HomeMy WebLinkAbout006-439-04-2306-LUP-1988-208 Application for Land Use Permit -
County of Sawyer y
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The undersigned hereby makes application for a Land Use Permit and agrees �
that all work sha11 be done in accordance with the requirements of the Sawyer °
County Zoning Ordinance and the laws and regulations of the State of Wisconsin. ,
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mailing address mailing address
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city, state, zip city, state, zip
Building Land Use Zone District }�j� ' (
QCj New O Filling (p3DJ(o2,D X, t+
( ) Addition ( ) Dredging Lot size f X jc�p � r�r �
( ) Alteration ( ) Grading
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( ) Moving on ( ) Acres �� �3
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New Construction �
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Size _ �_2 ft wide ft wide j
_ y���ft long ft long �
Floor area � ��� sq ft sq ft p
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Total hgt _ l�,(g�� to peak to peak x �
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Stories � �
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No. of bedrooms �"--' rear lot line or waterline
(year round) or (seasonal) �� ��� ~
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Type of bldg or addition i � � � i o
( ) Dwelling i I� � i � rt
(� Garage (1) 2) car I ^ ��• i � ti
( ) Storage building � i C rt
( ) Boathouse � � �,�,• � r•
' EX�T� �
( ) Livingroom Wfs i o
( ) Bedroom i� ��t' t � �
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( ) Kitchen-dining i �,-/ (°� F, �/� i
( ) Porch - enclosed/roofed � �� y � i
( ) Deck - open ,�Oi a�/� i
( ) `}�I i
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Type of construction i � �i
( ) Frame ( ) Block � M� Z
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( ) Log ( ) Concrete i � �
( ) Pole l� Steel � � °'�
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( ) Metal ( ) � �
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Construction cost $� �,�� �Q � � �
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3 2 98 � ; r
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Sanitary Permit g/-QM v�
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Issued Denied
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owner Zoning Admin strartor
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� � � � � State and County Scace Permit # 10 370 •
. . � � i PermitApplication Cou�tyPermit # �1 -bl�a'
forPrivateDomesticSewageSystems Counry SdWyeT'
-DENOTES STATE APPROVAL REQUIRED CST 80 - 347
)ate Approval Received from State if Required State Plan I.D. #
A. OWNER OF Pf20PERTY Mailiny Addiess:
MC�f T���t/ C. t�/i1 � S.S.��1 1�-I ' � / cY 0 /L�D. /.l �b� f' �.(/� �1G,,/ � P
i. LOCATION: �' .e� Z. /I,�tL�Y< , Section T N, R � '
'� . �, _� E (or)�# _y�City F Y
Subdivision Name, nearest road, lake ur landmark Blk# Village
/� `�J� Township C� rn � P �-
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.. TVPE OF OCCUPANCY: Commercial 'Industrial 'Other (specify) 'Variance
Single family �_ Duplex No. of Bedrooms � No, of Persons
�� SEPTIC TANK CAPACITY 'fSU Total gallons No. of tanks �
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefabconerete Poured-in-Place Steel�_Fiberglass Other (specify�
New Installation � Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete_Poured-in-Place_Other (Specify)
- - - - - ---- -- -- ----- - - - --- - z — � - - - ---- - . _ . _
_. EFFLUENT DISPOSAL SYSTEM� Percolation Rate � Total Absorb Area �s � sq. ft.
New�Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top)—No. of Trenches
Seepage Bed:�_Length.�t.��Width �•� � Depth �3 � '� Tile depth (topL� ���� No. of Lines `�
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 3 � Distance from critical slope s� ?'
�'ATER SUPPLY: Private � Joint ❑ Community I� Municipal ❑
wners name as listed on EH 115 if other than present owner:
, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
fJisconsin Administrative Code, and inat I have sized the effluent disposal system from the EH�115 prepared
?y the Cer1t�ified Soil Tester
JAME _�-7Qvn .r S �Q �`e �t.� C.S.T. # .SS � and other information
�btained trom /( c' � SS i� ry � (ow �ner/builder�.� p.`. � �` / _ � �r� �
'lumber 's Signature �Qi*y���� ,� /'e.�- MP/MPRSW# nN Phone �i�9 r
'lumber's Address— ftl_ -��-��/-�� . ��
iPLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well Ioca-
� tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not 6een drilled p!ease indicate.
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Not Write in Space Below - FOR COUNTY AND STA7E DEPARTMENT USE ONLY
e of Application 3- 24 - 81 Fees Paid: State 14 . 00 County 36 . 00 Date 24 b1arch 1981
�mit Issued/��e,�peg( (date) 3- � Q- $ 1 Issuinq Agent Name E13171e Sec�12y
;�ection Yes No State Valid# Oatc Redd
counry (white copy) 3. owner (green copy� OIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
sta[e (pink copy) q, plumber (canary copy)
Revised Date 7/1/78
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Department of Zoning and Sanitation
Sawyer County
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Inspection Report �
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Arnold, Lawrence, Neil �,
Owner *Martin C . Laessi¢ �
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Address *Route 1 420 North St . S±ratEorci. WI 54484 _ �
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Name of business �
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Builder
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Addresa CD
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Plumber ponald Thompson o�
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Addresa Route 2 Box 102 Winter , 4VI 54896 �'
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Inspection '�
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( ) Private ( � Public Property Sanitary-instal o £
Dwelling Setback - lake �* �
Violation Mobile HM Setback -•road o
Garage Setback lot lin "'
( ) Sanitary ( ) Zoning Privy d
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Discu3sed with owner yes no �
Discussed with builder yes no A
Discub5ed with plumber yes X' no
Discussed with yes no
Date �p - / ��� ��
Signature of Officer N�. �, _