HomeMy WebLinkAbout024-641-14-1403-LUP-2008-307 Application for Land Use Permit (*Non-shoreland*� r ,� � ,��
County of Saw��er � � � �
JQt� 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 witYiin ��
the property's bounda.ries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REi�UIRED PERMITS HAVE BEEN ISSUED. �.
PRINT-USE BLACK INK OR PENCIL � i
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�f.���1��2', r,U�c�,,�'" "�1� G 5 �� � 1t� � � �
Owner Build�er �' �
'�> ��` ' i C:� ��' �� �
IVlailing Addr ss 1 Maili�ig Address �O
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City, S te, Zip � City, State, Zip �
-� G� rs � �,r�3 '�� � .3��±� �
c� l�.� Q 1� �-
Daytime hone Dayti�ne Phone �
Additional Information: Zone District: ��.'� !o
C
Lot Dimensions: f�
p �
Date lot was created: �- �/'�-0 � Acres: �. v n
0
Is there wetland near the proposed structure? If yes, how far � �
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Building Land Use Floodplain: ( ) Yes (p(� No J � �
( New ( ) Filling � � �
Addition O Dredging Driveway access off of a(Check one): 1�,� �
( )Alteration ( ) Grading ( ) Pr•ivate Rd ( �Town Rd. '�o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy (v �� �
� ) � ) � � �
o r
Primary Structure Accessory Building Addition �� �
� Dwelling ( ) Garage-attached/cietached ( ) Deck �
( Year round ( ) # of car stalls � Porch � �°'Q'Q'��' � '-'
�. ~
) Seasonal ( ) Storage Building (�pEnc:csed CD
O Frame built on site O Screenhouse (�) Living room � � C�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � (f'�
( ) Mobile/manufactured ( ) Other ( ) Bedroom �
O Othe primary st ucture O O Kelocate/enl�arge � ,"
� � � O O # ofnew � �
• �
Additional Information: � �� .�
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Type of Construction: � �. �
( ) Frame (�'Log ( ) Pole/metal ( ) Block ( ) Concrete C�, �`
Q
( ) Other ,�►'� �
�- ' � .��.
Construction Cost: Primary Structure $ .e���'`� �
Accessory Building: $ Addition: $ (��� �
,-, '�
Deed: Vol�Pg� Certified Soil Test# �� "� a � z
CSM: Vol___/() Pg �� Lot#�_ Sanitary Permit# �� - � ��� � ��� �
Plat Envelope �r: �8-�� �'
�, �
Condo Vol Pg Year Installed: � �
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Aff of ex septic Vol Yg___ Owner When Installed: `�
.
. ,
Previoizs office approvals/actions: �
Varianc..: # LUP: #�—S'7S SP� '� CUP: # �
' t�Re ort: # Change of Zone District: �I�0�
lnspectio p
a w►�
. .
Describe the construction using these columns. Lis1: the dimensions of each struc:ture in a separate ' '
column. List each story, each additi�, each alteratio in a separate oly,m�n.
#1. t-�rsu �, .�
#2. �'s �z'r"1 k'�- � #3. �0 f�- N #4.
Size ,�-� ft. wide -�� ft. wide � ft. wide ft. wide
_�i.� ft. long _� ft. long �� ft. long ft. long
Floor area _��� sq. ft. �(' r{T sq. ft. G � sq. ft. sq. ft.
Hgt. from grade ,Zt� to peak ft. hgt. ft. hgt. ft. hgt.
Stories _� stories stories stories
# of bedrooms _�
Rear Lot Line
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Fire Number and Name of Road 1 y �-�'� > � � j/ / s � N
1 . Enter lot dimensions and indicate north by arrow. Signat e of C)wner or Aut orized �Qgent:
2. Indicate the location and size of the requested construction _ Q > >
Signatuie
activities. / �.� f� Y'a y y 5
Print Name: tti�� u-� � { �'�-�
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
s�ptic 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
cent�r1111e Of tlle Toad. acting as owner'(s) acient, 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: $ 7�
�,i�-�,.�,�,�, ir. vv �
�%�.,G��a� ' �
Iss eu Date Signature of Issuing Agent
M ��J /(c 2Gt�9 50% Rule: Average Roz�d Setback:
Expirat�ate
Office Comments:
ROUND LAKE �
!4 TWP 41 R. 6 W �
, 2
�• 5.6
2.1 I .I
5.4
5.5
1.2 4.2
3.I ��
g.2 S � -�
.4.3 4.1 �� .
/�
�''�`��-V` f J���f%�
� CHIPPEWA RIVER �-'�' ''
�-��"` WEST FoRK
/�-�-�'�--.'������ �'� I (� DAM
8.5 ` �
8 4 is.r
14.i
i4.2 , /4.�5
13.2
/4.3 13.3
14.4 � v � 13.4
13.5
14.� i3.7 � i3.6
14.5 � �
9.5 ia.i+ \
13 8 �
a
4.I 14.7 19.f� ` 13.9
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14.12 �4.10 J . �SJo /�
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CERTIFIED SURVEY MAP NO.
SE 1/4 -NE 1/4 SEC. 14 , T41N, R6W
TOWN OF ROUND LAKE
SAWYER COUNTY , WISCONSIN
N,1/4 CAR. 9EC. 14 2690.12� NE. COR. SEC. 1♦
TI1N, 1�6W S.fl9� - 66� - O'7�� W. T41N, R6W �
•�a 1610.56� �e 30T9. 58
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' TFR ao� .
43,711.66 SQ. iT.
�,y°� 1.0035 ACAES 1 91�'19 N; 299Q 5.2637.D�12��W.
� 640 /
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LOT 1 'Je. "'� i
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�0 .00 �O�' �- b� PN �
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/�a'9 � / 3 ROO TOWN RO�D
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m i� � 41 /
'1:� / � O 50 75 300
�69�, 5 /
LEGEND �
�� SCAIE - 1�� = 50�
� — FOUND 2�� I.P. CAPPED W�TH � � ��
T 3� BMONZE TABLET 0� $CON , /
' tq� f1\ ....."'`,S_/ti !_/
o — ser Y' x 24� I.P. ��$p �:' GENEC. �` �'
WT.-1.15 L85/LIN. FT. :�A ' •
a,A � i SHAFFER �
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� E%ISTING BUILOING �� �/� /���� `��U 'S1fF - Q
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THIS INSTRUMENT wA5 DRAFTED BY G. C. 5. �-..�.0 ��/ SUR�
ILl.I. EOU GLAIRE, M��SCONSIN �� � � cJ
L. 5. NO. 7 a �
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