—_. Provide sketch below of system
(empioyer) (lnclude direction and percent of slope and al� applicable distances)
z0' y � ���I" PLAN VIEW (Locate Percolation Test & Soil Bore Holes)
15' � �� ��'� _,� ,
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PROFI LE (Indicate Groundwater or bedrock where applicable) i I I
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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�ot write in space below - FOR DEPARTMENT USE ONLY
Date of Application -_____ _.__ _ Fees Paid State 1�[� County �v'�_
Permit Issued/R�}s�Wd.�date) �7�T .1�/ ��3_ Inspection Yes _AZ__� No
Issuing Agent Name ��siv__[1sa�_-. _. Valid No. -- Date Rec'd �
DIVISION OF HEALTH, P.O. BO% 309, MADISON,W I.53701 -fievised 4-1-73
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� � D.:paztment .of Zoning and Sanitakion . ,
Sawyer County
Inspection Report
Name of Property d U�� e�
Descr ipt ion � �� w �� . � �� �n � ,01 ' a C'c��, o���
Owner _„�fz�0�+ P�'" _ Address
Builder Address
Master Plumber �� T�o�,�L As�dress _ �/n /�`�,�,�„s_�,,�
Viclation Inspection - Check box
( ) Sanitary ( ) Zoning (� House (x) Sanitary Installstion
( j Garage ( ) Setback - Lake
( ) Privy (�) Setback - Road
( ) (X) Setback - Lot line
(X) Private ( ) Public
Comments d !l�� U- •
_....�.------
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Discussed with Builder� ,� Yes ( ) No
Discussed with Plumber ( � Yes ( ) No
Date of �nspection 1 �
Signature of Officer hv 1 �