HomeMy WebLinkAbout014-842-10-2111-LUP-2008-246 . �
Application for Land Use Permit: (*Non-shoreland*) r ,��
County of Saw�,�er � � �
PO Box 676 - Hayward �%VI 54843 `J
715/634-8288 r�
*Property that is not located within 300' of a creek, river or stream or within 1000' of a
flowage, lake or pond or does not have any of the above waterbodies located within
the property's bounda.ries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �„
PRINT-USE BLACK INK OR PENCIL
U I t1 Ct'.. ��..���C�:a �fl C.1�.��,� C7(�?1�'Q.� o�-�
Owner � Build��r �
1`10 5 7 t�t �+�. �Utx.c�, o:
Mailing Address Mailing Address � p
C 0.`n`�' ,��� ���`�:z l � �
City, State, Zip City, State, Zip C
(��.�y— �l��;1 ��
Daytime Phone Dayti�ne Phone
Additional Information: Zone District: (� 'o� -�
.
Lot Dimensions:
Date lot was created: Acres: �C7 0 �
Is there wetland near the nroposed structure? If yes, how far � �
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Building Land Use Floodplain: O Yes �O No � ;�
QQ New ( ) Filling �
,-,
O Addition O Dredging Driveway access off of a(Check one): "
O Alteration O Grading O Pr�ivate Rd � Town Rd. J �
0
O Moving On O O County Hwy O State Hwy p, N �
( ) ( ) � � �
N � r
Primary Structure Accessory Building Addition � � �
O Dwelling O Garage-attached/cietached O Deck N W
( ) Year round ( ) # of car stalls ( ) Porch � �
( ) Seasonal (� Storage Building ( ) Enclosed rb �
O Frame built on site O Screenhouse O Living room o �--
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom N L .-
( ) Other primary structure ( ) ( ) Relocate/enl'arge � � "
,
( ) ( ) ( ) # ofnew q �
8 Qa
AdditionalInformation: g � „�
$ ' �
N
Type of Construction: d �
( ) Frame ( ) Log �Q Pole/metal ( ) Block ( ) Concrete O
( )�Other ,�
�d
Construction Cost: Primary Structure $ � �
Accessory Building: $ �q . (�1 �`—"` A��dition: $ �
,-.
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Deed: Vol ' �-��� Pg� Certified Soil Test# ��" � �'"Q z
CSM: Vol '— Pg --- Lot# Sanitary Permit# � � ' t�`�7 �S o, 7�
Plat Envelope �r� N
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Condo Vol Pg Year Installed: � �
Aff of ex septic Vol Pg Owner When Installed: '-'
Previous office approvals/actions: � '
Variance: # ;LUP: # SP: � CUP: ����C:.'�� $I�
Inspection Report: # Change of Zone llistrict:
t �0��'�
Describe the construction using these columns. Lis1:the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a separate column.
#1. � �I #2. #3. #4. '
Size � ft. wid ft. wide ft. wide ft. wide
��S ft. long ft. long ft. long ft. long
Floor area � ' �� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade �� to peak ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms Q
Rear Lot Line
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Fire Number and Name of Road �y(��7 l� '�_�K= �(j�;a. �
1. Enter lot dimensions and indicate north by arrow. Sign ure o )wner r Authori ed Agent:
2. Indicate the location and size of the requested construction �
s�9 t�
activities.
Print Name:� C
3. Also, indicate the location and distance to the well, The above certifies that the liste information and in entions are
true and correct.,that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and the laws and rerulations of the State of Wisconsin, and if
centerline of the road. a�t��s as ow�er�s>aGe�t, has the permission of the owner(s)to
perfortn the work requested on this application. The above
personsls hereby give� permission for access to the property for
onsite inspection.
a�.�
Permit fee: $ 1�C��"
-�,u�.�� }� , ��-
Issue Date Signature of Issuing Agent
Z�x 50% Rule: Average Roz�d Setback:
Expiration ate
Office Comments:
1201 ,..%-''�—'- -_—_._. ---___._.
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