010-941-16-1404-LUP-2000-622 a�D
' Application for Land Use Permit r c .
County of Sawyer ;� < �
PO Box 668 - Hay�vard `VI 54843 �y �
715/634-8288
The undersigned hereby makes application for a Land lise Permit and agrees that all work � �
shall be done in compliance �vith the requirements of the Sa�vyer County Zoning Ordinance �-
and the laws and regulations of the State of Wisconsin.CONSTRUCTION NIAY NOT
BEGI�' UNTIL THE PERI�IIT IS ISSUED. I
PRI: T- US BLACK INK OR PENCIL �'
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- ��I I e,rfa l�' t,�r�e.�a ' ��
O�vner Build c o �
�i�,����- �� �� �� �
l�laili g Address Maili � Address �
��� �/ �'t� !.,> .� cP,�
Cit , Sta e, Zip Cit , tat , Zip
7/� �3 � �- �'� � 7/ � " -- 0 �
Day ime Phone Dayfime Phone �
Buil � Zg Land Use
New O Fillin� Zone District R ''� �
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( ) Addition ( ) Dredgin� �
( ) Alteration ( ) Grading Lot Size �� a �� �� �j�. �
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( ) i�loving On ( ) �,� ,/' � I
( ) ( ) Acres r = �
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n
Prin � Structure Accessory Btiildin� Additiou ! �
-. �
�Dw 11ing �ara� attache detached O Deck �Q �
ar round �) N of car stalls O Porch �C3 ���
( ) Seasonal ( ) Storage Building ( ) Enclosed � �� �`
,�
O Frame bu;lt oi1 site O Screenllo�ise O LivinQ room � �
� ) ��lodular'manufactured ( ) Greenhouse ( ) Kitchen �,�1 ,;�
( ) tilobile'mailufactured ( ) Other ( ) Bedroom '6 �! � �
O Ottler primary structure O O Relocate;enlar�e �,' �
O O O # ofnew "� ��
'� '. '1
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Type Construction =
rame ( ) Lo� ( ) Pole/metal ( ) Block ( ) Concrete � �
( j Other 'Q
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Col�struction Cost S��� �C�� — ��� �� '�� �"
, �
Vol � �9 Pg 3a� of Deed Certified Soil Test # � -�55 �i� �
CS��1 �'oi P� Sanitary Permit # �(', - �l5 7 �'�� �z
Plat En��elope � Or: ��
Condo `'ol P� �'ear Installed � VI
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.�ff of ex septic �' P _ O���ner �Vhen Installed: �� �
6 ►���+'` �
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� Application for Land Use Permit - Page 2
Descr�i e,I Construction: List dimensions of each structure, story, addition, or alteration. ,
#1. /""`�'� #2. �ylBfE� #3. #4. "
Size� ft. wide � ft. �vide ft. wide ft. wide � �
�(� ft. long � ft. lon� ft. long ft. long
Floor area a� sq. ft. �7� sq. ft. sq. ft. sq. ft.
Hgt. from g�ade� to peak_� ft. hgt. ft. h�t. ft. hgt.
Stories�_ _� stories stories stories
# of bedrooms _�
rear lot line or �vaterline of lake/river
� ���� ��
In the box sketch in: ���i �'
Locaticn a:�d size cf a:l
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existin� and proposed structures. !�� � � � ^ _ � _
_ �-- � _' / ^�
Location of septic system. � . � , 30
e��� ' '- , o�-�
Indicate distance to: � r �y�yi
�Vaterline/`Vetlands �f 1
Road �
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Lot lines '
Septic systemiprivy � �
��'el l (
Distance behveen structures. � ��
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Indicate North. ��_����f � / `
� ��� �6 t %
Fire \ui��ber: �
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Si nature of O�ti�ner �
�Tlle abo�e certities that the listed �
iiiform�tion and intentioiis are tnie and �
correcc. The abo�e person's hereby �
�,i�e permission for access to the
propert�� for onsite inspection. ------- CetlteClttle Of road-------
[ssue Date October 2�, 2000 Expire Date October 25, 2001
r /f�fi�%�i�
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Siynat�u�e oFZonin`_ Administrator
OF H AYWARD
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287253 STATE BAR OF WISCONSIN FORM 1 - 1998 Re9iste�'S OHica i 5c,
Sawyer Counry j
WARRANTY DEED Received lor recoro th�s �9 tlay of
Document Number �CT q D 20 0 o a�o clock
�/� M antl recor�etl as vol. �/�
tRe or�s on oagr.• 3�'�
This Deed, made between Joseph G. Donnellan, an�adult man, Granror, and > >^- �' i�iiy��_,;_
Albert G. Rivet and Patricia A. Rivet, husband and wife as survivorship. aegisier
marital properly, Grantee.
Grantor, fw a valuable considerarion comcys ro Grantee the foilowing �=�'O`�
described real es[ate in Sawyer County, Sta[e of Wisconsin:
That part of the Southeast Quarter of the Northeast QuaRer (SE%.NE'/.),
Section Sixteen (16), Township Forty-one (41) North, Range Nine (9)
West, described as Lot Nine (9), recorded in Volume Seventeen (17) of Rerorai nrca
Certified Survey Maps, pages 194-195, SuNey No. 5290. Name and Retum Aadmss 9, y,
A/ I(�vc�
-+�. Qc�' /.�i D 3
N�Y��d,w7 SYfY3
ow-vaia�-iaoa
Pamel Identificauon Number(PIN)
This is nol homestead propecty.
(is)(is not) �
SIMI�W �.
FEE
Together wifh all appur[enant rights, ti[le and interescs.
Grantor warrants that the [itle ro the Properiy is good, indcfcasible in fee simple and free and clear of
enwmbrances ezcept all easements, exceptions and resereations of record.
Datcd this�day of l 1 'L`i��n G`��.
�.��,�� /���
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' �� oseph G. Donnellan
y?'1�t�E�•C— � .��
AUTIIEN'I'ICATION ACKNOWLEDGMENT
Signawre(s) STATEOP WISCONSIN )
)
SAWYERCOUNTY ) /STI�
authenticated Ihis_day of Personally camc before me this _ day of
;C� - , 2000 the above named m me knuwn to be the
o executed the fore�oing instrumen[and acknowledge
��.� � \
'i'ITLE:MEMBER STATE BAR OF WISCONSIN
(Ifnot, � *N F� vl7Ef<olF
authorized by§706.06, Wis. Stats.) f '��,
� Public, S ��
THIS INSTRl7MEVT wAS nRAFfED BY J, M��tnissi � ermanenL (If not, state expiration date:
Attorney Thomas J. Du1Fy ��l'q� - .Zc;oZ)
Hayward, WI J����h�F WlSC�NS�
(Signart�res may be au[hemiw�ed or acknowledged. Both are not „"����� �O� �� � (� �F� Q ��
nc<asary.) ✓ r J
'Names of perwns signing��any capaciry should be ryped ar p�in[ed below Ihcir signaNres
W ARRANTY�FF.O STATE BAR OF WtiCON5P1
FORM No.I-199!
InfortnalqnPro(essionalsLompany Forqpulac,Wucunsin 800655]021