HomeMy WebLinkAbout026-126-00-0900-LUP-2006-270 \
Appli���r Land Use Permit(*Shoreland*) r .� �__
F,GE G�M County of Saw}�er � � �,
��a� PO Box 676 -Haywazd WI 54843 'i —
715/634-8288 �
*Property that is located within 300'of a creek,river or stream or within 1000'of a � R
flowage,lake or pond or has any of the above waterbodies located within �•
the property's boundaries. /�
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE(�UIRED PERMITS HAVE BEEN ISSUED. T— O)
R�.',q � PRINT-USE BLACK INK OR PENCIL
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�in�l�l �,�l, /L! s - �1��1/�Y'-1 r /71�I�' o.
Own r Builder � �
���A�a.,P A�' �. N. ���� s��'� ��� o:
ailing Address Mailing Address � O �
�1,A. /��, /��l�� Ss�i �,,�oA�'� l,�L Sz/��'_3 " O
Ci�,State�ip ity,, tate,Zip
Ce�/ 7l� .��s�4 -oo i� �7is�s{/-��o .�
Daytime Phone Daytime Phone t _. '
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Additional Information: Zone District: }� Q-� N
Lot Dimensions: /�o �'S�ScJ _ •\
Date lot was created: Acres: ��U � � �
Is there wetland near the proposed structure?If yes,how far o �,
Building Land Use Floodplain:( )Yes ( )No � �
�New ( )Filling Chippewa Flowage:( )Yes �(No � �
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. �
( )Moving On ( ) ( )County Hwy (�State Hwy °O �
� ) � ) � �
Primary Structure Accessory Building Addition o �
QQ Dwelling �}(,l Garage-attached/ciaiact��d �.Deck �
O Year round (2)#of caz stalls O Porch W
( )Seasonal ( )Storage Building ( )Enclosed �,
O Frame built on site O Screenhouse , ��:(�_�,�L,iving room'������_ c�
�Modulaz/manufactured ( )Greenhouse ( )Kitchen "
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge �
( ) ( ) ( )iF of new �
AdditionalInformation: \ p
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Type of Construction: � �
�'Frame ( )Log ( )Pole/metal ( )Block ( )Concrete p� W
( )Other ��
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Construction Cost:Primary Structure$ ���ooc�, �
�o
Accessory Building:$ /�DOGs, � Addition:$ L,�,occi _ ��ciC � I�;
f.G�
� I-.+
Deed:Voi 5 i S rg_��_ CeriiFied Soii Test r� O�-�6 S2 � z
vc 7y
CSM:Vol Pg Lot# Sanitary Permit# OC�-�Q S �
Plat Envelope Or: ��"� � -�n
Condo Vol Pg Yeaz Installed: e:> I
"Loads and Flows": Vol Pg Owner When Installed: � �
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Previous office approvals/actions: �
Vaziance:# LUP:# SP:# CUP:# c�
Inspection Report:# Change of Zone District "
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Describe the construction using these columns. List the di:.:�^�in,�Af�llt6fflRl�el�e in a separate
column. List each story, each additio% ��e�h alteration in a se arat�A�b�n. -�J ` //
#1. }�p/I'� G #2. � L #3. #4. � 1% � �.�� �
Size�_ft. wide �` _ft. wide ,�ft. wide �" fr. wide
yL/ fr. long IL, fr. long �ft. long �ft. long
Floor area ! ��5' sq. fr. �4�U sq. ft. [0 7z sq. fr. _�S sq. fr.
Hgt from grade � _3 to peak 9 ft• hgt• /� fr. hgt. LP` ft. hgt.
Stories r/� � stories _�_.stories I stories
#of bedrooms � _
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Lake ame �-�� . !S
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Fire Number and Name of Road s � � Cc) '/��� ��� . � '� _
1. Enter lot dimensions and indicate north by arrow. $jy�ature of wne or rized Agent:
2. Indicate Che location and size of the requested construction `�������
Signature
activities. � i � ��� � ��
PnnWame:Fi����4i".- �y S
3. Also, 1nQlCate the loCatlon and d1StanCe to the well, The above certifes ihat the listed intormation and intentions are
We antl corted.,Nat all work shall be pertormed in compliance
septic tank and drainfield, wetland aTeas, IOt 11nes, with Ne requiremenis ot the Sawyer County Zoning Ordinance
and ihe laws and regulations of the State of Wiscronsin, and if
centerline of the road and waterbodies. acn�9 a5 owner�s)a�e�G nas me Pe��Ss�on or me owoer�s�ro
bld hause�OU� bv��d�"9 pedorm the work requested on this application. The abov
`QG��� a�t �,t4�� personsls hereby give permission for aaess to ihe property r
� G,wd b �° S onsite inspection.
Permit fee: $ ,� !� 5 la.s� ,�oo� -�ro„^ oN��^
Total land azea within 300' of the�vaterbody: (A) ,'��� � � nj/h� � �
Total impervious surface area [including this project] (B) Z y(a5 fi �
(B) / (A) x 100 =% Used ,z �a (Shall not exceed 15%[or 25% with a condirional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes No j
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Issue Dat-�� Tc-_`� Signature of Issuing Agent
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_I � � � � .� � , a0� � 50% Rule: Average Road Setback:
Expirat��-io�i D�ate
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Office Comments: ('�9��j �,U �y �'y/0�7FlS (�/- j�y�� E-�/if��7laU ,
/�i4-1v o� /�i//S %yl/79�T, C�`
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