HomeMy WebLinkAbout010-941-26-2120-PVY-2024-007 t
�
�
SAWYER COUNTY ZONING&CONSERVATION ADMINISTRATION !
10610 Main Street,Suite 49
Hayward,Wisconsin 54843-0676 k�
(71�634-8288 -�
www.sawve rcoun tveov.ore
i
NON-PLUMBING SANITARY PERMIT APPLICATION Cj
In accordence with Chepter DSPS 391,Wis.Adm.Code and �
Sawyer County Private Sewage System Ordinance
APPLICATION INFORMATION-TYPE OR PRINT PAGE: af
y Owrc�Name Prupv�y I.egal Dacrip�ian
��� ? p • �N�.� N"'� �. S �6 ,T 4( N.R � W
Propcny a'�s ailing Md�as Lot Numbcr Blak NumM
, !C � �
ny,Stete . Zip Code Phono Numbcr Subdivision Nemc m CSM Number
�' ' 2 Gt/ 53�/� �60���35�-7�79 �S� ay .�� �3a
TYPE OF BUfI,DING:(Check one) Stete Owned ciry Neorest Roed� �M� � `
❑Public �]or o a�nily�well' -No.of bedrooms �y���` Fia Number#
0. QTawn of �./ /O
PUBLIC BUILDI /LAND USE: sxp�e���he ucdpur�crse�«mis Parcel Tax Number.(12 digit lesacy number)
permil.li.e..campgroimd.2stivd,ic�mtioNmMnainmenl event etc.11 O � D � y / � / .� � z O
— 1� — (� —_
^� t i — --
TYPE OF PERMIT: TYPE OF NON-PLUMBING DEVICFJ SYSTEM/fO1LETNNIT:
�/ ❑Privy-Pit Toilet(CSTN )
�NornPlumbing(Privy,Toilet,Restroom,EtcJ ❑Privy-Veult Tailet(200 gal.min.capaciry mquired)
(Vault siu:�allons or cubic yards
❑Othcr. Vault Privy Type:❑Concrcte❑Steel❑Polyethylene 0 Other
❑�C�m�sting Toikt S;strm ❑lncinerating Tcilet LNvice
f I�Ponable Restroom Uni� ❑Other I
RESPONSIBILITV STATEMENT:
I,the undersi�ed,assumc responsibility for thc insWlation of ihe non-plumbing sanitary rystem for which this permi�is issued.1 funha egtee tl�et
any dw•elling in conjunclion with this pennit x�ill not be provided with indoor plumbing and/or xata hookup.1 will usc Ihc non-Plumbi�g rys�an
indicaled as a means of xacte disposal,end I will carry ancer to und from the struaurc.I undersland that beforc indoor plumbing and water hoak ups
erc instnllcd,thc proper Stae and Counry Pertniu wiU bc applicd for.1 funher underswnd�het uny dcvietions from the ebove will wastiro�c a
viol¢tion of Sawyer Counly Ordinences end would subject mc to the penahies of�he Ordinunca. By signing Ihis npplication,1 om also granting
permission to Ihc mning dcpartme�t pmonnel�o mta my property et eny reawneble lime for thc purpose of inspeclion to acwre compiiena wilh
the zoning end seni�ation laws reletive to thc irnancc of ihis pertnit.
O�mcr's Nome:(Prin�) � Ow�Kr's Sipfwure� '
' ^Z �
l�
OFFICE USE ONLY:
Disopproa.d rt CST Duelssued Issui�A ISignelere
�Approv d �Owncr Givcn Initid $I50.00� r/ � .rj�5'l 3� ��;1���,�.
.l Advcrse Dcimnination %1
COMMENTS:
"E:pires 2 years from date ot�ssue
*NO REFUNDS AFTER ISSUE OF PERMIT
SHORELINE PROPERTY: YES❑NO If"Yes,"Name of the bod of water. L�hl{J L0.k-c.'
CONDITIONS OF APPROVA EASONS FOR DISAPPROVAL:
�T��I��" �
r� WW'11�
S � aN �
eev.oan9n6 ��� li!!�C,:�S���!��}
NISSUE OFDPERMITR .{::� 141`� �-'�� MAY O 2 POZ4 _,r
��N ��,,,_�_..., . ; i�-g3o
NON-PLUMBING SANITARY PERMIT APPLICATION
PAGE:Z of 3
Privy Plot Plan
� SzsL a"�7�� 1 `oT �av� w�e�,P v�
��vv�ey .
/
Please include thc followiog information with distances an thc above plot plan:
❑ North Arrow
o Nearest Road
❑ Site Address
❑ Structures
o Well
❑ Property Lines
❑ Lake, River and/or Stream
o Wetlands
Minimum Setback Requirements:
• 10' from any slab conswcted accessory building
• 25' from any habitable building
• 45' from any property line
• 50' &om any water supply well
• 75' from the ordinary high water mark of navigable waters
• 130' from the centerline of state highways or 66' from right-of-way line, whichever is greater
Rev.04/29/I6
NON-PLUMBING SANITARY PERMIT APPLICATION
1'AGF.:j of�
General Requirements,Recommendallons and Stsndsrds:
1) The privy structure should be inscc[and vemun proof.
2) All windows,ventilators and other openings should be screened with#16 mesh to prevent enttat�ce
of insects.
3) The privy structure should be provided with cross ventilation of 2 square feet of screened opening
for each seat.
4) Privy doors should swing and be self-ciosing.
5) Privy seats shou►d be provided with hinged covers.
6) The entire installation should be kept clean and sanitary.
7) Freshly slaked lime or other equally effective disinfectants should be used at frcquent intervals for
odor control.
8) Floors,walls, seats and urinals should be scrubbed as often as possible.
9) The outer base of the privy should be banked with earth.
10)Concrete,cement block or metal flashing should extend 6"above the ground end 12"below the
ground to prevent entrance by insects and vermin.
11)The footprint of any priry structure shall not exceed 40 squaze feet and not be used for storage.
12)Maximum height of any privy struchue is limited to 10'.
13)Privies for public buildings shall comply with SPS 353.63
14)For open pit privies the bottom of the pit shall be a minimum of 36"above any restrictive factor
(ground water, saturated soils,bedrock,etc.).
15)A certified soil test is required for open pit privies and must be filed in the zoning of�'ice before
permits will be issued.
16)A ceAified soil test is not required for a sealed vault privy.
17)Sealed vault privies shall have a water tight vault made of materials approved by the Department of
Safety and Professional Services(DSPS).
18)Sealed vault privies should be ventilated with a pipe of at least 3"in diameter which terminates at
least 1' above the roof of the privy and in accordance with s. SPS 382.31 (16)(a)to(�.
19)The sealed vault privy should be pumped out when nearly full by a licensed septic hauledpumper in
accordance with ch. NR I 13.
20)According to DSPS 391.12, the storage chamber of a sealed vault privy shall have a minimum
storage capacity of 200 gallons or one cubic yard.
21)The storage chamber of a sealed vault privy shall confortn with the requirements of DSPS 384.25
relating to holding tanks.
Rev.0429/16
MAP OF SURVEY
LOT 2 OF CSM NO. 6630, LOCATED IN THE NE 114 -- NW 114 OF SECTION 26, T. 41 N.,
R. 9 W., IN THE TOWN OF HAYWARD, SAWYER COUNTY, WISCONSIN
PROPERTY ADDRESS. • 10422N SAWMILL ROAD HAYWARD, WI 54843
SURVEYOR'S CERTIFICATE
1, JASON R. NELSON, PROFESSIONAL LAND SURVEYOR W THE STATE OF WISCONSIN,
HERMY CERTIFY.'
THAT ON THE• ORDER OF AAWN CZ4JKOWSKI, 1 HAW MADE SURVEYED AND MAPPED
LOT 2 OF CSM NO, 66M, LOCATED IN THE NE 1/4 -- NW 1/4 OF SECTION 26,
1. 41 N., R. 9 W , IN THE TOWN OF HAYWARD, SAWYER COUNTY, WISCONSM,
INAT THIS AW IS A TRUE REPRESENTATION OF SAID SURVEY;
THAT SAID SURVEY AND MAP COMPLY WITH CHAPTER A--E 7 OF THE WISCONSIN
ADMINISTRATNF CODE; AND
Cr TO THE BEST OF MY KNOWLEDGE AND
INARTW III 71NAG N
HA YWARR IC
BFARMS ARE REFERENCED TO THE
NORTH LAME OF LOr 2 OF CSM Na WM,
BFARLMC S 88,50,12, E
SCALE• ONE INCH = 50 FEET
0 50 100
ELEVATOON INFORMA77ON
ELEVATIONS ARE NGVD29(Fr.)
THE R4S,E' FLOOD ELEVATONN OF LAKE HAYWARD
IS 1189.00
CABIN
FLOOR aEV. - T 191.98
LOWEST ADJACENT GRADE (LA.G.) - 1189.69
Wr I r-W NO 8030
NOTES. -
THE ORDINARY HIGH WATER LINE (OHWQ OF LAKE HAYWARD AND THE UNDEUNEATED WETLANDS SHOWN APPROXIMATE
AND FOR REFERENCE AND NONAtGULAtORY PURPOSES ONLY.
THE 40' WETLAND SETBACK SHOWN IS APPROXIMATE AND FOR REFERENCE PURPOSES ONLY. CONTACT THE SAWYER
COUNTY ZONING DEPARTMENT FOR 40' SETBACK DETERMM77ON PRIOR TO PLANNING OR CONSTRUCTION,
ANY LAND BELOW THE ORDINARY HIGH WATER MARK OF A LAKE OR A NAVIGABLE STREAM IS SUBJECT TO THE PURM
TRUST' IN NAVIGABLE WATERS THAT IS ESTABLISHED UNDER ARTICLE IX SECTION f OF THE STATE CONSTITUTION.
UNLESS NOTED, THE EAVE LINE OF STRUCTURES IS SHOWN.
SEE CSU N0, 6630 FOR SECTION TIE AND ADDITIONAL INFORMATION.
A TITLE COMMIAMENT WAS NOT PROVIDED BY THE CLIENT AND A TITLE SEARCH WAS NOT PERFORMED BY HEART OF THE
NORTH SURVEYING OF HAYWARD, INC.
THE SURVEYED PARCEL IS SUBJECT TO RIGHTS OF WAY, RESMICTIONS, RESERVATIONS AND EASEMENTS THAT AMY EXIST
THROUGH UNRECORDED MEANS OR RECORDED DOCUMENTS
S 8B'50'12" E
�• �'�� 4�1 ail
I J0' SEMCK • \ " !
I p \40 ,� !
+� 816I
42d 102
42Z89' 1 spy
28%A
I w �,. LOT 2 1I ,
I MMUMBIE AM
t4,200 SO. Frf ` I CSM NO. 6630
I 1 67,800 SQ. FT.f °1� , f i 191.02 '
+ 1.5G AC / * 4 �
b, (INCLUDIN ROADR/W) 119a68
I b I j w► j V
Ls
II89.69
10' �G1r I Olp iYM'
N 8847'15" W
1
1 I
' LOT 4 CSW NO. OX j
1 1
4p % 4"147
Lff.1 cm My mat
I Ur--1 ✓TLJkv
T9
?MAY
�1 I:I
01 2024
SAWYER COUNTY
ZONING ADMINISTRATION
LEGEND
FV MID 5/8' SO. IRON RAR 13 UMM POLE
Cum a4*W CZAJKOWSKI
JOB NO.:
A&2LCZWKOWGZ6
BEAR? OF ThF NORTH FAX: , 6/L;34-6444.
( ) R£OORDED DATA — r — OJ{ UMITY LAME
- AO
SCALE 1' K 50' ACAD:
IOM9N DUFFY RAAD
�41I6 APPROXMIE IA1mETMATED 14iIIAAW — d — SE7R4CK LIAR AS IIOIIn
- CZAJ74/KOW51G
COAM'LE7m OB/02/2f OOORD CIAJXON5Kl
54843
y. WWW.HONSU�RYfEMG.COM
S R VEYI V G OF 2 A 1[ V V AL[ 14D, INC17
119�l1 SPOT EiEVATlO1V
-2MGf8l
Pa 50
c
O
Sl2/24,10�14 AM Real Property Listing Page
R281 EStdt2 Sawyer County Property Listing Property Status: Current
Today's Date:5/2/2024 Created On:2/6/2007 7:5522 AM
�Description Updated:1/18/2019 '�Ownership Updated:8/31/2021
Tax ID: 12820 THOMAS L&DAWN E CZA7KOWSKI BEAVER DAM WI
PIN; 57-010-2-41-09-26-2 01-000-000200
Legacy PIN: 010941262120 Billing Address: Mailing Address:
Map ID: .5.2D TNOMAS L&DAWN E THOMAS l&DAWN E
Muni�ipality: (O10)TOWN Of HAYWARD CZAJKOWSKI CZA]KOWSKI
STR: 526 T41N R09W 206 ROLLER AVE 206 ROLIER AVE
BEAVER DAM WI53916 BEAVER DAM WI53916
Description: PRT NENW LOT 2 CSM 24/311#6630
Remrded Aaes: 1.530
Calculated Acres: 1.510 w Site Address *indicates Private Road
Lottery Claims: 0 10422N SAWMILL RD HAYWARD 54843
First Dollar: Yes
Waterbody: Hayward Lake J property Assessment Updated:4/4/2024
Zoning: (R-1)Residential One 2024 Assessment Detail
ESN: 444 Code Acres land Imp.
G1-RESIDENTIAL 1.530 51,700 13,400
�Tax Districts Updated:2/6/2007
1 Sta[e of Wismnsin 2'Year Comparison 2023 2024 Change
57 Sawyer Counry Land: 51,700 51,700 0.0%
O10 Town of Hayward Improved: 0 13,400 100.0°0
572478 Hayward Community School Distric[ Total: 51,700 65,100 25.9%
001700 Technical College
+ Recorded Documentr Updated:2/27/2023 �'Property History
WARRANTY DEED WA
Date Recorded:8/30/2021 434343
DESIGNATION OF TOD BENEFICIARY
Date Recorded:2/16/2023 443356
TRANSFER ON DEATH DEED
Date Remrded:11/13/2018 415377
CONVEYANCE RECORDED NOT USED
Date Recorded:9/28/2018 414608
CERTIFIED SURVEY MAP
Date Recorded:7/23/2003 313405
WARRANTY DEED
Date Remrded:7/3/2001 292125
https:lltas.sawyercounrygov.orglsystemlframes.asp?uname=Eric+Wellauer ���
� -. - . . .. � F_, .
.Lv � -^Y�L. I ��.'k�y` !:" . :• - _ � ' +� e •Y� . �_
� 1 J� � aM�,r � ."' �1 'r ���� ._,
"' � S � a t,�.� s 4'�'�f� • y .a • 4L �� � � I � „� �
,�� ♦ 3 � �r : 'Yw�M� .
. �� ��� r ��. � � J� ��' `�( 't�� . �t� � 'd �� ��,.. .. �� .
� � . � � � . 44 e . , • `^� F r
w �y . � . � . e _ t.
�i - a `�y 4 ..;� �s�ei � _ �c.r y �y
� y��'� .`^��: '� FF
'_ +- * 1. •
k, ,F. . ' .. r" " ' : • .
.
r,�
lS�e s y _. . ypp .• .�e
' '.{s� `� s. � e�. , p; .. .. �° '�� � !�, : C�,
.++' ,k.S J' . � � � T� � .� QL R�#. .J
� � Y �� ��� K.C! � f ' ��-. ♦�4+�� • � � r #
a a Y �� f� - �. {
� �� �� ������� �� � �. , .,:�a ,k' tiH - x �r �� T �} .
,
, .
,. ..5 . . , � . '" . ::.r i, ,� 9}f '
.. �1 ;�t: ,.
.:� ..� #� � A,, . � rr
� i iT' iM ° � � �. 1�.' :` ' .�� .,
� s
a �) a'.
�� :fti. - -`! `_ �.4 t��+. !I� r� �1.. .K� a"���.
, f 'r �, � f �.t' :�. . 4 � „ + ,
mt' s r,,"�, +t , . _,i.
� � - i '
� . �> d ��a. '. V . '�,��� . . � � r �tt. 1� ' �°� y b,p. 2�,'�' j y., a
� �'. .'S i � , a ' � . ,.
. +
�
�� : � i * y..- l ; .. .�f. 4 I` • ,,�^ : ,N .
� 4 . = " : - ' - : �:�„ �`' � . a = - s. ` . . -
_ • r . � :.
- . .-:
. - � ., _'. � . �� -- -
-
. , c .
� � y � � '� � S ry.•� �' - � Y � .. A�` A .
y.,)f A'�".. � .�vay L._ �.� -a, i. � � �.sE �151.. � r.�rr -+1� � � � y_�V�+, . ���
� � . , _,., • e ' . .� . . -
,
...
� . , ., . �.�:: . ; .: . ,,,y.,.�� ' ... . z -::. ����'�' i a* . ��•y�+:
.. . .
. . �,- '� •• • 7 t
.�� -..- -- !
,�..�.� ' .i .��j f
� lXy,si'" �J . ��a�+�.
1 �'�-" �.� 4•s
. •
I �:... �. ��. ...
I tl � ^f�-_.�
.
��
. r -
' � �� + � . � y ' �
' ¢i
't ' .��,, M .j .., :�� - ' Y ��; �,�� +d .n .�
, c�
�t,;g ' � +,�:- r' ` '" _ , ' i'' k'"•. . � «� ` E � - ";��1�
� '?� 4^ _i�`
ia �° �' .t ) _ � � y rik.' . I�. .' .
t. ' '�2' . , .� - , 1 i. �� .�. �y:� t
t '��� , ' '�,�:' „�:�� - � � � _ ' .... �. -�.+t` .
i . . �"� . � m , . . � .° . 1�,. K. � , �
'a, — ` +�:i. •�y �/r �. 'r >+ , »'r�'.� . 1�
: <
- �. . . --._�Ti ' :�: r: r :.� � , i.� . . '. � � ♦ k� •�' r'
. , •
, �
> , .
,. . _ . . . . . ' '
., ;. - - . .. .-� . - .
� �.,. :
- � . .�r�. c�. -.�, � . • ' +C i.+pp
.,,. ..tiey��.�. :'i.. � y., y�.. . , 4, ��'� , , :.. . ' :Mt���
:. .� . � .; � � _. � _ .,..
.,p, _�
. � ,- r. .. � „�i . . ,
. .- . • � . c. . '- 2.... s ' _�..;. �, � ' ..:.. � ""
a
+i' _ �
�y .
- ' i. f.. . y :.x `S3 .
.�. ..' . :� . , .
w54 . . -,• . �
. �
. ..,�.. t q. � - 'r .L��. � < . . .. .
. f�:. - �k '+ �� '�I�
��� { �^ \', . •' { q 'y. .` �« , — _ _ l" : + � I i
� _� .5 4 zl_� ' � � ,..
� .
� .. w , . � . 'i '�.
.� � � .�,.`� . .s r „ f:fi:a ''rl +„,�,� �Y = ��"e.` �� �
�+;. � tA. .��� .� Y ���. n4 ^ .� .^.. � ' . . � � ��� R '� . �
a
. n. / } y.
� I . { 1 _ 'I � 1 tll �:', '". F �. I �M1 - _ � _
�1 �'� y� 11 /� n � � �.�I � ]�� .�
'�r'' � 4 .� �� s � ,� h a � s�il �.
,. ^ a rf': . �, . � .: -
♦ ' ..
` � a � ! �.��'i�y. � af � .��� � .r � � � � � � '� .
i � .. .�.�a., � ze� i � �, .
� � �^ a�,K �� � . .��'a . .
M j� Y
4 k � S��-� • � e1, �
p i �. .�, t" .t'�' .,.-rsy 11 r •�
M�' . +� N�. �' � � •.: � .Y � �YF�}' � � ��} �
a > .
+ .. �� � �f 3 r E
,«r�I rW � .� :r � � ' �� � _ �y,i� _. .
�' � ,v f
.b i�r\ �'s t �. �,.,.
l• i "•
�� � � ��<Y � `.� � � '
1 ? .i�;. ti��' , • -ti .� ~.�`'P\v i� •! � 1 . � �. , ' �. �.
M w ,. ,yy •,lt � J 1� 'i rr� � �a.
u
� 1��' � . 1 . � i .
? {. • �. i - � ' 1 �1
�
a
�n . 4� � Y.�1 . ` '� �� �
k • p,� � � ��. '� �p
r :., � � �.., �,�, . _ .. �� "�' N
� j i f � - .Ci. • � ` � �„ ' - ' "'y4,<�.. ' i .
�
.7� .ti �� �.1�. � �c5 � �� ..� t� ' �i G�� � "�14i �' '' r
�
.. . . , �_ .
,.a ,
� I{i� n �, "... s ... . ..' � �, ��. _ " . '°� �'+ :�e
•'
� . _.
1� '� � _ ��`�. . . .
.
_1 � � ",}' r P�,�1�� _ s � •H "' i.� �� 4 e� '
� -
. �
. ,tt� y �.� • Laa ,, : i
" . �.. ,t� �" r� ry �♦ . � ��� ' �. 4 Y. �
(x��. > , . � �i 4, � '+< �
� � � �`." � .� {$� 3� y' � iL A .a x�'i .i.� �,� � .
. '�: `♦ � .'!F a � . . i e� . _
. •
� �� ,� � .. � .
'�� i ' ,�� � � � ! �.�. .. .,w , � .:. , ..a:. � t.
. � .: � .
r , i: .
� .
;,
aa.i' �,:. t .� .}� . � �..� �
. . S ...; _..� �1 i��" �.��
�
. : ' t : >. t. �+ ' ""�
, �.. . ..tu . I.i �
� � ' .
/ n+ �'
I'* � -
' . t ' �k�'i' . �
.�
�
� • �
• � •
�
: � •
� �
•