010-941-21-2308-LUP-2000-408 � f__ _ ,,�,�
Application for Land Use Permit
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County of Sa`vyer �, < '
PO Box 668 - Hay�vard WI 54843 � �
715/634-8288 �-
The undersi�ned hereby makes application for a Land Use Permit and agrees that all �vork� "
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance r
and the la�vs and regulations of the State of �Visconsin.CO�iSTRUCTIO�i NIAY NOT �
BEGIti UNTIL THE PERi�IIT IS ISSUED. 2
PRINT — USE BLACK I�K OR PENCIL �' �
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O�vner Builder � o
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Mailing Address Nlailing Address (
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City%State, Zip City, State, Zip ,�
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Daytime Phone Daytime Phone
Buildin� Land Use �
O Ne��� O Filling Zone District �`�� i �
( ) Addition ( ) Dredging � "`
(dj��lteration ►^oo � ( ) Gradin� Lot Size ^ �
( ) Movina On ( j � c�.,
� ) � ) �cres -S . `l ��, '1� � 1 �
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Primary Structtire Accessor�� B�iilding Addition 3 7/ � <
(,�D�vellin, ( ) Garaae-attached;detached ( ) Deck ��� �
( ;�''Year round ( ) r of car stalls ( ) Porch �'`� ��� ;
( ) Seasonal ( ) Stora�e Buildin� ( ) Enclosed ` �`` �
O Franle built on site O Screenhouse O
Livin� room � I �
( ) ��lodularlmanufactured ( ) Greenhouse ( ) Kitchen �� �`` `'
( ) Mobile/manufactured ( ) Other ( ) Bedroom ;`"
( ) Ottler primary structure ( ) ( ) Relocate;'enlar�e i � �
� ) ( ) ( ) # of ne��� ► �-
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Type of Construction c `J `
(�j Frame ( ) Lo� ( ) Pole/metal ( ) Block ( ) Concrete � � �
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( ) Other �' �
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Construction Cost S .�S L���T1 <�
Vol 5�3� Pg��of Deed Certified Soil Test ; q� y !'y.� �Q-.�' �° �
CSM Vol �� Pg�_ �a� �, Sanitary Pern7it � ��- /�2�/ �I q �.�D� �I-'�_� z
Plat Envelo c. Or: � ~
p' .��t j LUf`� �b-l7;� -J' I
Condo Vol P� ��8� Year Installed �
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Aff of e� s�ptic �' P O���i�er When [nstalled: � �
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, srory, addition, or alteration. �
#�. ��,k; iZi�i� i= #2 k3. �a.
Size� ft. wide ft. �cide ft. wide ft. wide
15 h. long ft. lon� ft. long ft. long
Floor area �E� sq. ft. sq. ft. sq. ft. sq. ft.
H�. from gade /2' to peak ft. hgi. ft. h�t. ft. hgt.
S[ories I stories stories stories
" of bedrooms
rear lot line or ���arerline of lake/river
In the box sketch in:
Location and size of all �� �S� - ,,�s�
existin� and proposed stnictures. .,1 .. � '
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Location of septic system. � Y�i
[ndicate distance to: ��� �
��'aterline!«"etlands ��� ���� ��C � > �
Road - �� )� + � G� .,
Lot lines i 1 ��� \
Septic s}stentr'pri�y S �' `� ^
\�'ell 4 `� /
Distance Ueh�een structures. 9 0 �
[ndicate Aortl1. !� r ��
"� � /S z j'�C �c� v� k S
Fire \umber: '� �
�D1�I Wi��wi✓ O
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ignature of O�cner
Thz abuce certifizs that thz listed
information and intentio�is are tnie and ll —�
correce. The �bo�e person's'hzreby —�'iS�e__S'(� ___ __-----'"
gi��e pzrmission for access to thz
properry for onsite inspzction. ------- cente�line Of t'oa�------
[ssue Date August 4 , 2000 Expire Date August 4 , 2001
OffICC C011ltllc'R[S: � - I
Si,�natur� o�Z�i in�s Administr:uor
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��> � /"X 30" IRoN P/pE PLACED
�" X P-K SPiKE PLAGED
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I , Rob�s�' $. Swanson, Wisconsin �egistered Land Surveyor,
do hereby certify under the provisions of Chapter 236. 34 of the
Wisconsin Statutes, and under the direction of Darlene Scholz ,
owner of said land, I have surveyed, divided, and mapped the land
herein described, and that said land lies in the southwest � of
the northwest } of Section twenty-one (21 ) , Township forty-one (41 )
North, Range nine (9) West , Town of Hayward, Sawyer County, Wiscon-
ain Hescribed as follows�
Coguuencing at the west 4 corner of Section 21-41-9'r thence
North 0 12' West along the west line of the forty 500.00 feet to
an iron pipei thence East 370.02 feet to an iron pipe which is
the point-of-beginning.
Thence North 3°11 � 30" East 864.32 feet to a epike in the �own
Road.
Thence south 41°52'30" East along the Town Road 631.�+1 feet
to a P-K spike.
Thence South 43°19�3�" East along the Town Road 283.70 feet
to a P-K spike.
Thence South 34°19�30" East along the Town Road 224.85 feet
to a P-K spike.
Thence West 791. 36 feet to the point-of-beginning.
Said parcel is subject to easements and reservations of recobd.
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?1� SWANSON {zz
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Page 2
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WARRANTY DEED
THIS DEED, made between HAYWARD FAMILY DF,NTISTRY, S.C., and
THOMAS J. DUFFY, an adult single man, Grantors, and JAMES L. TABBERT and
CHERYI. L.. TABBERT, husband and wife as st�rvivorshin marital ��ertv_, Grantees,
WITNESSETH, That the said Grantors, for a valuable consideration of one dollar and
other valuable consideration, conveys to the Grantees the following described real estate in
Sawyer County, State of Wisconsin:
That part of the Southwest Quarter of the Northwest Quarter (SWl/4NW1/4), Section
Twenty-one (21) (21), Township Forty-one (41) North, Range Nine (9) West, more
particulariy described as Lot One (1) as recorded in Volume Sixteen (16) of Certified
Survey Maps, pages 82-83, Survey No. 4044.
This is not homestead property.
Together with all and singular the hereditaments and appurtenances thereto belonging;
And the grantors warrant that the title is good, indefeasible in fee simple and free and clear of
encumbrances except all easements, exceptions and reservations of record, and will warrant and
defend the same.
Dated this�day of�/J�er , 1994.
f{�-e Offb� � . 2 � 3 8 9 4 ��J` I � lJ I- .St',/�l.
Sevryax Go�m1� ( )
�� �� �� � � `� � HAYWARD FAMILY DE T RY, SC
AD19 et o'�
t��,d ,�,,.ts,a m.d,,��_ by Patrick T. Duffy
ol yh�x�de cu }xr}� � 3
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--------------;,�mn�a. (SEAL)
THOM J.
TF;�'����sER
�,?` �v�����,' Personally came before me this o?n�day
$ -�—�'� ��,�( M.MfT���q�� of ���-,��,,� , 1994 the above
FEE ,��0 �� M�y named Patrick T. Duffy for Hayward Family
�pTARy Dentistry, S.C., and Thomas J. Duffy, to me
� ,...,. {t' known to be the persons who executed the
� pUBL�G � foregoing instrument and hereby
\�: acknowledge the same.
���o,t,qrF oF w�s�°�S'
������....�.��� �•
Notary Public, Sawyer County,
My commission: �/�— 9/
This document drafred by: ,r�.5 3 9 Pl� � � 3
Attorney Thomas J. Duffy
Hayward, WI 54843
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