HomeMy WebLinkAbout024-841-11-4410-LUP-2008-292 ,�.--- �
A lication for Land Use Permit: (*Non-shoreland*) r ,� �, ,
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County of Saw�Jer � �
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 p
flowage, lake or pond ar does not have any of the above waterbodies located within s
the property's bounda.ries. $
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REi�UIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL �
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L2� �'14r� � ON -rJ4 h c5-e �� a'
Owner
Build��r �' 'b
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Mailing Address Maili�ig Address � O
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City, State, Zip City, State, Zip ��
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Daytime Phone Daytime Phone � p �
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Additional Information: Zone District: /�_/ �" �
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Lot Dimensions: 8 0 o K G� '� ► X `�`�6 �
Date lot was created: S ' � �'� � � � � Acres: � - �` `�a n o
O t
Is there wetland near the proposed structure? If yes, how far_T�p � P
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Building Land Use Floodplain: ( ) Yes (X) No �
(x)New ( ) Filling �
O Addition O Dredging Driveway access off of a(Check onf;):
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( ) Alteration ( ) Grading ( ) Pi•ivate Rd ( ) Town Rd. � o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy o �; �
( ) ( ) � o �
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Primary Structure Accessory Building Addition � � °
(, Dwelling (X) Garage-attached/�ietached ( ) Deck -�c �
(,�) Year round (�) # of car stalls ( ) Porch � �
Stora e Buildin ( ) Enclosed CD
( ) Seasonal ( ) g g ,� �
( ) Frame built on site ( ) Screenhouse ( ) Living room � � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen I � ��
( ) Mobile/manufactured ( ) Other ( ) Bedroom '� r --
( ) Other primary structure ( ) ( ) Relocate/en�'.arge o � �
� ) � ) O # ofnew o ` ��
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AdditionalInformation: � ��,�,�y, �` � A
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Type of Construction: � �
�c) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � c �
1
( ) Other � y
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Construction Cost: Primary Structure $ �
Accessory Building: $,��� 6� oUD � Addition: $ *� ,�
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Deed: Vol 5�Pg Certified Soil Test#�y-�l,f `� z
� /US Lot# �3 Sanitary Permit# y �5J�0 fL�Y( o� �
CSM: Vol / Pg �
r�5Y2 Y Or: N
Plat Envelope �
Year Installed: a �'a �j �
Condo Vol Pg � �
Aff of ex septic Vol Pg Owner When Installed: "
c�n�T� .� 17�b.0� V�� �� l�e v �
Previous office approvals/actions: �
��~Y3`� CUP: #
Variance: # LUP: # b5 -2112— SP� �
Inspection Report: # Change of Zone District: � �
a� �
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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 . o� o � #2. #3. #4.
Size �ev ft. wide ft. wide ft. wide ft. wide
���ft. �ng ft. long ft. long ft. long
Floor area � sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from grade 1 � � to peak ft. hgt. ft. hgt. ft. hgt,
Stories 1 stories stories stories
# of bedrooms x
Rear Lot Line
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Fire Number and Name of Road � �, � ! Y c,c1 . h�� l�d(.� e r �a .� �
1 . Enter lot dimensions and indicate north by arrow. Sign e of C)wne �Aut`ho�'ized Agent:
2. Indicate the location and size of the requested construction � �..-.-
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 reciulations of the State of Wisconsin, and if
centerline of the road. a�t��9 as ow�er�s� ane�c, 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: $ /00°"4
,� ��;� � G`��s�
Issue Date Signature of Issuing Agent
, Z Uo 50% Rule: Average Road Setback:
Expirati n Date
Office Comments:
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SHONM AS 86� W1DTH FOR
� MAPPING PURPOSES.
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GRAPHIC SCALE '
TAX ASSESSMENT PURP
aoo 0 20o aoo soo isoo Information contained on tl-
� advisory. Map accuracy is I
a quality of the public record
was prepared. It is not intE
( IN FEET ) � substitute for an accurate
1 inch = 400 ft.
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FZ LIMITED 5457 WARBLER CT LAVAILE WI 53941
SAWYER COUNTY CERTIFIED SURVEY MAP NO.
LOCATED IN THE St/2 SEtI4 SECTION 11 T41N-R8W
TOWN QF ROUND LAKE SAWYER COUNTY WISCONSIN
NoTE . TF��S 1NLLu�FS Qq{ZT oF Csl1'�, 158`f
EAST LINE SEt/4 ASSUMED L E G E N � -
TO BEAR NOY03'48"E 2646,68'
❑ = SET 1/2" X 1" X 24" IRON BAR
w'f. t.To �Ss.�tii.l.. FT-
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SCALE 1"=225' 2 j W. �
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