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HomeMy WebLinkAbout002-840-17-5206-LUP-1988-283 , Application for Land Use Permit ' , County of Sawyer . y 0 F The undersigned hereby makes application for a Land Use Permit and aqrees � 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 m«�.��. �- � � � �. �(�T k Ic.�_ �'(a-12�N� �i�t�L��?, t— Owner Suilder P.O, E�Ok -j 2, 1736 Johnquil Lane � � mailing address mailing address 1 W}'��(� W t _5�-� Plymouth Minnesota 55441 city, state, zip city, state, zip Building Land Use Zone District 2[Z -2, ( ) New ( ) Filling (�Addition ( ) Dredging Lot size � � ( ) Alteration ( ) Grading �n n ( ) Moving on ( ) Acres t�,� I ( ) ( ) �oRG1-4 To tvew Construction�lc�NldqT�� C-�RY��E Size �I� ft wide �Z ft wide � � � � ft long � Zp ft lonq � Floor area 333 5q ft 38U Sq ft .,��p ° ro Total hgt �'L to peak �Z to peak `Z� x � Stories �_ _� / l No. of bedrooms �' rear lot line or waterline (year round) or (seasonal) i i � Type of bldg or addition i i o i m c O Dwelling i i tr, rt (.}�Garage �zar i� i a o O Storage building i i C rt ( ) Boathouse i c/� �!�` '(� i u�i ( ) Livingroom i `X� �`\1�1�J i p� ( ) Bedroom i i � (.�Kitchen-dining'f3RP-F � � Q i i (�Porch - enclosed/roofed i i N O Deck - open i i � ( ) i i � ( ) � � .p„ i , ' � Q � Type of construction i i I (�Frame ( ) Block i i ( ) Log ( ) Concrete � � � ( ) Pole ( ) Steel i i (J1+� ( ) Metal ( ) i i �� i � � i m Construction cost $�5�.� � � � i o J — � ' � ' � Vol '�j�2 Pg jQ4- of deed i i � i i i i CSM Vol Pg � � i w � � n � � i o Cer. Soil Test �—�.55 � � fD r __________CL road ___________________ z Sanitary Permit gQ —��� � • z �Rl1v :$3q �(;O ��S os� lr�r C" C' N 27 oczo�B� l9&� � Issued Denied N� -2. 8 , N � � - ��o��. �T�r� -��r� S' owner Zoning Administr tor }` .....�} � _ �iVS �t��I ���� ��4t� •� ���.i'� � ��k G ` ��� . � �� � � . � � ��_ � � � � C ~� �� ;�� � � d ��' �.� � ,� �: � ; �� , r ~� .��� - .,��' _„_ _____.. �'� G Ri��u,� rc,�£ f -� . ���► ��`'�tER � � - . t�AKE � ;�,� : i.► ,;;„ O , � �,, .. . �'� � ��i,4 I Y� •� � � `�' .1.Q� �; ' :1.7 I � � � � t <� .� 9 �, t� �.� ' Mi!\ �u w -':... ' „r . � � .. � . . � ... `-.__"' � '+�,5,��; -------. _ . '1.10 '3.� � �,.; __ i 'Z.7 �` � �, � :2.1 ,. . :I.t1 1 m :2.4 �:.. :t.i . � ' :1.1. � � ,4 .�;. � ti ;I.1� i � / �._ 2.S t . �.-. : I .3 ` . c3'�l Yo[ 2 Pe �79 :`.� �2.�+ �� . �s"�..21 5.W ' : 3.Z � _- _ ` � :3.2. .� � '3�2. ' _r� � :3.13 \ :39 :3.7 . \ :�.9 � � - '. . C,..�M. Ym�. ! Po �t� :a.o • � �, �io`� �� �, � Rin� � STOi`1r� . :3.Ip � � : 3.s � ��' �`'� ��; .. l_,!1 i< E .�� � �� . `. � �;� �,;: �;� �.,, ' � �. � � � ---�� .. � ,� a,.'. . ,,. � � 1 �� �,�b� _ e�r � ��� � / v� � . 014Z. fi�� � � atatc and Coun:y State Permit k �� I'��in�it Applicu�iun County Permil # '���1'� , „�„ for Priv.itc Domestir,Sewaye Sys:ems County 'DENOTES STATE APPHOVAL EEC]UIRED CST 80-155 )ate Approval Received from State �.f Reyu�,red State Plan I.D. tF __._„ A. OWNER OF PHOPERTY PAailiny l�ddres�.�. 61z4 Virginia Ave. : � �, (G , � Fi��T�1 �L' ,��/ �/j/1� i � ��"y`v�' i.i LpCAT ON: ---',fr---- '/<, Seotlnn 17 , T 40 N, R-� E I,il W I_ntx City Sub i�sion Name, Paz't Of CiORF��est ruad, lake or landmark Blk# Village �.,' � �` I,Ut ,���� �.�/�!-._ � �` /� ownship R� S�"—�� C ' �� . -- i � .-.-�--�- . PE F OC UPk CV. Commercial � Industri;il 'pthur Isnecify) °Varianr.e $ingle tamily � Duplex No. of [3cdrooms 'j� _No. ol Pcisons� �� SEPTIC TANK CAPACITY�Total gallons No. nl tanks % HOLDING TANK CAPACITY Total gallons No. ol �enks Prefab concrete Powed-in-Place Steel /� F���er9lass Other (spet i fy� New Instatla�ion Replacement ? Lift Pump Tank or Siphon Chamber_ To gnllons Prefab concrete__Poured-in-Place_Other (Specify) . - -. _ . ._ _ . .__ - -- - - - �----- ---- ------- -_ EFFLUENT DISPOSAL SYSTEM� Percolation Rate � Total Absorb Area�lZ—sq. ft. New Replacement r� Altemate (Specify) Seepage Trench: No. Lin�al Ft. Width___._ Depth Tile depth hop�._No.of Trenches__ See a e Bed:.�c _ Len thtv�..t'�—Width ' De th � ��Tile dc th to � r P y � 9 �-�--- F' --��---.1-- p ( pl-.1�—No. of Line� � . Seepage Pit: Inside diam tcr__Liquid Depth No. ot Secpa9e Pits_ Percent sloP� of land y�� Distance from cri[ical slope —_ 'ATER SUPPLY: Piivate}{�Jo�!.J Community �J Municipal �� nris name as listcd on EH 115 if othei than present owner: ' , the unders�gned, do herehy certify that the information I have mport�•d is in accord with Section H6220, ` "Jrconsin Admir.istrative Code, and that I liave sieed the effluem Ais�,u,al sYstem from the EH-115 preDared n the Certilicd Soil Tester, � �:"�ME ���// � %�7 !�j � � � C.S.T. #,� '� �� and other information i�-I-�`-�ff--'�— ���.L� ,h�alned ro� m ��� 1� (� (owne�/buJder� �� � .��mber's Signawre, ' r �17� � _���"Z;' �t -7 -� aL� �P/MPRSW-# � �� � Phof�e # 'f_��c � � � : 'I:imber's C.Adress�Lf' ��,Y ,�'�� t � — � PLAN VIEW� orovide sketch hclow of sYstem (inchide direction of slope and all distances in accord with H62.20.Well loca- ,� tion shall be included on the sketch. Indicate or dimension lor.ation of a�l wells on the property or neighbors �I property. If well has not been drilled plcase fnJicate. _._nt-� - ' /�- ; _ �— /� L ' � '1 � , / � ���ifi ' , � � . , � ��� � ; � f - �--- ,,� / �� � �� �� �--�- + - 7_ � i ��Y /� � � � �� ��a'� ��r 4 � ! � � -�--�-_L_�� � - � � -�'-�'� --� � ; w � � � � f �._ ; �� , i �� � � � ,��•l�-�� - �- + - —�-----�--- � ,�` � l� , �, ; - - - - � � , ; , �� � , �- _ --- , ;_ . _ , � � � ;�� �_ -- ,. i ,, �i " ' � � �' 3� � __ -- � ;--�---�- - �,� � i�� _ n; . � � � , -+- - -+-= � �� � �r i � � 1 � � �" �2 � 1 ���1� ��'�� , � � � �� �,, _ , - --1-- -- � ,., _ �_ � -�_. �� _ _ � � , _ -�--�- -� �- _� �� -� : . - , , . I � , ;- - �, �, � � I � . . � ..A��_�. � .I��,.� .� I _�C '�,�' ':`�t � .E'.. ��� �_w � "'�� l l Not Write in Space Uelow � FOR COUNTY AND STATE DEPARTMENT USE ONLY co-: ot AVP��tation 7-14-80 Fees Paid State 14 . 00 County 36 . 00 Date l4 �Tnly 19Q'� ��rit Issuad�r�pd� (date� _L1L��_Issuing Ayent Name F;1d171E Nehrlin� pection Yes No State Valid# Date Rec'd _ �o�mty (white copy� 3 ov .�en copv! DIVIcinN OF HEALTH, P.O. BOX 30J, MADISON, WI 537p1 ate IPink coVYl S. pi .-r. �c.a-i3rY :oF�v1 � Revi�^�1 Date 7H/7p . REPORT ON IPJSPECTION OF SANITARY PERMIT #_�•�y_ � ' Name ar,d Address of Permit Holder Person/Persons at Site 2 Date of Ins� �0 1lN �ol-FMnr� L,IUi RN O�NNlg ��� ` r� L � � � ��/� � nA-u. �SYu�F Time of Inc ecti �i73r�2, ress, tcense o. o ns a� ing p umber P ,. , � � 9��o .�.M, �(.i�INSTALLATION CONSISTS OF: � Septic Tank � Seepage Trench �Dosing Chamber []Seepage Pit � Seepa eg Bed ❑ Holding Tank [] Fill System '�T�EN : ermanen re �erence �niJ� scri e : Nw Gc2k�r2 Cr (�l.pG. E�cT7'onn eF �; pl,v�'1 Elevation of vertical reference point:�G�` _____ Slope at site: � �o S, ( ' '4ATERIAL AND DEPTN OF SEWER: �'J � � " � '6',<[PTIC TA��K: Manufacturer:_��pC__ _ Liquid Capar_ity: Tank Inlet Elevation :_ q� _ _____ _ Tank Outlet Elev: $ � /d � Ft to lot or property linec �,�c,___-- _ _ - - � ft to well � 7 ,3ao i :')D1; ;ING TANK: Manufacturer:_ N of gallons : H of gallon pump set for a cycle _ 9allons ; total capactiY of distribution lin �s _ gallon ; size of pump ______ head; gallon per minute horsepower _ ; brand name of pump and nadel number Is the warning device installed? ❑YFS ❑NO Wired? ❑YFS �NO (fi HOLDING TANK: Manufacturer ___ _ ; o ga ons � . cons�ruction ; depth to the cover ft; If septfic t- anTc—is being used are baffles removed? YES ❑ N0; ft from residence; ft from well ; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑N0; Wired? ❑YES ❑ N0; Locking device on cover? ❑YES ❑ N0; Diameter of vent and material Distance from building to vent — i �; SEEPAGE PIT SIZE: A of pits; _____ ft diameter; ft liquid depth; ft to residence; ft to well ; __ ft to property line; ft. to ordinary high water mark of lake or stream; ft to edge of slopes greater than ; seepage pit inlet pi�e-elevation ft; bottom of seepage pit elevation _ft. , :.0) SEEPAGE BED SIZE: _ �_ ft width; _��_ ft length ; � � tile depth; � - y0 li.neal feet tile; _� ft to residence; ��� ft to well ; �� ft to lot cr proper:y line; _�� ft t.o ordinary high water mark of lake or stream; _�� ft to edge of slup�s greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line enterin4 bed `�.� ' ft. ;�_ 1 SEEP,�U�Tk�h7�. : Total length of seepage trencFi ft; width ft; tile depth ___ ft ; ft to well ; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes , water courses or drainage ditches; eler,ation of tank discharge line entering seepage trench _ ft. �,12) Has system be�n installed in area indicated on EH 115? �,YES � NO i13) Has system been installed in floodway? �YES �NO F]oodplain? �YES � NO �G1LHR-SBD-609 N. C —' Signature of Inspector: ���� � � �,�y� ) ,,:. Department of Zoning and Sanitation ' Satayer Count.y o E b Inspection Report ro H OWneT Pauline M F ,7chn L . Coleman Addrees _6124 Virginia Ave . �' Euin.s , hIP1 554�4 0 Name of business � -- r Builder n Address ,� -- - --- � Plumber LaVern Denni.s 7 Addre:�s [dinter° , [�i �.` s��pg6 Inspection y (X� Private ( ) Public Property ;;anitary-in3tal S � X Dwelling Setbe,ck - lake `+ � Violation Mobile HM Setback - road � M Garage Setback lot line ( � Sanitary ( ) Zonin� Pr1vy �e a N ti `\ � H �WELL C` �'' y x x, � I m 3co'± \j� �p, N � (}��' 3('c.o '7" n � C YT9�o .%c�. � 35� � o�@ m � rt d �j4 I-� CoUiN 4G y�( �"S� II�- 4 , � r+ �i.M. --3`i — �rE4T i ro � N � I Diti+IlINC � � • � �{0 m � / FF I Deck - _���� - ' " � c�'u �_ � GArr�cnL � Sj�oPC � � I a F'� � r �I M�ous I µ V w � F' ,y� — --- - _ � H S _.�%� -- d - -`--- --- UQIf�IQ S iONf� LAkE I� . I Discussed with owner ) yes no � Discussed with builder � yes no Discuased with plumber yes no Discussed witli yes no CO Da.te �I S �fu �. �i _ I Signature of Cfficer v�� 1�`,� ����j'ml ---�-� /��Y�G �2S/�,F'C//Oe.. (�(/� �h /luJ _e� / .qJirLJ.z / " � „�;y,l .i �. ;�:t.i "r !�nr ��.�nJ. ,_.� . . , . �� i ' CwnLt' ��t :oawya� . ..3 0 The undetoigned hrreby mal<as applia3tio�, for �, . .• �� U�« Permit and agrees � that a].1 work sk�all be done in acc��r��'�n��_^ !Nith �1�:� -.�� e�.�;��aircmer,ts of the Satayer � County Zoeio� Gr3inan�.c �uid the �t <w_ .� � .r o i ' � �- � � - '.n� State of Wisco�sin. � i �� ;�i. � i , ,)*�:.,Y At:yCK INY.IP�:dC2L ; (�'c�n� Michelle A . :�n1 I E�'�I� ' _�.t � t� � l � �� I<. _�a G _`— -- ,, - ; , r � . t _—�_ Owner �--�--- �-� �-- 3u� � '.. _ --�- ---�-- � , _ m _/73G� _..�oNNQuiL � N _ _ Il_' _.i �r ,-. .3i3�-- -- -- -- mail�..ug adu�ess � ir:i_iii. � . . � ... � � , �J I [, r i 1.`S(m Q�1�.'�� ,-J P/ s.,� � 7�_ ___ ��� � _._ � r . ._l' / ��_�.�.S.'. _-_ �_'�__:J C1C}� , state , ziE) � ' � ' � � ' � - Bcilding Land Use c� n� ; ,_: ; _ ._1i�2-------- ( ) New ( J Fillir.c � � (� Addition ( ) Dredginc ,. , . . _ _ ...-_. ~ ( ) Alteration ( ) Gradiny �' n ( ) Moeing on ( ) ------__ , _ 4 . 71 acres v _ . _ . _ ._. _ -- I I*1 i ) � � --- -- � C �? ,nr�[�C �-oUntoA'[�� � -pi New Construction ( appit�or�� ��"��'- ���`�' � _ ���j1 n Size ZO ft wida . � ` ��'"�`� 1� 3 7 f'�t .on9 ___.'. _'1 . _ '- �.: 1c>n�.� Y — -- N `1 `I� sq fc €�� y �;:� r �_ ' � Floor azea _ ___. _ �, " .__ p; � + r Total hgt � 9 to neak _ / y __ �-� '� ���y4, ,x Stories � ---- __ ._. _-. _ i No. of. bedrooms ---------- + ' '-�--�--=�»t--�*�--t� water] ine � ___ _ _-- � ___ .. ._ _ .-- <- (��_o+c l�eac�i�al ) � ,u��`� L � � � � ` � � Typc oT bldo � eddii.i^n � C�iZr� .: -' �i ' ' �� mrG � � ���� U O L-welliny � v� �g` S, (� G,ir�ye C'-� ('�) c�r IV�"� � '� ' < i1 ; ) Storag^_ b;ii lding . i � � , �• � Nj�ATIOn� � � /` �� ! !hy Aoathousc - N[w F� ��r � . �,� o (�7 Livingm� :n �' �OU�T�on� � i /� /�\s - � � (�Q Iiedroom . � � f � ` o . go�i6i Go v / C� ,o*,� O xitchen-�:i�iiny i� a"� � . ( f o L N ( } Pozch - enclosed/r� , � ' � 6 , :�.: , i r m . r O neck - ope.: i \ w , �- o ( ) __ --- --- � � �;� � � r2" � I ( ) ------ ' �* . � 5 `",a � N r' _______ ___ / V � I P,0 � � O 1�e oi �on::t� �ic:tzUn i / Z � rnl 1 rzame ( ) L'lcck i k ( ) 1.og ( ) Conci �•L�� �� w � ) i � 0 ,��. Pole ! ) St.ce i � � ( ) Meta] � � ___.__ ____._ � , 4 1��� i ti� �-��� �� � � �1� pOD. GD\TlO�f � �— O Constrtction c:.,�:t $�:09ui_ 9R_.R�`�j2� i � 'a4it � I OUD. h=11T�S � — I\ .�� f ,�r- �l WU v�l 392- — � g- --104 of decd i j /ti � K2 o:.sy -� -� � { /l:ti/ � ��—� _ � i;SM Vol -----'-'�*---------- i `� ---- ---. �_._ ,.�� � 9 � t� c � � --..,.�_ Cer . Suil v ;r. �O - 1 �: �_ _... � �_.. - --- - � � q ` �IO - --- ------------- z Sani.taiy Yeimi.0 _�'L'_- ��.1..---- - _ .. _ . . � -`.iC'' F� F ***EFMV 539 , 100 . 00 _S�'n%fi,_�_�--- .• � _ - — _ __ .__ . __ _- -- — ' ��Z- i)� �ii �" 3 N � Isaued �__ , L - � -.._ . ----- � -.. ,,,�._'-'.:.-iL� - -- ----- --—- --�--- - �-----�-- C £ � ' - ---- `�.'�-=�=(�': -�-�- _ E. Patrick Dargis �wnEr zoning Admini trato � . • - :�Xi4� ' 1 � ......s:,.., -.......�=v__a:.3YYlt"e�"�"" _" _ .._...�w��.�...�....�...de..—..-+