HomeMy WebLinkAbout024-741-02-2405-LUP-2008-224 Application for Land Use Permit: (*Non-shoreland*) o o _ `
County of Saw�✓er � � ,✓ �'
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 above waterbodies located within �
the property's bounda.ries. � 1
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED. �
PRINT-USE BLACK INK OR PENCIL �
l�n�� � . �t//�L � V • C . �/�f/L���s � �
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O er Build�er ¢' �� �
����'h��2�.y u/oe� �. �f /D..�/S"E ��c.��.c� �2��:
Mailing Address Mailing Address O
G%���o.c%� /�ij/, s1"3d'7 ��`�.,os lit�� SS�ss �
City, State, Zip City, State, Zip
�/Z - 70� -- /�7� �/� `7`�Z -9Z/� � �
Daytime Phone Dayti�ne Phone � � �
Additional Information: ��`�v"�a �� one District: � �� � " � ' �
�tl/.�/�/s,�/, i rj�
� /03, �X x / 9�'•� � �/
C/SZh D �J,�T� Lot Dimensions: /os. L�x / 7��6�' ` �'
� �
Date lot was created: 1 Z'l T-0 7 Acres: • �� /�-C o � �
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Is there wetland near the proposed structure? If yes, how far /1�> � y
Building Land Use Floodplain: O Yes (�C)No � �
� � �
(�New ( ) Filling cr .�. � ��
O Addition O Dredging Driveway access off of a(Check onf:): -' �, (`
O Alteration (� Grading QC) Private Rd O Town Rd. d � �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � N
( ) ( ) � o �
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n«:..-..,..., Cr .+ , A ,.o�� r � , 1 rr � �n N
. ��...u.y �:2::.�k::, �_c.,..�.:o.} Bai.�inb Add't'..r. o .c Io
( ) Dwelling ( ) Garage-attached/detached ( ) Deck ;' W
( ) Year round ( ) # of car stalls ( ) Porch r, � �
O Seasonal OC) Storage Building O Enclosed � �
( ) Frame built on site ( ) Screenhouse ( ) Living room }'�' �-- �
Kitchen �
( ) Modular/manufactured ( ) Greenhouse ( ) c� � ��
( ) Mobile/manufactured ( ) Other ( ) Bedroom � s A
( ) Other primary structure ( ) ( ) Relocate/enl'.arge � �
� � ( � ( ) # of new , �
00 �
0
AdditionalInformation: � �' �
aN �
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Type of Construction: �
( ) Frame ( ) Log � Pole/metal ( ) Block ( ) Concrete N
( ) Other � �
Construction Cost: Primar,y Structure $ � �
Accessory Buildin�: $ �' � 7 �d� Addition: $ ^ �
� �
Deed: Vo1353tz� Pg Certified Soil Test# �� : z
CSM: Vol .30 Pg 3Z Lot# � Sanitary Permit# ��� o, '`�
Plat Envelope Or: N
�
Condo Vol Pg Year Installed: �. �
�
Aff of ex septic Vol Pg Owner When Installed: "
�
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Previous office approvals/actions: �n$
Variance: # LUP: # SP: � CUP: # '►'►�,
Inspection Report: # Change of Zone llistrict:
3q131
. ,�
Describe the construction using these columns. Lisi: the dimensions of each structure in a separate �
column. List each story, each addition, each alteration in a separate column.
#1. #2. #3. #4. �
Size .� Z ft. wide ft. wide ft. wide ft. wide
_�ft. long ft. long ft. long ft. long • `
Floor area � b sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade to peak�ft. hgt. ft. hgt. ft. hgt.
Stories�_ stories stories stories
# of bedrooms ',
.� -- � 7 g, 6� ' ------__.___..,__ _ _ :,f
,`, Rear Lot Line
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Fire Number and Name of Road ` � �' r' t-t y��`� �� h� �w� �-+'�
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l. Enter lot dimensions and indicate north by arrow. Sign ure of C)wner or Authorized Agent:
2. Indicate the location and size of the requested construction `--�2' �
Signature /
activities. G �,,,`��—
Print Name: � N� � 4
3. Also, indicate the location and distance to the well, The above certif s 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 regulations of the State of Wisconsin, and if
centerline of the road. a�t��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: $ 3-� 7�
�� -
Issue Date Signature of Iss i g Agent
oZ(�d° 50% Rule: Average Road Setback:
Expiration ate
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351008
PAULA CHISSER
REGISTER OF DEEDS SAWYER COUNTY, WI .
12/27/2007 10:30AM
REC FEE: 15.00
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