HomeMy WebLinkAbout024-741-29-2101-LUP-2008-366 � Application for Land Use Permit: (*Non-shoreland*) o o �
�� County of Saw�,�er � �
PO Box 676 - Hayward �VI 54843 � X
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 witr►in �
the property's bounda.ries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. '
PRINT-USE BLACK INK OR PENCIL •
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Owner Build���r T �' �
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Mailing Address Maili�ig Address O
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Ci�tate, Zip City, St�Zip
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Daytime Phone Dayti�ne Phone
Additional Information: Zone District: � —�
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Lot Dimensions: ��Sc'.�`l �( l3 0�/.YY
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Date lot was created: ��—/2`O� Acres: � , �� o
Is there wetland near the proposed structure? If yes, how far ,�/j� �
Building Land Use Floodplain: ( ) Yes � No �
( )New ( ) Filling �
(�Addition O Dredging Driveway access off of a (Check onf.): �,
O Alteration O Grading O Private Rd Town Rd. � o
O Moving On O O County Hwy �State Hwy o� N �
� ) � ) � v, o
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N N r
Primary Structure Accessory Building Addition � �o °
� Dwelling ( ) Garage-attached/cietached ( ) Deck "'
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( ) Year round ( ) # of car stalls ( ) Porch Q � �
( ) Seasonal ( ) Storage Building ( ) Enclosed .� �
( ) Frame built on site ( ) Screenhouse ( ) Living room ' �
Kitchen �'�'
( ) Modular/manufactured ( ) Greenhouse ( ) �,
( ) Mobile/manufactured ( ) Other ( ) Bedroom � --
( ) Other primary structure ( ) ( ) Relocate/enl'.arge ' A
� � ( � O # ofnew o
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Additional Information: � � A
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Type of Construction: °
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(� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
( ) Other � � �
Construction Cost: Primary Structure $ � �
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Accessory Building: $ Addition: $ ��oo. ��z� �' � -
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Deed: Vo << Pg Certified Soil Test# oo-z.3 z-- �P� - 1 R z= °G
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CSM: Vol ;,2 S� Pg j35 Lot# / Sanitary Permit# oo-o�y oo-z7� �o -as-y � �
Plat Envelope � ��3� Or: N
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Condo Vol Pg Year Installed: �. �
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Aff of ex septic Vol Pg Owner When Installed: "
lr� a� p�
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Previous office approvals/actions. �_a3� I
Variance: # LUP: # 9 Q-3�a r�� SP� `� CUP: #
Inspection Report: # Change of Zone District: � �
ZsB��
Describe the construction using these columns. Lis1: the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a separate column.
#1 . �yj;a �� �Z�c� ,� #2. #3. #4.
Size !�, ft. wide ft. wide ft. wide ft. wide
� ft. long ft. long ft. long ft. long
Floor area C �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
Rear Lot Line .
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Fire Number and Name of Road �� � :Z l•� T���lZ C'-4-�? /Z(�
1 . Enter lot dimensions and indicate north by arrow. Signature of C)wner or Authorized Agent:
2. Indicate the location and size of the requested construction � � � � • '�
nature ��i��-
activities. _
Print Name: �i
3. Also, indicate the location and distance to the well, The above certifies that e 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 requlations of the State of Wisconsin, and if
centerline of the road. a�t��s as oWner�s� a��e�t, has the permission of the owner(s) to
perfortn the work requested on this application. The above
persons/s hereby give permission for access to the property for
onsite inspection.
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Permit fee: $ ��
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Issue Date Signature of Is in gent
50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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I
PAULA CHISSER
SAWYER COUNTY, WI
REGZSTER OF DGEDS -
338679
OS/12/2006 8:00 AM
RECORDZNG FEE 13.00
Pages 2
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C�rtfied Survey No. 7 2 3 1 VOL 2 8 PG 1 3 5