HomeMy WebLinkAbout002-840-31-5410-LUP-1988-251 Application for Land Use Fermit
County of Sawyer y
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The undersigned hereby makes application for a Land Use Permit and agrees � �
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 of Wisconsin_
PRINT - USE ONLY BLACK INK/PENCIL
Pamela J. and - '
Roy B Watts ���`. � ���� ���� � �� �� '��
— �
Owner Build � -` �
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mailing address mailing address ' �-
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city, state, zip city, state, zip ''G
Building Land Use Zone District RR-2
( ) New ( ) Filling r
( �Addition ( ) Dredging Lot size 2�� � X 348 � ,�-r �
( ) Alteration ( ) Grading �, n
( ) Moving on ( ) Acres 1 . fi0
( ) ( )
�
New Construction � 9
i-h H
Size ft wide ft wide �o vyi
ft long ft long �
._ �
Floor area sq ft sq ft �
u�
Total hgt �'T� to peak to peak x �
Stories ! , �
No. of bedrooms -------- rear lot line or waterline
(year round) or (seasonal) ,, i
i
Type of bldg or addition i I i v� C
( ) elling �, i i �, rr
( Garage (1) �2) car i � �, ` i Q' o
O Storage building i �.k�7 i C rt
O Boathouse i r; i r•
i �
� i N•
( ) Livingroom �` i � � � �. i � �
O Bedroom ; i 1 c!;_ r , � i i
! � i
( ) Kitchen-dining , i _ �y � � � � � i o
( ) Porch - enclosed/roofed � +r � �--`" �i N
�� `, �{. � i i
O Deck - open i ` �J'� � ,,�yL i �
( ) '�-•-.�i �f �, a 7i" . '1 , i �
� �; �� .� � o i
O � i �r ''S' �� _ � � �
W I
; '�/ j �.\� i F-' �"�
Type of construction ' - �i ,�;�� �' •' � ��!�-_ � � � �
O Frame F�lock i �� � s �3 � �_ .. --"Ii � i
( ) Log ( ) Concrete � i �•� � � � � � o i
( ) Pole ( ) Steel i j'. �° � �^-
( ) Metal ( ) �
' �. � ' ;`� i
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Construction cost $ � � �
���'�����. i � �.. i
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Vol 420 Pg 500 of deed i �"- � �,.,
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csM vol 12 Pg 166 ; j �.� i �
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Cer. Soil Test 83-176 � �` �i. "Loa` � �� �
_. �
----------CL road Y------------------ o �
Sanitary Permit 83-153 " � � '� � f � y- '�� �,�r , o
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zssued 29 September 1988 Denied �
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ROy Watts owner �y 7oning 1�dmini trat r
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SAWYER COUNTY CERTIFIED SURVEY MAP
. 3� Nw2 c A part oP G.L . 4, Seo. 31 , T. 40 N. , ,R. 8 W.
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"'=) • Set 3/4�x 24��I.P, rt.1.l31bslft.
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�y� y��3� SCAIE 1"= 60'
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-� 33.00'
� "o� S 87°19' IO��E 347.89 plat 6 mea. ��' \Q.
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SIIRVEYOR'S CERTIF'ICATE
I, LYI,E L. ELLIOTT, regietered land eurveyor hereby certif� that by the direction of
ED..WATTS, I have eurveyed and mapped the land parcel whioh !e repreeented by thie
Certified Survey Map:
The ezterior boundaries of the land paroel surveyed and mapped is deeoribed ae followe:
A part of Government Lot 4, Seation 31 , Townehip !�0 North, Range 8 Weet, Town of Base
Lake, County of Sawyer, State of Wieoonein, and more particularly deecribed es followe:
Commenoing at the West Quarter oorner of eaid Seotion 31 , thenoe S B7°19' 10" E 33.00 feet
to an iron rod being the goint of beginningi
thence S 8'► 19' 10" E 347.89 feet to an iron pipei
thence S 3°Oly'30" W 200.00 feet to an iron pipe;
thence N 8�°19' 10" W 347•88 feet to an iron pipei
thence N 3°Oly' 19" E 200.00 feet to the point of beginning, eaid pamel
oontaine 1 .60 aoree more or leee, end eub�ect to ex�y eseemente or reatrlctions of record.
I have fully complied with the provieions of Section 2j6.31y of the Wieoonain revieed
Statutee and the subdivieion ordinance of Sawyer Covnty in eurveying and mapping eame.
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21� ; 1 : 3 ,�r'".N\SC�1Y$/
� ' L. ELLIOTT land eurveyor
�,�.�. �, ��--�� ��' Wi conein Regietration S-1j00
so.rv� c�r LriE l. ELUp � Date: MsY 9, 1988
i�r �oora u;s �f d s �'�� � I hereby oertif� that thie survey ie correat
pnw a� ;°`oaixr � ��ER, � ' to the beet of � knowledge and belief.
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'�' w'S�o^5,^ APPLICATION FOR SANITARY PERMIT 00
� � IL � R SAWYER cqu�vry �,
(PLB 67) v,
�� oecaarmenrov UNIFORM SANITARY PERMIT t"'r W
��� IflIXJSTRv,LqBOR 6 HUTRfI RELFTIOf15� �S T 8 3 - 17 6 3 9 3 9 8
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' ttach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8�_ x 11 inches in size.
�?e reverse side for instruc:ions for completing this application. PLEASE PRINT
"'s ERTY OWNER edll e e WdP . MAILING ADDRESS
`-� �J ` v . �
�;,_ P RT LOCATION Qt�'Y:
. , ,/ ,�,.�-:�&�:
= 1/4��w 1/4, S� , T N, R � -E-f�er) W TOWN OF: �S t � K �
JT NU�E3ER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE P�AN I.D. NUMBER
h �1 � 2
':PE OF BUILDING OR USE SERVED
�� 1 or 2 Family Number of Bedro�ms: 2 [� PuL,lic (Specify) :
-iIS PERMIT IS FOR A:
� New System ❑ Tank Replacement L_] Repair
i� Replacement Soil Absorption System I� Revision �� Privy
� Alternate System CJ Reconnection ❑ Petition for Modification
"= THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
�Seepaye Bed LJ Seepage Trench � Seepaye Pit � Holdiny Tanl<
r i System-In-Fili ❑ In-Ground Pressure U Vault Privy C; Pit Privy
i� Existing, For Which A Previous Permit Is On File, Permit # issued
� An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Ffberglass Plastic
ntic Tar�k Capacity
�:t Pump Tank/Siphon Chamber
o�ding Tank capacity
', �nufacturer. � �
THIS IS AN ALTERNATIVE SYSTEfJI C01�1PLETE THIS BLOCK: ❑ Mound � In Ground Pressure
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
'ptic Tank Capacity
''t Pump/Siphon Chamber
.anufacturer:
?ERCOLATION RATE ABSORPTION AREA ABSORPTION AREA �UATER SUPPLY:
(Minutes per inch�: REQUIRED (Square Feet): PROPOSED (Square Feet):
` '�'� 2� Private �� Joint ❑ Public
the undersigned, hereby assume responsibility for i tallation of the privat wage system shown on the attached plans.
�m of Plumber (Print) gn MP/iv4P�Rfi1W� No.: Phone Number:
� A ��A�1�R� � '14 �7�5 � 6 �- 5�a'T
u ber's Address: ' Desiq r:
�; � v�a �z � 5�8 `�� �
— -- - — .
W GOUNTY/DEPARTMENT USE ONLY
gnature of Issuing Age t: Fee: Date: ❑ Disapprovod
❑ Owner Given Initial
� 6 � . 0 Q 8 — 2 3 — $ 3 X� Approved A;lverse Determination
�ason for Disa val:
;ternate coursels) ot Action Available:
�HR-SBD-6398 (R. 5/82) DISTRI6UTION: Original to CountY, One Copy To; Bureau of Plumbing, Owner, Plumber
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DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
1_ABOR & HUMAN RELATIONS pRIVATE SEWAGE SYSTEMS DIVISION
�.G. BOX 7969 BUREAU OF P�UMBING
P��AD�SON, WI 53707
� CONVENTIONAL ❑ ALTERNATIVE $Ia1eVIanlU. Numben
(I� assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
, NAME OF PERMIT HOIDER�. AODFESS OF PERMIT HOLDER� INSPECTION DATE�.
!
.' �� ,v ��rt,� �- [d - c�/,��`..a. rz r a �3o a i A ,� a � cu% 7 - ia - 8 y
I6ENCH MANK IPr�ma��e•n relerrnce Vuiml DESCfiIBE IF DIFFERENT FHOM PIAN qEF. PT. EIEV. CST HEF PT. ELEV
I(
{_
j���ame ol Plumber�. MP/MPRSW No Counry Sanrtary Permi� Number
�_ Jr `f'�L
u� $3 - /S 3
:'EPTIC TANK/HOLDING TANK:
fPnANUFACTUREfi LIOUID CAFACITV TANK INLET EIEV TANK OUTIET Ei_EV WAFlNING LABEI LOCKINGCOVER
� _(� p� .y PHOVIDED�. PROVIDED�.
� �T�CI� . c.�t Q / / . J� 97 .3 �YES ❑NO ❑YES ❑NO
i3FDDING vENT DIA.. VENT MATL. HIGN WATEH NUMBER OF AOAD�. PROPERTV WE�I: BUILDING j VENT TO FRESH
' '�/ � "�AH"' FEET FROM �'"E t � IqIR INLET.
' �c >zs > s
'_ CJYES ❑NO �7 tr � �IYES ❑NO NEAREST — ��
uOSING CHAMBER:
�GAANU��+CTUREH BEDUING U(]UlpCqpnG7v vUMVMpDEL PUMPrSIPHpNGtANUPAC7UHtH WAqNINGLABEL LOCKINGCOVER
- � PROVIDED�. PqOVIDED�
❑ YES ❑NO ❑YES ❑NO ❑YES ❑NO
'vALLONSPERCYCLE: PunnvarvocoNrao�sor�eRariorvn� NUMBEROF P�OPERTv WELL BUILDING VENTTOFRESH
IIDIFFERENCE BETWEEN FEET FROM ��"E AIR INLET
'UMP ON AND OFF) ❑YES ❑NO NEAREST
t:OIL ABSORPTION SYSTEM. Check the soil moistureat the depth of plowing �r vr,rH uinn�erer� nnn,F�Tin� nNo �.,n�+Kwc
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE
!ie soil is dry enough to continueJ MAIN
�ONVEN710NALSYSTEM:
BEQ/7RENCH wiorN iery,TN No oF oisra vire sNncwc covr�� wsii�e nin s�irs LiOUID
1NLNCMES I / MAI Inl � PIT DEPTH�.
� DIMENSIONS �p� � „�S� •--- 6 • S�-r.�w - -
:,HAVEL DFPTi� �ILL DEPTH UItiTH PIPF DISTH PIGE � DISTR. PIFE MATF.HIAL NO DISTN NUMBER OF PHOPERTv WELL BUILDING VENT TO FRESH
i.-� �OLY PIVES AdOVE COVEH ELEV INIE i EIEV END VIPFS LWE. AIR INLET�
; // � . ,//� p FEET FROM
� e 97, / �7 Q �d(. � 7�.3 �� Z NCAREST---� '�" ��O 7 ZiS —
':40UND SYSTEM:
� Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
� and furrows thrown upslope� mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
� meets the criteria for medium sand. TIONS MEASURED.
, ❑YES �NO
'SOIL COVER TF.XTURE PEHMANENT MAHKERS OBSERb'A710N WEILS
_ ' ❑VES ❑NO ❑ YES ❑NO
'�)EPTH OVEN TRFNCH {iE 1! ULPiH OVf N ', P.ENCH HFU UEViH Of 1OVSOIL 5OOU1 U JEf Uf�D MU�CMED
�(EN7tH EUC,ES ��
— ❑YFS ❑NO �YES ❑NO ❑YES ❑NO
"RESSURI2ED DISTRIBUTION SYSTEM:
':JIDTH LFNC,TH NO OF LAT[HAL SFACING GHAVEL DEPTH BEIOW PIPF FILL OEPTH ABOVE COVCR
; P..ED/TRENC!-I r— raF.vcNEs
DIMENSIONS
�� MANIFOLO 7UMP M1IAMPOLL DIS7R VIPE MANIPOLDMATEHIAL NO DISTH DIStR PIPF UISfHIBU7lONPIPEMn1EAlAL & �UnRKING
' ELEv ELEV DIA ELEV PIPES DIA
ELEVATION AI�lD
DISTRIBUTION
` irJFQRMATION HUiE SIZE NOLE SpACING DRILLE D CORHF_C7LY COVEH MATEHIAL VFHTICAL LIF 7 CORRESPONOS TO APGROVED
� FLnNS
❑YES ❑NO C�YES ❑NO
1'..OMMENTS: PERMANENT MARKEHS�. p85ERVATION WELLS NUMBER OF PROPERTV WELL�. BUILDING�.
FEET FROM LINE
_ ❑YES ❑NO ❑YES ❑NO NEAREST�_
Sketch System on Retain in count file for audit.
'�everse Side. Y
S r TITL
71LHR SBD 6710 (R. 01/82) 7 � / . �
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