HomeMy WebLinkAbout024-741-06-3314-LUP-2008-030 ✓,
Application for Land Use Permit: (*Non-shoreland*) o o , k
County of Saw��er � �
.�� PO Boa 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 above waterbodies located witr►in r-
the property's bounda.ries. v
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL �,
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Owner Build��r �'
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Mailing Address Mailing Address � O
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City, State, Zip City, ate, Zip
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Daytime Phone Dayti�ne Phone �' Z
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Additional Information: Zone District: l� ' �
S.�Jy A-�,z�3 = �3€s l,. 7y' k
�� a s � k �• Lot Dimensions: `�i��1lc� x 3�'i x byo•�L � '�
Date lot was created: ,� vL7 � �� � I �1�Z� Acres: � � y L� o r`1 �
Is there wetland near the proposed structure? If yes, how far Yt� � � �
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Building Land Use Floodplain: ( ) Yes (X)No � � � D
�New ( ) Filling y,-, W
O Addition O Dredging Driveway access off of a(Check onf.): �� 7
O Alteration O Grading O Pi•ivate Rd (x) Town Rd. �0 2._
O Moving On O O County Hwy O State Hwy � N
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Primary Structure Accessory Buildin� Addition � � �
(� Dwelling (� Garag -attach detached (/� Deck � W
(� Year round (3) # of car stalls ( ) Porch ��
( ) Seasonal ( ) Storage Building ( ) Enclosed � `�
(� Frame built on site ( ) Screenhouse ( ) Living room �"'� �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen o � �.
( ) Mobile/manufactured ( ) Other ( ) Bedroom �' 1 .-
( ) Other primary structure ( ) ( ) Relocate/en7,arge � �, A
( ) ( ) ( ) # ofnew os �
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Additional Information: p � ;
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Type of Construction: d �
�Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
( ) Other
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Construction Cost: Primary Structure $_j p(>� C>C>C��. `�`' � �
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Accessory Building: $ Addition: $ � �
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Deed: Vol3yyzSL. Pg Certified Soil Test# ('$ —Db � °G
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CSM: Vol `; Pg�Lot#�_ Sanitary Permit# ��—�� � 7�
Plat Envelope � �y$3 Or: � � �
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Condo Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: � �
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Previous office approvals/actions:
Variance: # LUP: # SP: ;� CUP: #_ \�
Inspection Report: # Change of Zone ]�istrict: �
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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 addition, each alteration in a separate column.
#1 . (�61,v,,� #2. �" �u-�.�- #3. � c #4.
Size a 8` ft. wide �- 2- ft. wide ft. wide ft. wide
y 7 ft. long 3 `r ft. long ft. long ft. long
Floor area � S8 y sq. ft. � y � sq. ft. 2� `a .�. sq. ft. sq. ft.
Hgt. from grade � �-- � to peak � z ft. hgt. � U�� �� �i�#..d t,� ft. hgt.
Stories � �- istories stories stories
# of bedrooms Z '
�(�,,,. �",',r,� '
Rear Lot Line 6 d �
r $° .
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Fire Number and Name of Road I � � �i�"� t,�J �--�r L D�'--�--t��'7-i (��� .
1 . Enter lot dimensions and indicate north by arrow. Signature of C)wner or Autho ized Agent:
2. Indicate the location and size of the requested construction ' � _� ,�/r�c'� �, �:.>
Signature
activities. ' � M�c°�N
Print Name.�cJA1�f �aN-%CU— � �..-�'�
3. Also, indicate the location and distance to the well, The above certifies that the listed in ormation and intenUons are
true and correct., that all work shall be performed in compliance
septic tank and drainfield, wetland aTeas, 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. aot��9 as oW�er�s� a��e�t, 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: $ 01 ?.S Od
A flr: 1 1 , � v0 'b -
Issue Date Signature of Issuin Ag t
/-}�r� i l , ZUD�t 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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� SECTION LINE DATA AND SECTION SUBDIVISION PROVIDED BY G' I",�
> � j'jf ��p�f�j SAWYER COUNTY SURVEYORS OEPARTMENT, LANDNET WDNR
�nC AND WI. CARTOGRAPHER'S OFFICE. 40p o 200
�plications, Land Surveying, Consulting, � ,�
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Part o£ t,he Stid 1�. - SW LF� Section � Township 1�1 North, Range '7 �Jest, Fa, j/y� � p
ToVm of Round Lake, County of Sawyer� 5tate of 4Jisconsin.
Sheet 1 of 2 �/ ��'
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