010-841-32-1107-LUP-2004-607 Application for Land Use Permit(*Non-shoreland*) o o�� T�
CounTy of Sawyer �, � "
PO Box 676 -Haywazd WI 54843
715/634-8288 '�
*Property that is not]ocated within 300'of a creek,river or stream or within 1000'of a �
flowage,lake or pond or does not have any of the above waterbodies located within � �
the property's boundaries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
PRINT-USE BLACK INK OR PENCIL
7 � ��F� s I�yO�n,�J �� t �M �TN ( "�iS1(J[7irr%�ac.
Owner � Builder <'
� �/ S�,v�y �,��r�p �v� �J C�-��n. ;� �� �
Mailing Address Mailing Address �
���ar�e a y � ��. s-��'.ZS' .4;c �,�o (��, �=-�h'�� � �
City,State,Zip City,State,Zip
��/�) 9��=3�-�/ l ( ���� )�1-5�/���% �
Daytime Phone Daytime Phone
Additional Information: Zone District �- /
Lot Dimensions: .��'.� X � . �
Date lot was created: Acres: o f�`� o
Is there wetland near the proposed shucture?If yes,how faz N n G
Building Land Use Floodptain:� j Yes �)No =°
(�New ( )Filling �
O Addition O Dredging Driveway access off of a(Check one): a;
O Alteration (�)Grading (1c�Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy � i,",
� ) � ) J e�t5<"NC�T 2��P0 �, ctJ�c2 � �
0
r
Primary Structure Accessory Building Addition � °
( )Dwelling ( )Gazage-attached/detached ( )Deck , W
�( Yeaz round ( )#of car stalls (�c)Porch c�l i�`! Sx/E �
Seasonal O Storage Building O Enclosed �
( )Frame built on site ( )Screenhouse ( )Living room � �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom ,
( )Other primary structure ( ) ( )Relocate/enlazge \
(}� .a�r��F'c�/a[_ ( ) ( )#of new �
1
�
AdditionalInformation: � p
�
� �
� �
Type of Construction: � �
Frame Lo Pole/metal Block �
(X) ( ) g ( ) ( ) (x)C�rLeta-i,J�, J's�AB
( )Other
ro ~�
Construction Cost:Primary Structure$��y ��r�v � �
rn
Accessory Building:$ Addition:$ � �
3� d �,`IG� �° �
Deed:Vol 7Zo Pg I �[; Certified Soil Test#_C�/-3S/���' _ `�' z
CSM:Vol ,��. Pg rf�2 Lot#_� Sanitary Permit# (�</- y3? b, '�
Plat Envelope � �'��� Or: �
N
Condo Vol Pg Year Installed: rn
Aff of ex septic Vol Pg Owner When Installed: " �
Previous office approvals/actions:
Variance:# LUP:# SP:# CUP:# a
0
Inspection Report:# Change of Zone District C�\�Q;
�\
Describe the construction using these columns.List the dimensions of each structure in a separate
column.List each story,each addition,eaclLalteration in a separate column. _
#1. (")YFICc `��C�n. #2. i n��r2`* ��1�U,Ec�l #3. x r� rv�u� #4.
Size��ft.wide ��, fr.wide �_ft.wide ft.wide
�ft.long _�_ft.long i o ft.long ft.long
Floor area / �'7 sq.ft. ��u sq.ft. t? sq.ft. sq.ft.
Hgt.from gade I q c,�to peak��ft.hgt. ��_ft.hgC. ft.hgt.
Staries 6 n/E 6 r/ stories G nl� stories stories
#of bedrooms �/c>/�6
Rear Lot Line
--�+'"� �^�-x� ��cl L-��'�r"(J �'�y ��!'.`'�/� � ,'a-�t'
Fire Number and Name of Road l�c�i�5 S LA/ '�ri L�' ��c�-4�� f�
1. Enter lot dimensions and indicate north by arcow. $j9nature of 0 ner or A th ized ent:
2. Indicate the location and size of the requested construction
activities.
�� '��
PnnWame: �5� C �' /1 I r�
3. Also,1ndlCate tlle IoCatlOn and cllStanCe t0 tlle well, The above certi s at the listed informahon antl intentions are
irue and conecL,that all work shall be pedortned in compliance
septic tank and drainfield,wetland azeas,lot lines and to the wilh the requiremenis of the Sawyer County Zoning ONinance
and the laws and regulations of the State of Wisconsin,and if
centerllne of the r0ad. acting as ownet(s)agent,has the permission of the owner(s)to
peAortn the work requested on ihis appliration. The above
personsls hereby give permission for access to Ne property tor
onsite inspecUon.
Permit fee:$
�.t�_ /
October 25, 2004 -
Issue Date Signature of Is in gent
October 25, 2005 50%Rule: AverageRoadSetback:
Expiration Date
Office Comments:
!
I
SAWYER COUNTY CERTIFIED SURVEY �
LOl'ATEO IN THE NE 1/4-NE i/4 SECfION 32,741 N,RBW,' N �
TOWN OF FInYW/�RD,SAWYER COUNiY,WISCONSIN. � e
PO6 w
NB9'00'13'E CL CRi B D Q
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FND 3' ACP ol� N8Y10�13'E 2285J0' N. UNE NE 1/4 S89'10'471Y 397.69' FryD 3/4' REBM
� N 1/4 COR o �--50037'541Y 4].03' NE COR
72-47- �I N89'00'13'E 400.00� 72-41-9 � 1'=100'
�100.00' S. R LIN CTH B �pp,00� T � I GRAPHIC SCALE �
g 100.00' 100.Oa' o —_ I �_�—-—_—- \ � a�
IXISiING
m BILL90ARD m \ ��e I.' 9EARINGS ME REFQiENCEO TO
____ 5. L1NE 68' AC ESS EASEMEM ____ � \ �� THE NORRt IJNE OF THE NE 1/4
100.00' x�W SEC. J2, T41N, RBW
EXISiiNG ACCE55 I �z ASAJNE� TO 9EAR
� FASEMEM TO NE-NE i V�W H89'10'IJ'E
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1�0 0 I Vlr
e � I J IEGFND ,.
� �k � $ n � �� O= 2T 5 9'qi�N BFR
�' p I ��� $ � w n m e � LOT 7 I � YN.Wf.1.3Jt/llN. Ff.
u,'�ry d � w v � w +. CSM f5&50 I
� ' � ¢ :� n n n :^ V19/P770 I I o=F705ING 7/4'ISHAF
�.N�� 4 h LOT 4 LOT 3 LOT 2 LOT 1 n
w g $ 36451 �.f. 36451 s.f. 36451 a.f. 76451 a.f. � �
# D r� z O.B4 AC f 0.84 AC 3 0.64 AC i 0.94 AC i w I �u�u�q��
- o e �",CON
� � ; O� m " SAWYER COUNTY ZIXJING DEPARTMENT APPROVAL I `•`y>\5.,.... Sj�%�'
{ :� $ � � � ; dEFF �
� ` � a F m I IS��bOI �. MU oCK :,k=
-� �` 8i' m DEPM711ENT�IPPROVAL � I =�: 5-]319 . _
;�'. Haynard
� I -y�., ws. �'Q"F
s � ¢' �` 58Y00'13'W 400.00' _—_—'—_—__—_—_—'J �,QSURVEIO\
SURJEYptS CWrIFlGTE LAND$ 6,
O I, JEFF W. MULOCK, WISCONSIN pEGISfERm LWO Sl1RJE1'OR. HEREBY CEKfIFY TNAT I ruve surr�rm, omom ,wo MAPPED A CERTIFlm SIJRJEY �pCq7ED IN THE �
M NE 1/4-NE 7/4 OF gC�ION ]2, Tl1N, RBW, TOWN OF HAIWARU, $AWipt CpUMY, WISCONSIN. MORE PARfICIRARL7 �ESCRIBED tiS FOLLOWS; �
� CAMMENCING AT THE N 1/4 CORNER OF SVD SECf10N 31; iMENCE N6ff{3'10'E I2&S.]0'NANC lHE NOflIH IJNE OF SND NE t/4; 1HENCE SOP�7'S4'W 43.0J' TO AN �
IRON B4R AT THE POIM OF BECINNING;
� 1HENCE SOP77'S4^N 384.88' �LONG THE Nt'ST IINE OF CSM�5650 TO AN �ppN BVi; T17ENCE SB9'00'111Y �00.00' TO AN IRON BM; THENCE NOVJ7'S4'E 384.98' TO j
� AN IRON [iV� TIENCE N89'00'1J'F �00.00' ALONG THE SIXRH R�N' LINE OF CRI B TO AN IRON 9Aq AT THE POIM OF BEqNNINC. Z
THE ABQVE DESCRIBED PMCEL COMNNS J,75 ACR6 0� LWD MORE OR LES$ pJ�p IS SUBJECf TO ML FASE4FN7S ANO RESERVATIOHS OF RECORD. >.
m
THIS SURVEY WAS AVDE IN COMPLVNCE Wfi�� CMM�ER 2JC.J4 OF p�$Cpl$�N S�ATVIES, AE-) OF THE WISCONSIN A�YINISiRATIVE COOE IND THE 511601VISION Z
REGUUTIONS OF S�WYEq CWNIY IN� T}UT 1 INYE SURVETEp, OMOm IND MAPPED 1}�E LWO HQiEM DESCHIBEO, ANO TNE IMP IS A COf3iECT REPR6ENTATON OF �� �
lHE SURVEY 1UOE TO THE BEST OF MY NNOWLmGE M!D BELIEF. TMIS SURVEY WA$ yApE UNDER iHE OIRECfpN OF PEfE SIMPSON. wWNNmw51e1J �
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