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010-941-26-3403-LUP-2000-376 � Application for Land Use Permit o c �.- _. County of Sawyer �, < � PO Box 668 - Hayward WI 54843 715/634-8288 � The undersijned hereby makes application for a Land Use Permit and agrees that all work shall be done in compliance �vith the requirements of the Sawyer County Zoning Ordinance � and the laws and regulations of the State of Wisconsin.COrSTRUCTION I�IAY NOT BEGI�i UNTIL THE PER`IIT IS ISSUED. (Z � PRINT — LSE BLACK ItiK OR PEI�CIL �' � � � � ` � a., � � �(��--`�Tt"�A x,' ��w��l P r �� Owner Builder I� o < �1 � ���s V�� Cau�ntv �' .� �� � I�lailin� Address Mailin� Address f�lsi v�;�icirc) tn1�� .S i/rA�! 3 City State, Zip City, State, Zip �3y ,�o� � c� �u 2�81 � Daytiine Phone Daytime Phone Building Land Use (' I�'e«� O Filling Zone District I _ (�Addition ( ) Dred�in� �� � ( ) Alteration ( ) Grading Lot Size � � ( ) �Ioving On ( ) � !i ( ) ( ) Acres _�? 7-(0/ � 8, 53 = ; � Primary Stnicture Accessory Buildiny Additioil �p � ( ) Dw�ellin� ( ) Gara�e-attached/detached ( ) Deck � � O Year round O r of car stalls O Porch i ' � ( ) Seasonal ( ) Stora�e Buildin� ( ) Enclosed �� �'I O Fraine built on site O Screenhotise O Livina room � � ( ) :�todular;'manufactured ( ) Greenhouse ( ) Kitchell � � ( ) Mobile/manufactured �Other , ( ) Bedroom � � • � ( ) Ottier primary structure • �'j � � ( ) Relocate�'enlar�e �C G1 y O O O # ofnew � p � I� '� Type of Constr�iction < ( ) Frame ( ) Lo� �) Pole/metal ( ) Block ( ) Coilcrete � ( ) Other " �� = I � �� , � Construction Cost S ,� C�0 � � — <' Vol��PQ of Deed Certitied Soil Test # � � �� 7_5 C:`// . CSM Vol lo� Pg� Sanitary Permit # 7y —� ;3 � � z Plat Envelope Or: �vP 9D-I$8 ,� - ^' Coildo Vol P� �'ear Installed � � Aff oFex septic �' � P O���ner �Vhen Instzlled: � ���g"� '��a�s� � Application for Land Use Permit — Page 2 Describe Construction: List dimensions of each structure, story, addition, or alteration. # 1 . #2. �3. #4. Size (�_ ft. wide ft. �vide ft. wide ft. wide �a ft. long ft. long ft. long ft. long Floor area av sq. ft. sq. ft. sq. ft. sq. ft. H�. from g�ade to peak ft. hgt. ft. h�t. ft. hgt. Stories l stories stories stories # of bedrooms �_ rear lot line or ���aterline of lake/river In the boY sketch in: � � � �e�� ' y�s�� Location and size of all 5 � � eE ` existin� and proposed stnictures. -�-�—d , �� d �Location of septic system. � zQ � '>ds� ,� Indicate distance to: ;� ��'aterline'�Vetlands Road Lot lines S Septic system!privy '�c' � , z `�'el1 -T.- � q- U Distance bet�veen stnlctures. ,� --� L � , � � T � Indicate �"ort11. +� � � � �c tfl o Fire �'umber: � 1 �S o?l�.$ L.J �lCc.►+�i leO� .g � �~ U1 ! � � �� . � �I � �� � � i z Signzture of O���n .,, � � The abo��e certities at the listed '� A y L I[1t01"tllat1011 dI1C� lritZ[1t10[1S 3Le ti"UZ �Ild � � coi-rect. The abo� e person's% hereby � 't „ ! �/ '' ; , `�i� e permission for access to the ` w ' ' properry tor onsite inspection. ------- Cent2Cli11e Of road------- Issue Date July 20 , 2000 Expire Date July 20 , 2001 �ff1CC C0111111e11t5: � � ` Sivll"1I111'C Of Illtl�� f�C�[lll[1lSlC�l[OI� _, LAKt ' _ ; ': . . . _. 9!7 - , , q ` . , _ , . � HAY WARD_ _ _ � ; �. _ __ � � : , q.IG , , , . , ,. _ , _ , , __ _ . .--- __ _ y . i �. � � � j � �- � i . . . ` _'..� . .. , � � �. 1 � . -__. ._ � . 1I i . . . ' . 4 .. . � .. _ . .. .� _ �_._.._ �. ._ . .. __ ' . I � i _ }-_ .q.� � :13 • 9� _+--- _ _ _ ,. ;. . _ _.:. ' •9.9 .9.10 . � ; . . . � .� � . , . .,Q�O .. . Z —i 3 - O-, ;,, � , ,yw� j .9.�r ,t r- � =-- 9.It ' e . , --- - - , ; � _t_ � i - , . ,. _i . ; .q:� , . � :.cL +� ' a _!._ . - Y--. � . i�.. . �. , . , _ _��- �__-'`< ' � r; ? .9.12 - . � _ r' q.lt� :9 I ; - �' � � 9.13 ✓ -t - � - +� _r _ , , - � , _ � , . , , ✓ + _ --- - -,--- __, . I . _ _ � , ; � � , , � f .�- � . 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