HomeMy WebLinkAbout022-738-20-4305-LUP-2008-072 Application for Land Use Permit:(*Non-shoreland*) � -
r a
County of Sawyer N � X
PO Box 676 -Hayward`VI 54843 0
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 above waterbodies located within
the property's boundaries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REi�UIRED PERMITS HAVE BEEN ISSUED. �
PRINT-USE BLACK INK OR PENCIL
// / / � �
�Ai7�� �T��/� Hu.vf .f 9.7s�,v�f��.✓ �.✓l�.fat�ia�/ a
Owner � Bu��Ur �'
3330 .✓�l,ryo.P �� �.�� .✓ G/,�..�9o,P .Q� �� �
Mailing Address Mailing Address �
��q���e� �J�s .3s'�G y . ,��r�s,� �� .�'y�G y �, �
City,State,Zip ity,State,Zip �
y..� 9�.�'-.�i�4 �.� 9s/���y.�
Daytime Phone Daytime Phone �
Additional Information: Zone District: /�-/ ��
.
Lot Dimensions:
, 1 ���r/ q�_ �
C`�
/
Date lot was created: �OO l Acres: � n �
0
Is there wetland near the proposed structure?If yes,how far .�D �
Building Land Use Floodplain:O Yes O No :°
( )New ( )Filling �
(Addition Dred in Drivewa access off of a Check one fD
( ( ) S� g Y � )� oa
O Alteration O Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy �,"', �
O O o S
r
Primary Structure Accessory Building Addition � �
( )Dwelling ( )Garage-attached/detached (XJDeck W
( )Yeaz round ( )#of caz stalls (�(jPorch .-.
O Seasonal O Storage Building O Enclosed �
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen N �
( )Mobile/manufactured ( )Other ( )Bedroom _
( )Other primazy structure ( ) ( )Relocate/enlarge w '
( ) ( ) ( )#of new oA �
I �
N
AdditionalInformation: O „
�
�
0
Type of Construction: tl�
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete p
�Other �d��.�7 .�v.ysE.? n����� ro �
Construction Cost:Primary Structure$ 9�DD. �� i/� �W,�'�' �
rn
Accessory Building:$ Addition:$ � �
�
Deed:Vol 91L Pg Certified Soil Test# 99-l�`J O(o-l3 Z- 04
z
CSM:Vol Pg Lot# Sanitary Permit# 0(o•203 � 7y
Plat Envelope Or: N J
Condo Vol Pg Yeaz Installed: �
Aff of ex septic Vol Pg Owner When Installed: % �
�
Previous office approvals/actions: U
Variance:# LUP:# SP: � CUP:#_Q�-p��
Inspection Report:# Change of Zone District: D�
5'y�
�
Describe the construction using these columns. Lis1 the dimensions of each structure in a separate
columi . List each story, each addition, each alteration in a separate column.
#1. i,�� � #2. #3. #4.
Size ft. wide ft. wide ft. wide fr. wide
fr. long ft. long ft. long fr. long
Floor azea_ �. ft. sq. ft. sq. ft. sq. ft.
Hgk from gade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms
� %C� '��'� ��� 'f` �� Rear Lot Line
��f W6i�t9i,! �
O�'�
..�GL � ,1.� �z� -
� , ,
�S i�'
z'
,
� �� /G�
�-- �-
S �
� . � , � � �
� .
o � .
�ti ,,� a_ .
�� y� ��
GJ,fll � �,yr.�lO�i�.tipE.C�i1 lw�E �qp ,
Fire Number and Name of Road;�3,�0 N y�/�,P90,P ���
1. Enter lot dimensions and indicate north by anow. ' atur f Owner or Aputhorized Agent:
2. Indicate the ]ocation and size of the requested construction � ��C'
2Ct1V1t10S. SignaNre
Print Name: ��P�PS� �(rw/�
3. Also, 1ndlCate the locatlon and d1StaI1Ce to the well, The above ceRifes that Ihe listed infortnation and intentions are
true and correcL,thaf all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer Counry Zoning Ordinance
and �he laws and reguiations of ihe Sfate of Wiswnsin, and if
CEritOLllriO Of YZ1E 703d. acting as owner(s)avent has the permission of ihe ovmer(s)to
peAorm the work requested on this application. The above
personsls hereby give permission for aceess to the propedy for
onsite inspection.
Permit fee: $ 7S�
�'1�lr.� � , �Z GiD 0 �
Issue Dat� Signature ofIssui g g nt
�� � , 2 Q�9 50% Rule: Average Road Setback:
Expiratio Date
Office Comments:
. -V\� �i �i C� -.
L
.� ..L
�
) .2. 1 .I . I ,
z
J
T
Z
W
�
�
2
Q
l�l
.3. 1 4.1 m
o �
0
� �
.4.�
POLISH ROAD 4'2
.14.1 .14 .14.2 O '
14.4
� . 14 .13.1
w
� ,146 �
. 15 . .15.3 .IS.
.16. 1
.15.5
.15.1
SCALE : I INCH =400 FEET FOR ASSESSMENT USE ONLY NO?
DRAWN BY : DATE : 7-18 -84 INTENDED TO SHOW CONCLUSIVE
COLON (:) INDIGATES GOVT. LOT EVIDENCE Of OWNERSHIP OR
BOUNDARY LOCATIONS