032-539-34-1406-LUP-2004-352 �
� Application for Land Use Permit(*Non-shoreland*) o o�� _
County of Sawyer �, �
PO Box 676 -Hayward WI 54843
715/634-8288 N �
*Property that is not located 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 UNTTL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ?�
PRINT-USE BLACK INK OR PENCIL � 1
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Owner
Builder ¢
�c�� C�-1 l C�(,� /�-V� -- — °�
Mailing Address Mailing Address � �
L�j,���iu�°-I�_I`� (�;'�1 �.� �
City,State,Zip City,State,Zip �
i'�%C� -'( f�� - � �P ��� � �
Daytime Phone Daytime Phone �
Additional Information: Zone District �-�— � �
LotDimensions:�(.�j�LL(; X ��%U•l; � � 1
Date lot was created: Acres: � .k7 n `I v
0
Is there wetland near the proposed structure?If yes,how far ��_ � j
Building Land Use Floodplain:( j Yes (�No :; �,
�New ( )Filling �
Dred in Drivewa access off of a(Check one): �
)Addirion ( ) g g Y
O Alteration O Grading O Private Rd O Town Rd. o
O Moving On O (x)County Hwy O State Hwy i."', �
( )--- � ) � �
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Primary Structure Accessory Building Addition � °
(;Q Dwelling (�Garage-a1t� etachedJ IXSDeck W
( 1 Year round (�)#of car stalls (_�Porch =
(�1y Seasonal O Storage Building �( )Enclosed �
(d Frame built on site O Screenhouse O Living room � ��
( )Modular/manufactured ( )Gxeenhouse ( )Kitchen � (��
( )Mobile/manufactured ( )Other ( )Bedroom � �
( )Other primary structure ( ) ( )RelocaYe/enlarge � '
� � ( � ( )#of new � ��
i
y
AdditionalInformation: U, A
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Type of Construction: 1� ���
(�Frame ( )Log ( )Po1e/metal ( )Block ( )Concrete C� -1��
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( )Other .d y
Construction Cost:Primary Structure$ �� G(>b"' � �
Accessory Building:$ ��)�io�— Addition:$ � �'�
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CertifiedSoilTest# �l �EL�1,ll��o tl4
Deed:Vol S�� Pg���. " z
CSM:Vol � Pg �D I Lot# %4 Sanitary Permit# �'��-Z,��_ � �
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Plat Envelope Or: N �;
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Condo Vol Pg Year Installed: � �
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Aff of ex septic Vol Pg Owner When Installed:
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Previous office approvals/actions:
Variance:# LUP:# SP:# CUP:#
Inspection Report:# Change of Zone District: �
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Describe the construction using these columns.List the dimensions of each structure in a se arate � ;�
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column.List each story,each addition,each alteration in a separate column. 7 � �-���J
#1.D.v E�-�-i rl(-r #2. ���;� Gj t o'��' #3. fi7EL��- #4.�
Size 4? ft.wide fr.wide _ 1 f� ft.wide Z4 fr.wide
�F� ft.long fr.long �t fr.long �ft.long
Floor azea �j �2 sq.R. ��G� s9•ft• Z Oa sq.fr. v�sq.fr.
Hgt.from grade ZD� to peak ft.hgt. �7�� ft.hgt. �(i(U� ft.hgt.
Stories y stories stories � stories .
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#of bedrooms 3
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Fire Number and Name of Road S �p S � �-Q'�-F �J I!1I 7CIZ T�"`-C-'�''�
1. Enter lot dimensions and indicate north by arrow. Signatu e f Owner or Authorized Agent:
2. Indicate the location and size of the requested construction __1i���� , � , ,,
ignaNre
activities. I �
PnntName: `� `�'4Y�� ��J�_
3. Also,lndicate the location and dlstance to the well, The above certifies that the isted inrortnation and intentions are
true and conecl.,that all work shall be peAormed in compliance
septic tank and drainfield,wetland ateas,lot lines and to the with the requiremenb of ihe Sawyer County Zoning Ordinance
and the laws and regulations of lhe State of Wisconsin,and if
CCritCTllriO Of 1.hC I08d. acling as ownet(s)agent,has ihe permission of the owner(s)to
peAorm the work requested on this applica�on. The above
personsls hereby give permission for access to the property for
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onsite inspection.
Permit fee:$ ��=-J � �
iLl� 13 2004
Issue Date Signature of Iss 'ng ent
July 13 , 2005 50%Rule: Average Road Setback:
Expiration Date
Office Comments: -7-� o2�S`���'�-�f�.�`�'��� �,D(-l3--2��
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REF. DATF� AERIAL PNoTo - 013 - 1970 SCALE: I INCH= 40o FEET FOR ASSESSMENT USE ONLY NOT
115G5 QUAD. - LAKE WINTER DRAWN BY: R.M.S. DATE: 9-28-79 INTENDED TO SHOW CONCLIlSIVE
D.N.R. LAKE SURVEY MAP COLON (:) INDICATES GOVT. LOT EVfDENCE OF OWNERSli9F OR
CORNER R55TORATIoN -VOL. I PG. 124 BOUNDARY LOCATIONS
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M/NK CAPITAL SURVEYING, INC. SURVEYING SERVICES
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CERTII'IED SURVEY MAP N 95• 16"E 800.00' 6 g'
STATE Or ',iIS(:ONSIN SS 600.00' '� �
COUNTY OF SAIJYER ) -��o e0 A ; �
I , Char'.e s Offerman , lsnd surveyor = o �s• , 2� � w° o �f
of the State of Wisconsin, do heraby eo `�oy w`•" ° wz
certify that I have made the tollowing � 500.00' ' _ ° o
survey in th�� SE4 of the NEh of Section w �, 22 , � "' o
31�, T . 39 N . , R. 5 W. � Sawyer County, ° o � o �
Wisconsin, m��re particularly described asf _ ro�
follows : 600.00' •
o� °o •
Co�nmencing at the East 4 corner of �' °' 23 0 '
said Section 34; thence N 3°17 ' 30" W, $ _
slong the East line oi' the said NE4 being ' _ � 0 soo.00 9i� _
also the centerline of a town road, - w�.° Zq s• °'
� . , 33• ol •�,o s�s ,t6~r+
727. 01 , the �ce S A.5°16' 11 ' to �ow' 600.00' 0 3 .oi
the ooint of real beginning and the se5° ie'w soo.00'
Westerly R-O-W of seid town road; thence m w
continui.ng S R5°16' W� 600.00 ' ; thence � °
N 3°17 ' 30" W, 462.00 � ; thenCe N85°161 E, 600.00 ' to the said ml�
;nlesterly q-0-Y7; thence S 3°17 ' 30'� E, along said Westerly R-O-Wt m o
462 .00 ' to the point oS real beginning.
I further certify that I have complied with the provisions of N � .
. Chapter 236 of the revised statutes of the State of Wisconsin in
a w�.Ni
surveving and mapping the same . � w o
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of �c-. . . .- /� _ e OFF[RMAN �__
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IEGEND
p 100 � �_ Iron Plp�s Found
Scele of Map: I inch — 200 �
�-.-o-- I' z24' Iron Pipe� S�f, 1.13 Ib./ft.
$TATE OF WISCONSIN I 0 StoneMon. Found
COUNTY OF TAYLC R � fi _.0— Iron Pins Set
—po— 2' x 30' Iron Pipe� Set,3.65 Ib./ft.
APRIL 5, 1972 I .urv. d t6.
� CHAR�ES O�FERMAN l.�nd Surr•yor of fl+. St�f� o! VJiacon�in, de h�r.by c.rlify fh.t en w
•bar� d��crib�d prop�r4y �:cordin9 fc oRicl�l r�cordt and 1h�} fh� �ccomp�nyinq m�p it � trw �nd cornd ��pr ��nl�tioe of }6� �xl�rior bou uf�f eF iM land
���,�y�� }bd �11 buildinqi �nd fmpror�m��� II� wholly wifAin fh� bound�ry limt, �nd !hd no �ncro�chm�nf � I�u^f prcP'rfY orn�n �p r fro� uid wrv�y
�supf u indiul�d.
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Rpi�l�.�d land Surv.y�r $' 2 r
�h.'G jv,"vr} :.._ ,. .'�!�•::�-.. • - . `
3q-39N-SW STR(1M