HomeMy WebLinkAbout024-741-14-4102-LUP-2008-212 � � ` �
Application for Land Use Permit: (*Non-shoreland*) r y y �
County of Saw�,�er � � '
U�%" 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 ,�bove waterbodies located within �
the property's bounda.ries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL �
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Owner Builder �
Cl l V'�" � �—� � --- � � ,_ �.� �,1 � � i�' ' `` � ♦
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Mailing Addres Maili�ig Address T— �
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Cit , State, �ip City, Stat , Zip� ' `�
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Daytime Phone Daytime Phone
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Additional Information: Zone District: � p:' �
r�a��c sc : ���., �.� �
l68SD�/ Covn�y f� Lot Dimensions:
µ�,,,�a.w� s v8�3 ,
Date lot was created: Acres: !.3, 7 S" n
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Is there wetland near the proposed structure? If yes, how far , ,.�
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Building Land Use Floodplain: ( ) Yes (�l No ��
( )New ( ) Filling � �
� Addition O Dredging Driveway access off of a(Check onf�): '��
( ) Alteration ( ) Grading ( ) Pr�ivate Rd ( ) Town Rd. N�
( ) Moving On ( ) � County Hwy ( ) State H��vy -C N �
� ) � ) l� � c°
Primary Structure Accessary Building Addition � �'' r
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( ) Dwelling ( ) Garage-attached/cietached ( ) Deck � W
( ) Year round ( ) # of car stalls ( ) Porch ,°,i�
( ) Seasonal ( ) Storage Building ( ) Enclosed „_�
O Frame built on site O Screenhouse � Living room .L�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom '� �
( ) Other primary structure ( ) ( ) Relocate/en�arge c � '
� � � ) ( ) # of new o ll�
Additional Information: � -- rn
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Type of Construction:
� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete o � 1.
( ) Other
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Construction Cost: Primary Structure $ � �
Accessory Building: $ A�3dition: $ ��- ,��(.`' �
,-.
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Deed: Vol� �( r; Pg 'z- <J Certified Soil Test# Olo— z8{o °C
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CSM: Vol Pg Lot# Sanitary Permit# 07-/d8 � 7�
Plat Envelope Or: N �
Condo Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: � �
W
Previous office approvalslactions: g.,►
Variance: # O -� LUP: # q3-3�8 SP: ;� CUP: # ,.;�;
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Inspection Report: # Change of Zone l�istrict: 't`� �,}�
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Describe the construction using these columns. List the dimensions of each struc:ture in a separate
column. List each story, each addition, each alteration in a separate column. � •�
#1 . L,,;;�,� Q��,N„ �d�� ,n� #2. #3. #4. ,
Size�_ ft. wide ft. wide ft. wide ft. wide
� ft. long ft. long ft. long ft. loyng
.
Floor area ��Z) sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from grade 15� to peak ft. hgt. ft. hgt. ft. hgt.
Stories ( stories stories stori�s..
# of bedrooms r � �
�y-- ti
Rear Lot Line
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Fire Number and Name of Road � �� � ��
1 . Enter lot dimensions and indicate north by arrow. Si n e C)wn .� Authorized Agent:
2. Indicate the location and size of the requested construction .,F - � ��-
Signature
activities.
Print Name:
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 and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and the laws and requlations of the State of Wisconsin, and if
centerline of the road. a�t��9 as owner�s> a�,e�t, has the permission of the owner(s) to
perform the work requested on this application. The above
personsls hereby give� permission for access to the property for
onsite inspection.
` ��_
Permit fee: $ �-�
� '7 , Z dv� � '
Issue Date Signature of Iss 'n A ent
Z,pp 50% Rule: Average Roz�d Setback:
Expiration Da e
Office Comments:
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GRAPHIC SCALE TAX ASSESSMENT PURPC
aoa a zoa aoo soo �eoo informotion contained on thi
advisory. Map accuracy is lir
quality of the public records
was prepared. It is not inter
( IN FEET ) substitute for an accurate fi
1 inch = 400 ft.