002-940-09-2207-LUP-1997-533 Application for Land Use Permit �, o `��
County of Sawyer y � �
PO Box 668 -Haywazd WI 54843 � `
715/634-8288 y
The undersigned hereby makes application for a Land Use Pemut and agrees that all work `!' �
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shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance �
and the laws and regulations of the State of Wisconsin. y �
r v� �- To p���U P PRINT-USE BLACK INK OR PENCIL x
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I�onalcl A. SocecKels Sr. �„�� Iti�.Crnnv n�� �
Owner Builder
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9dO.SN STAZE ROAD ��' TZT- .3 � �
Mailing Address Mailing Address �
Hc�ywo,rc�� wi s�I$Y3 ��t�I��A�D
City,State,Zip Ciry,S te,Zip
c�.s�-�3y- aaso
Daytime Phone Daytime Phone
Building Land Use
O New O Filling Zone District /S,- �
( )Addition ( )Dredging
( )Alteration ( )Grading Lot Size 300� x '7 3 O�
QQ Moving On ( ) �
( ) ( ) Acres Jr. ,".�"� ,�
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Primary Structure Accessory Building Addition ;� �
Q�Dwelling ( )Gazage-attached/detached P6 Deck �
(�Yeaz round ( )#of caz stalls ( )Porch o
( )Seasonal (}4 Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room
( )Modulaz/manufactured ( )Greerihouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge
( � ( ) ( )#of new �
Type of Construction I"
(Xj Frame ( )Log ( )Pole/metal ( )Block ( )Concrete >
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( )Other "
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Construction Cost$ 30�0 �
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Vol ' Pg of Deed Certified Soil Test# csr 93-30� �°,
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CSM Vol Pg Sanitary Permit#g_3_ SZ��,_ S O
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Plat Envelope �� � �
Condo Vol Pg Yeaz Installed I 99 3 � I„
Owner VJhen Installed: �,, j"
Aff of ex septic V P �
IZornlcl A ��ecKelc Sr.
Application for Land Use Permit—Page 2
Describe Construction:List dimensions of each structure,story,addition,or alteration.
#1. #2. #3. ' #4.
Size 2 � ft.wide �y ft.wide r� ft.wide ft.wide
a y ft.long L O ft.long ft.long fr.long
Floor azea��sq.ft. �sq.ft. ''; sq.ft. sq.ft.
Hgt&nm gade I y� �p� 1 � ft.hgt. ft.hgt. ft.hgt.
Stories 1 �stories stories stories
#of bedrooms I
reaz lot line orwa«.:;..�� lake/rivea-
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In the box sketch in:
Location and size of all 'r�
existing and proposed structures. ;6� << �
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srpr�c tanK
Location of septic system.
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Indicate distance to: � �_`"'-•,� »`X sv'
Waterline °`�'"�'��d
Road � �
Lot lines o 6_
Septic system �
Distance beriveen structures. J
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Indicate North. �' �`
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Fire Number: 3
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Signature o Owner
-------centerline of ST Ase RoflD a7 road-------
Issue Date 02 October, 1997 Expire Date 02 Oct. 1998
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Office Comments: i-
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