HomeMy WebLinkAbout024-841-11-4414-LUP-2008-239 ; ,,__
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Application for Land Use Permit: (*Non-shoreland*) r ,� �
County of Saw�,�er � � �
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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 ,�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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�a1r�G S�Are G k S� ►- S��i ro e k �o�t5�� t, c�i'o,� I•��. �
Owner 51�a.o•� K S��o c� Build��r ¢'
2a� ?7 �Cr74N l�itol Lk Sc%o. / o:
[�/532 W S�a�-r �
Mailing Address Maili�ig Address �
� N y � wa r y�_ � �
City, State, Zip City, tate, Zip �
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7/�- �SSI- /!�N7 715- .�SS -/l147 �
Daytime Phone Dayti�ne Phone
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Additional Information: Zone District: C-1 �
Lot Dimensions: �
Date lot was created: Acres: z, 3/ o �
Is there wetland near the proposed structure? If yes, how far �1 p �
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Building Land Use Floodplain: O Yes O No � �
(t�'New ( ) Filling � �
O Addition O Dredging Driveway access off of a(Check onf;): � �,
O Alteration O Grading O Private Rd O Town Rd. p o �
O Moving On O O County Hwy O State Hwy N N
( ) ( ) � �, o
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Primary Structure Accessory Building Addition � � �
( ) Dwelling ( ) Garage-attached/cietached ( ) Deck '� W
( ) Year round ( ) # of car stalls ( ) Porch � �
( ) Seasonal ( ) Storage Building ( ) Enclosed { �
(�rame built on site O Screenhouse O Living room � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen ,,��,
( ) Mobile/manufactured ( ) Other ( ) Bedroom , .-
► �
( ) Other primary structure (�j M,;,r�T�_ ( ) Relocate/enParge � �p, �
( � ( ) ( ) # of new � � �
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AdditionalInformation: o i �
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Ty of Construction: � „
(�rame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete o
( ) Other ,�
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Construction Cost: Primary Structure $ � � �
Accessory Building: $ y?ppD Addition: $ � �
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Deed: Vo1,35Y/db Pg Certified Soil Test# U`' z
CSM: Vol 2� Pg 235 Lot# � Sanitary Permit# � �
Plat Envelope t* 7L7� �r� N 0�
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Condo Vol Pg Year Installed: c�
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 District: �
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Describe the construction using these columns. List: the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a separate column.
#1 . r►,; - #2. #3. #4.
Size�_ . wide ft. wide ft. wide ft. wide
� ft. long ft. long ft. long ft. long
Floor area 2 yt0 0 sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from grade �2 ► to peak ft. hgt. ft. hgt. ft. hgt. '=
Stories / stories stories stories
# of bedrooms p
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Re�r Lot Line � ''_
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Fire Number and Name of Road S��f� �v� 77 E � i � �(�?uJ
1 . Enter lot dimensions and indicate north by arrow. Signa C)wner o ut oriz�d Agent:
2. Indicate the location and size of the requested construction �
Signature
2Ct1V1t1eS. PrintName: Ta�l L sc��o c� S�
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 rec,ulations 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: $ z /() 1� !UD
3!a
Z�� C�G�,���� ,�'�. G���y��
Issue Date Signature of Issuing Agent
r,uD �-.S �Z DD�j 50% Rule: Average Road Setback:
Expiration ate
Office Comments:
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; SHOWN AS 86� W1DTH FOR
� MAPPING PURPOSES.
GRAPHIC SCALE
TAX ASSESSMENT PURP
aoo o zoo aoo aoo isoo Information contained on tf
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advisory. Map accuracy is
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was prepared. It is not int�
( IN FEET ) � substitute for an accurate
1 inch = 400 ft.
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PAULl�CNI93ER . �.
sA1fYER CWNYY, WI
REGISTER OF DEEDS �
340971
OT/2'7/2006 8:00 A!1
AECOPDING pE6 13.Op
APE7C
Pages y 756y1�9paaeR�lpi
71�Narvud WI54W
3145�PAL•715A?1-2T79
SAWYER COUNTY CERTIFIED SURVEY
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