010-941-21-3407-LUP-2000-170 " Application for Land Use Permit �, �
County of Sawyer ;� < � '
PO Box 668 - Hayward �VI 54843 y �' �
�1�/634-8288 � �
T11e undersi�ned hereb �
� y makes application for a Land Use Pennit and agrees that all work
shall be done in compliance with the requirements of the Sa�vyer County Zoning Ordinance O
and the la�vs and regulations of the State of w'isconsin.CONSTRUCTION NIAY NOT
BEGIv UNTIL THE PER��iIT IS ISSUED. �
PRINT — USE BLACK INK OR PENCIL � �
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Owner Builder � p
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Mailing Address Mailing Address
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City, tate, Zip City, State, Zip
(7i5) � 3 �� - � � �5
Daytime Phone Daytime Phone '
Building Land Use
(,� New ( ) Filling Zone District ��
( ) Addition ( ) Dredgin� �
( ) Alteration ( ) Grading Lot Size �
( ) Nloving On ( ) °
( ) ( ) Acres sj � J �
� I
,.,
Primary Stnicture Accessory Buildiny � Addition � ��
( ) D���elling ('�,Gara�e-attache ,detache� ( ) Deck '� �
O Y"ear round (� = of car stalls�" � O Porch j� ,
( ) Se�so►lal ( ) Storage Buildin� ( ) Enclosed .� I
O Fra«Ie built on site O Screen��otise O LivinQ room �� '
( ) �lodular,�►nanufactured ( ) Greenhotise ( ) Kitchetl I � I�
( ) �tobile/maiiufactured ( ) Other ( ) Bedroom �� ���
( ) Otlier primary structtire ( ) ( ) Relocate!enlarge � <
( ) ( ) ( ) # of new �� � �
Type of Construction v �
�Frame ( ) Lo� ( ) Pole/metal ( ) B(ock ( ) Concrete �
( ) Other � !
= �
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Construction Cost S ��a� �
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Vol �(p0 Pg___(�(�_of Deed Certified Soil Test = 99—J/$ � I..0
CSM Vol Pg Sanitary Pernlit r 9q-lia � �z
P(at Em�elo � � ,
p' Or: �,uY' `� 8 5 7� � ^'
Condo Vol P� Year Instal(ed I� � i�
.Aff of ex septic �' P O���ner Wllen [nsta(led: � i�
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story�, addition, or alteration.
# 1 . #2. #3. #4. _
Size 2(v ft. wide ft. �vide ft. wide ft. wide
L�� ft. long ft. long ft. long ft. long
Floor area �'Z`( "� sq. ft. sq. ft. sq. ft. sq. ft.
H�. from g-ade ►� � to peak ft. h�t. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms
rear lot line or waterline of lake/river
In the box sketch in:
Location and size of all �
existin� and proposed stnictures. ��,
_�
Location of septic system. N
�
Indicate distance to: � �
��'aterline%Wetlands (V� � i � �p�Q �__�_ \\
Road
���1� '�
Lot lines �
„ �Q 'xlL
Septic system/privy � `f__.__ �--- -- ,- ! - — �
�t'ell � ' ��,; 5� �� �� � � � , ��„�.o �
Distance bet�veen structures. � ���� �
tl "ir {of�'�'' 6� ����
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Indicate �orth. � �d/�� - - -- — - — - .
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Fire \umber:
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'bnature of O�� r �
�I�lle ❑bo� e certitie� at the listzci
intorm�tion and intentions are true and
correct. The abo��e perso�l's- hereby ���/;� S�
�si� e per�i�ission for access to the
property for onsite inspection. ------- CenteClltle Of road-------
Issue Date May 11 , 2000 Expire Datz May 11 , 2001
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Document No.: (Recording Data:
2 4 9�4 6 ( aeQ�si�,5 o,n«
( Sawyer Counry
}55 '
� ceived lor recorA this �O day ^S
WARRANTY DEED ( �a o is ai `��cek
� M and recnrded a vo/l .��
� ol f�or on pape_ �
l.
( Register
�
( Depuly
Retum to: Lein Law Office
JUDITH ANN GEIER, an adult woman,Grantor, conveys and warrants to JOHN C.
GAJEWSKI,an adult man,Grantee,the following described real estate in Sawyer County,
State of Wisconsin:
Tax Parcel No.: 4109213.12.7
, That portion of the Southeast QuaRer of the Southwest Quarter(SE�/.-SW�/.),Section Twenty-
one(21),Township Forty-one(41)North, Range Nine(9)West,more paRicularly described as
foilows: Beginning at a point on the South line of said forty which is 350 feet West of the
Southeast comer of said forty;thence running West along the South line of said forty a
distance of 100 feet;thence running North parallel with the East line of said iorty a distance of
233 feet;thence running East parallel with the South line of said forty a distance of 100 feet;
thence running South parallel with the East line of said forty a distance of 233 feet to the point
of beginning. Subject to�ght of way of town road along the South 33 fset of said forty.
This is not homestead property.
Exception to warranties: Subject to easements,restrictions and reservations of record.
µ=
Dated this �c�J day of August, 1995.
� .1�.c1�-k-_�--.�„� ����.-�_(seal)
F � '�th Ann Geier
.��P��o�`.
`� F' �G cseaq
STATE OF WISCONSIN J
� }ss.
COUNTY OF �U��y�� )
Personally came before me this �5�� day of
August, 1995,the above named
Judith Ann Geier
�„�..����,,.,.,.
�,•°Q���.��•�.S��F�, to me known to be the person who executed
d i' �'sthe foregoing instrument and acknowledge the
' Ni�7�iRy'� ' ame.
��s �" �� ���7�r�% ���
�.NllBLIC f
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,��y���,p;W�g�O��`O Notary Public SR u'y?r C.OUII(y �/I��S.
��u��� My Commission exryires: �'> �'�%•ii4i1F��
THIS INSTRUMENT WAS DRAFTED BY:
Lein Law Offices
Post Office Box 761 �
Hayward,WI 54843
'DOL 5 6 0 PG 13 6