HomeMy WebLinkAbout022-638-33-4401-LUP-2008-297 Application for Land Use Permit:(*Non-shoreland*) o o �
County of Sawyer �
PO Box 676 -Hayward WI 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 above waterbodies located wittiin �
the property's boundaries. v�
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REi�UIRED PERMITS AAVE BEEN ISSUED. � ,
PRINT-USE BLACK INK OR PENCIL /
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Owner Builder �'
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SSlO L1J Tow,vl;.�e R�� 31 ic;� �'Ty 2R v�-v � /�
Mailing Address Mailing Address O ���
S?�c�iSo [u; 5Y �� l�elc�� r��<, w,�. sv>••.�• � �
City,State,p City,State,Zip
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Daytime Phone Daytime Phone �
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Additional Information: Zone District: !�- � �
S9�'7 f/o c s�-1,�,� �z�.
Il"i F`r�y-L.��S � w�. 53SSB -bys� LotDimensions: �
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Date lot was created: Acres: /C7.c7 o �
Is there wetland near the proposed structure?If yes,how far G �
Building Land Use Floodplain:O Yes 6Q No `�°
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( )New ( )Filling �
OO Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd (�Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy i."'., �
���,E.— ( ) � g °s
Primary Structure Accessory Building Addition r � °
O Dwelling �Garage-attache detached O Deck r "'
( )Year round (1)#of car stalls ( )Porch �;,�
�Seasonal O Storage Building i}Q Enclosed � �
O Frame built on site O Screenhouse O Living room �� Vl
( )Modular/manufactured ( )Greenhouse ( )Kitchen o � �
( )Mobile/manufactured ( )Other ( )Bedroom � � �
( )Other primary structure ( ) ( )Relocate/eniazge �,, '
� � � � ( )#of new la � �
AdditionalInformation: ' A
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Type of Construction: � �` �
�Frame ( )Log ( )Pole/metal ( )Block ( )Conerete a
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( )Other ° �-1
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Construction Cost:Primazy Structure$ o �
Accessory Building:$�S� c c a c u Addition:$�6 o m o '` � � �
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Deed:Vol l.�9 Pg �'"7 Certi f ie d Soi l Tes t# �l'S-��_____ � z
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CSM:Vol Pg Lot# SaniCary Permit# c�[ - C>e�`' b, �
Plat Envelope Or: N �
Condo Vol Pg Yeaz Installed: � ��
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Aff of ex septic Vol Pg Owner When Installed:
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Previous office approvals/actions:
Variance:# LUP:# n�- 3Wo_SP:� CUP:# $5-o!b
Inspection Report:# Change of Zone District: ��g/�S
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Describe the construction using these columns. List the dimensions of each structure in a separate
wlu}nn. List each story, each addition, each alteration in a separate columa
#l.c/e7ec�<.�' CNRe�� #2.<i�c(es+�� i��itr�.� #3. #4.
Size�ft. wide _L ft. wide ft. wide ft. wide
�ft. long _ 'f�' ,ft. long fr. long ft. long
Floor area� sq. ft. �yo sq. ft. sq. ft. sq. ft.
Hgt.from giade /.3 to peak /2 ft. hgt. ft. hgt. ft. hgt.
Stories � / stories stories stories
# of bedrooms O
Rear Lot Line 5(r�
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Fire Number and Name of Road c`�S�� W To c� rv= ��`��� ��
1. Enter lot dimensions and indicate north by arrow. S' nature of Ow �r or Authorized Agent:
2. Indicate the location and size of the requested construction • v� _f�t;w�
Signature
activities. �-
PnntName: � EhFb L"��'�SI-
3. Also, indicate the location and distance to the well, rne abo�e�rt�res ma�me r5cea ���a�d ��ie�eo�5 a�e
tme and cortect,that all work shall be performed in compliance
se tic tank and drainfield, wetland areas, lot lines and to the with ihe requirements of lhe Sawyer County Zoning Ortfinance
P and the Iaws and regulations of the State of Wisconsin, and if
CCRtCL�1R8 Of�1C 202d. acting as owner(s)agent, has the pertnission of the owner(s)to
peAortn the work requested on this application. The above
personsls hereby give. permission for access to the property for
onsite inspection.
Permit fee: $ � r/-S
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Issue Da e Signat�e of Issui ent
O ZOD 50% Rule: Average Road Setback:
Expirati n Date
Office Comments:
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FOR I I I
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GRAPHIC SCALE TAX ASSESSMENT PURPOSES ONL'
o zoo aao eoo ieoo Information contained on this map is
advisory. Map accuracy is limited by tf
quality of the public records from whic
was prepared. It is not intended as a
( IN FEET ) substitute for a� accurate field survey.
1 inch = 400 ft.