HomeMy WebLinkAbout024-641-13-2401-LUP-2008-318 / r
Application for Land Use Permit: (*Non-shoreland*) " '�
0 0
County of Saw��er N �
PO Box 676 - Hayward�VI 54843
715/634-8288
*Property that i� not located within 300' of a creek, river er strPam er within 1000' of a c J
flowage, lake or pond or does not have any of the above waterbodies located within �
the property's bounda.ries. � t
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED. �
PRINT—USE BLACK INK OR PENCIL �
�\ �
�� � ���-�'� �1 ru( {�'l v 4 ((/ � l ti l� �n rrC�., � �
� 1� � � J A i 1 — �, (�,
Owner Build��r �:
C `�
'l�I"� l� ��„v� G��,ti�- l�� s� ��
Mailing Address Maili�ig Address O �
2 •�cj, �C`�' � S��,"� � �
City, tate, Zip City, State, Zip ,� �
��l � y�'Z- ����7 ��� � ,�
Daytime Phone Daytime Phone � �
Additional Information: Zone District: �l� � � �
-�- "�-
C� "`
Lot Dimensions: �
�'l0 Z /�S v '�
Date lot was created: �C���� Acres: o � �
Is there wetland near the proposed structure? If yes, how far � � ��
Building Land Use Floodplain: ( ) Yes �No � � �
( )New ( ) Filling � ('�j
�Addition O Dredging Driveway access off of a(Check onf,): �, �
O Alt tare ion O Grading O Pr•ivate Rd ,�) Town Rd. t� o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ;� N �'
� �
� ) � ) � o � �
Primary Structure Accessory Building Addition N � �°r.. \
( ) Dwelling ( ) Garage-attached/cietached ( ) Deck \ � �
( ) Year round ( ) # of car stalls ( ) Porch �. .-�
( ) Seasonal ( ) Storage Building ( ) Enclosed � � ,
O Frame built on site O Screenhouse O Living room � � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � � �
( ) Mobile/manufactured ��Other ( ) Bedroom W .-
� A
O Other primary structure �,) �4' 3 v L`� G'e�L<i�l�� O Relocate/enl�arge �
N
� � ( � j�,a.,�, ��-Z ( ) # of new 1 �
O �
� n �
AdditionalInformation: c � �
Q � �n
o c�,
' ' �Type of Construction: o
( ) Frazne ( ) Log (��Pole/metal ( ) Block ( ) Concrete o�
l" °
( ) Other � ro y
� �
Construction Cost: Primary Structure $ � �
Accessory Building: $
A��dition: $ � ���� � �
�
Deed: Vol �L Pg�_ Certified Soil Test# t�'%`� � �i�z `�g.yy�O �`' z
CSM: Vol --� Pg �— Lot# — Sanitary Permit# �/� — yL'� �-u� c, �
Plat Envelope Or: `� �
�, N ��
�
Condo Vol ^ Pg � Year Installed: � �
�
Aff of ex septic Vol — Pg J' Owner When Installed: "
0
� ��
` r�
Previous office approvals/actions: 6fo - 50l .�
��- 05�,
Variance: # LUP: # O�- 5 Z SP� � CUP: # 05-d�� �
Inspection Report: # C hange o f Zone l�is tric t: c�5- O y �
� � � a 6�
� �
� z yis�
Describe the construction using these columns.List the dimensions of each structure in a separate �
column.List each story,each addition,each alteration io a separate column.
#1. lv �I d�u Ex #2. ,�,1 /�70 #3. #4.
Size ^� _ .wide _�_fr.wide ft.wide ft.wide
�ft.long 3 D ft.long ft.long fr.long
Floor area (a 60 sq.fr. z 7o sq.ft. sq.fr. sq.ft.
Hgt.firom grade to peak fr.hgt. ft.hgt. ft.hgt.
Stories� stories stories stories
#of bedrooms 1 . �
�.` ;�1 ,r__ - -- __3 ",�
Rcar Lot Line �
!�� �j�� 7�''? �����
a y'�'p+'k`M���,Sk '� � ��`
i
/�I �,�°Q � l��r��� �, �`P �.
I�J ,��'�� Q,�Q,�o ��kfr
� �, �b�� � r�,�.i5�`����.��
,� ��b ��` �
(a��� ��
5 � � ��f ���� �
�
,i� �
�"���''" ��a- �'�
5' �� ' ���' ��
,��;S ��
,, , �
� ����
�' , Po;,�� ���
����
Fire Number and Name of Road �� ��N"��nl� ��
1. Enter lot dimensions and indicate north by arrow. $' u e of W �or Authorized Agent:
2. Indicate the location and size of the requested construction
� Signalure
activiries. � �_ , ��',� � �
Print Name: �
3. Also,IndlCate the IoCation and a1StanCe to t}le we�l, true antl wrrecLethataall�work`shall br pedormed intcnmplance
septic tank and drainfield,wetland areas,lot lines and to the w�m me req���eme��or me sav+yer co�nry zo��o9 om��a��
and lhe laws and reculations of the State of Wisconsin,and if
CEriYeL�:1C Of Y110 703d. ��'999 adinp as owner(s)ayent,has lFe permission of the owner(s)lo
�� �l�y pedorm the work requested on this application. The abnve
Q�.�'d��,�,U�� �lC,S-l'.� `'� personsls hereby give permission for access to the propeM for
onsite inspection.
Permit fee:$�
���71vc��an. ZS� 2Uo S " -
Issue Date Signature of Issuin Ag n
ZS- �jU 50%Rule: Average Road Setback:
Expira ion Date
Office Comments:
TOWN OF ROUI`
SEC. 13 TWP. 41 No
�2
I
.1�.� 5.� �
.7.1 .T.2 ,7.3 •7.8 /
,._.
� ui 3.3
.8.1. � ��-. ,o � ,� `2?J $.b
o� �
� •T.S � RI V E R
� O �
-v\ 76 � S z.vv �
�
""`-'�
� w� ..� .7.T .8•i l . � �,-.�
.7.4 L�.� . .� _ ^��-� �--'�
�� .`� .Z ��—��1�1_�--�i---1
M00 E LAKE ij> - 1
RESOR`� GONqC� � � �'_s� 1� C HI PPEWA R IVE
' �`"~��— I
►:� ..�—
� ` �N ST FO@ ,= �--_�--�\� _
� 2
Y/ \
�� `l ���� ���'—`'�/
��� �-
.io•� �j .9.1
�
M OOS E �9�* �
L A E � �� �.�3
K o.z �
I �
�' A.2
�� .10•3
� 14.2 0
� \
,�
I .11.1 f
� �(
12.1
J .11.2
(
t���:3
.iz.r
I 1 r.9
u.5 J 22
I ,.., ,.