HomeMy WebLinkAbout018-837-29-1102-LUP-2008-094 � -
Application for Land Use Permit: (*Non-shorelan�*) r ,� � ,
County of Saw�✓er � � X
PO Box 676 - Hayward �%VI 54843
715/634-8288
*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 ,�bove waterbodies located within �
the property's bounda.ries. �
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CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HA�'E BEEN ISSUED.
PRWT—USE BLACK INK OR PENCIL �
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Owner Build�..r ¢'
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Mailing Address Mailing Address p �
��Y �GA//_____.�"�r�.��/� ���H ��/TLL� l.(LL�� i_J y/� C��D
Crty, State, Zip City, State, Zip �
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Daytime Phone Daytime Phone (`.
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Additional Information: Zone District: /e 2 � Z �,
Lot Dimensions: +7�a x � �s �
Date lot was created: �.�-/ '��� Acres: J�, '7`� o �
Is there wetland near the proposed structure? If yes, how far �
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Building Land Use Flood-plain: O Yes (k)Nc� �
�New ( ) Filling Cn �
O Addition O Dredging Driveway access off of a(Check onf,): �7 �
O Alteration O Grading O PI•ivate Rd OC) Town Rd. � o
O Moving On O O C��unty Hwy O State Hwy C+� i;
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Primary Structure Accessory Building Addition v. � o
�l Dwelling ( ) Garage-attached/cietached � �Deck � � �
(� Year round ( ) # of car stalls ( ) Porch � � �
( ) Seasonal ( ) Storage Building ( ) Enclosed ►v � '�'
(� Frame built on site O Screenhouse O Living room � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �� Irn
( ) Mobile/manufactured ( ) Other ( ) Bedroom o
( ) Other primary structure ( ) ( ) Relocate/enl'.arge � � A
O O O # ofnew � �
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AdditionalInformation: � � �
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Type of Construction:
oN "
�i Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete
( ) Other
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Construction Cost: Primary Structure $ , . �� � �
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Accessory Building: $ A��dition: $ �
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Deed: tioi3$�I g 53 r3zi Certifiect Soii I'est##�Q� �
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CSM: Vol � 7 Pg�Lot# ( Sanitary Permit# Q$-p(a? � 7�
�-r-- � 7 3� �'
Plat Envelope Or: N
Condo Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: � �
Previous office approvals/actions:
Variance: # LUP: # SP: ;� CUP: #
Inspection Report: # Change of Zone l�istrict:
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zoo�?
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Describe the construction using these columns. Lis1:the dimensions of each struc:ture in a separate
column. List each story, each addi ion each alteration in a separate column.
#1. m►4�t �uitc��n`j #2. ��1` #3. #4.
Size�_ft. wide v �(�ft. wide ft. wide ft. wide
�_ft. long ��ft. long ft. long ft. long
Floor area�()(c�/ sq. ft. _c�� sq. ft. sq. ft. sq. ft.
Hgt.from grade ��-�to peak � ft. hgt. ft. hgt. ft. hgt.
Stories_� �stories stories stories
# of bedrooms�_
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Fire Number and Name of Road 7�,-��[� ����
1. Enter lot dimensions and indicate north by arrow. Si nature of C)wner or Author'zed Agent:
2. Indicate the location and size of the requested construction �
'gnature
activities.
Print Name:���("f�I��YI �n0(�/"1
3. Also, indicate the location and distance to the well, The above certifies that the listed information and intentions are
true and correct.,that all work shall be performed in compliance
septic tank , ��31��c'lI'e3S, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and the laws and rec;ulations of the State of Wisconsin, and if
centerline of the road. a�t�n9 as oW�er(s)ac�ent, has the permission of the owner(s)to
perform the work requested on this application. The above
persons/s hereby give permission for access to the property for
onsite inspection.
Permit fee: $ ��,�.��'
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Issue Date Signature of Iss ng nt
�Ll,L/ �Q . 2 (�9 50% Rule: Average Rozid Setback:
Expiration Date
Office Comments:
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PAULA CHISSER
SAWYER COUNTY, WI
REGISTER OF DEEDS
343301
hGALE� l�>Zoo� 12/O1/2006 8:55 AM
F2ECORDING FEE I3.00
D �00� 2DD �(OD
f'ages 2
SHEET l OG 2
Certified Survey No. ,�, 3 � 3 VQL 2 9 PG �+ 0 �