026-938-10-1203-LUP-1999-572 j. o� -.�. . . I
`S,.
• �✓ _
Application for Land Use Permit _ � / �- �
County of Sawyer �, s
PO Box 668 - Hayward WI 54843 ;� 1 _
715/634-8288
� �
The undersigned hereby makes application for a Land Use Permit and agrees that all work
shall be done in compliance with the requirements of the Sa�vyer County Zoning Ordinance �
and the laws and regulations of the State of Wisconsin.CONSTRUCTION i�1AY NOT , ,
BEGIN UNTIL THE PER�ti1IT IS ISSUED. �� � (_ �(� ��j� L����
PRI�1T - USE BLACK INK OR PENCIL �' �
a-
��,�'v� 1Zr�vis �.��� .�`"�l�e=«�c'r-.r��►/ a
Owner Builder o �
JS�S_� .��,�C�x��i� �l�'. ,���� � �
Mailing Address Mailin� Address
/.�.�i�l�/�'��%� �'�f� ����'/�����/ S'���=� __
City, State, Zip City, State, Zip _.
�� ` S 54��� �/S- �s y-;SG��S� �j� �—�� ._ ����J'� _
,
Daytime Phone Daytime Phone �
Buildin� Land Use ,`�
( �) Ne�v O Filling Zone District �-� y�
( ) Addition ( ) Dredgin� �
( j Alteration ( ) Grading Lot Size �
( ) Moving On ( ) �
( ) ( ) Acres �� N �1[> �
�
-,
�
Primary Structure Accessory Buildin� Addition G °�
( ) Dwellin� ( ) GaraQe-attached�'detached ( ) Deck � ^
( ) Year round ( ) # of car stalls ( ) Porch � I��'
O Seasonal j�;) Storage Buildin� O Enclosed � � �-�:
O Frame built on site O Screenhouse O Li�in� room ^„� IT'
( ) Modular,�manufactured ( ) Greenhouse ( ) Kitchen ; i �
( ) Mobile/manufactured ( ) Other ( ) Bedroom 'C �
( ) Other primary structure ( ) ( ) Relocate!enlarge � >
( ) ( ) ( ) # of new � �,
Type of Construction �� -
a
( ) Frame ( ) LoQ (.�Pole/metal ( ) Block ( ) Concrete �
( ) Other -' `
�
� c;
�
.� _
Construction Cost � �/ ['��'Z.C3 �% ��
W
Vol (e 7� Pg�of Deed Certified Soil Test #
CSM Vol P� Sanitary Permit # z
Plat Envelope Or: , ^'
Condo Vol Pg Year Installed C.�•� � � rt �1"r�,�;' ti,. �
Aff of ex septic V P O���ner When Installed: �`,`°��` �
,
�i��'/�
�-1 i s c�� �"y��.
Application for Land Use Permit — Page 2 �
Describe Construc[ion: List dimensions of each structure, story, addition, or alteration.
#1. �Z. #3. #4.
Size :� � ft. wide ft. wide ft. wide fr. wide
� ft. long _ ft. lon� fr. lon� h. long
Floor area sq. ft. sq. ft. sq. fr. sq. ft.
H�t. fi-om gade to peak ' y'� h. hgt. ft. hgt. ft. h�t.
Stories stories stories stories
# of bedrooms
rear lot line or waterline of lake'river
In Ihe box sketch in:
Location and size of all
existing and proposed structures.
Location of septic system.
Indicate distance to: 9
lVaterline/�b'edands! ` �
Road �
Lot lines _
Septic systen�/privy
�Vell �(������--- � ��
Distance between structures. 1 ,`s.
.___ ^ 3 � `'� � �
` �
Indicate I�'orth. ----`� �_- 7' •T
r +�
Fire Number. � � '
�\�
�r,
,� �r
�
Signat e of Owner
The above certifies th�t the listed
infomtation and intentions are trve and ��
correct. The above person/s/hzreby � �,
oire permission for access to [he
properry for onsi[z inspec[ion. ----- cen[erline of road-------
[ssueDate September 29 , 1999 ExpireDate September 29 , 2000
OfEice Comments: l� C'Y!7 ���2i��
Si�nature of Zonin� Administraror
) F SAND LAKE
TW P. 38 N. R.9 W.
.1.2
z.i .z.z
.I. I
•3•2
�. I
4.3 �
�
.3.I
4.2
, .13.2
.13.1
.14.1
.13.3
- 277714
DocumentNumber WARRANTY DEED
This Deed, made belween ROHLFING FAMILY TRUST dated April qegis�er s on�ce 1 ss
15, 1993, Grantor, and DARYL G. DAVIS, an adult man, Grantee. s�wyer couniy J
Witnesseth, That the said Grantor, for a valuable consideration R ce�� d tor recortl this day ol
A D 19 at . o'tlxk
conveys to Grantee the following described real estate in Sawyer Counry, M and recordedasvol.
SfBt2 Of WISCOf1Slf1: o Re on page '
����r�� Register
� Depury
C
Recordin Area
Name and Return Address
Attorney Michael A.Kelsey
.� � a ��
026-938-10 1202
(Parcel Identilcation Number)
/
The Northwest QuaRer of the Northeast Quarter(NWY,NE'/.) of Section Ten (10), Township Thirty-eight(38) North,
Range Nine (9)West.
See reverse for additional terms.
TRAhSFER
� / 8,�,sn
� FEE
This is not homestead property.
Together with all and singular hereditaments and appurtenances thereunto belonging;
And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances
except subject to easements, exceptions, restrictions and reservations of record and will warrant and defend the same.
Dated this_day of , 1999.
ROHLFING FAMILY TRUST,dated April 15, 1993
"�rd F. Rohlf g, Truste � �
ACKNOWLEDGMENT
AUTHENTICATION
ST TE OF SOUTH CAROLINA
Signature(s) � COUNTY
Personally came before me this �day ofS�-�1'L F_ ,
1999 the above named Richard F. Rohlfing, Truslee,to me
- known to be the person(s) who executed the foregoing
authenticated this_day of ,_ ins ment and acknowled e the same.
�
sgnature signature 1 _ • �
type or print name �-+��I . �1.���
type or print name �� p--
Notary Public[�rl�S"County, SC
TITLE: MEMBER STATE BAR OF WISCONSIN M c mmis ion is ermanent. (If not, state expiration dale:
Qf not, _�
authorized by§706.06,Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY 'Names of persons signing in any capacity should be typed or
Attorney Michael A. Kelsey printed below their signatures.
State Bar No. 01013300
(Signatures may be au[henticated or acknowledged. Both are not VOL 6 � 3 PG Q • -�
necessary.) �
�
Inlotmetion Pmleaaionela Canpany FonE tlu Lec,Wisconsin BOOb55-202i