HomeMy WebLinkAbout024-741-05-1102-LUP-2008-368 .
Application for Land Use Permit; (*Non-shoreland*) o o ..
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
flowage, lake or pond or does not have any of the above waterbodies located witriin z`��
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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Owner Build��r � �` �
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Mailing Address Maili�ig Address O �
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City, State, p Y� P
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Daytime Phone Daytime Phone �
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Additionai Infor�t�� Zone District: �-z l !-'-f �
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� �� ,� �,�-� �� Lot Dimensions: �
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Date lot was created: (�-Z-os Acres: � o �
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Is there wetland near the proposed structure? If yes, how far � 6 � �
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Bui mg Land Use Floodplain: O Yes O No � o
(�New ( ) Filling � rc
O Addition O Dredging Driveway access off of a(Check onf:): �, J�
O Alteration O Grading O Pr•ivate Rd O Town Rd. o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � �; �
( ) ( ) N o �
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Primary Structure Ac ssory Building ^ , Addition N � o
( ) Dwelling (,�Garage-attache /cietached ( ) Deck � �
( ) Year round (y}# of car stalls ( ) Porch — �
( ) Seasonal ( ) Storage Building ( ) Enclosed � �
O Frame built on site O Screenhouse O Living room �� �,
O Modular/manufactured O Greenhouse O Kitchen a O r`
( ) Mobile/manufactured ( ) Other ( ) Bedroom �' � �
( ) Other primary structure ( ) ( ) Relocate/enP,arge �� "
( � ( ) ( ) # ofnew c � Z
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AdditionalInformation: � "` �
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T pe of Construction: � �
�Frame (� Log ( ) Pole/metal ( ) Block ( ) Concrete N �
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( ) Other ,.�
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Construction Cost: Primary Structure $ � �
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-Accessory Building: $ 2 STpo o Addition: $ ^ �.
332.��Z /�'"' a� 337�r4B CD
Deed: Vol 3s Pg ►�� Certified Soil Test# �25-Z�� °Q z
CSM: Vol a7 Pg SS Lot# I 76�� Sanitary Permit# �5-277 � �
Plat Envelope �r: �;
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Condo �Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: `�' �
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Previous office approvals/actions: ,G����
Variance: # LUP: # olo-Ug2_ SP: � CUP: #
Inspection Report: # Change of Zone ]�istrict:
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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 . GRRn�� #2• Hv�st #3. #4.
Size 3� ft. wide _�� ft. wide ft. wide ft. wide
'�_ ft. long '3� ft. long ft. long ft. long
Floor area Zn sq. ft. �'3Zo sq. ft. sq. ft. sq. ft. ;
Hgt. from gradeZ� '- o`� to peak "2..6�-U ft. hgt. ft. hgt. ft. hgt.
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Stories I �2 Z.. stories stories stories
# of bedrooms 4
Rear Lot Line
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Fire Number and Name of Road �� ]aD9S (U �,,,,� �\v�:r ����
1 . Enter lot dimensions and indicate north by arrow. �
Sigfiature of �n�� �thorized Agent:
2. Indicate the location and size of the requested construction ,����
Signatur
activities. �� � ��'O� L-�
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 �aws and rec,ulations of the State of Wisconsin, and if
centerline of the road. a�t��9 as oW�er�s� a��e�c, 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: $��
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Issue Date Signature of Issuing Agent
Dc�.fr�V�a,v , 3o Zer�9 50% Rule: Average Roz�d Setback:
Expiration Date
Office Comments: (.(�w'�"..Q�,...� S��GO C�O J �L��� (9'�t � Cc��
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PAULA CHISSER
SAWYER COUNTY, WZ
REGZSTER OF DEEDS
330792
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RECORDING FEE 13.00
eages 2
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