HomeMy WebLinkAbout010-941-32-3102-LUP-2006-291 /
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Application for Land Use Permit: (*Non-shoreland*) o o • �
County of Saw�Jer � �
PO Box 676 - Hayward �%VI 54843 � ��
715/634-8288 �Q
*Property that is not located within 300' of a creek, river or streazn or within 1000' of a
flowage, lake or pond or does not have any of the ,�bove waterbodies located within �
the property's bounda.ries. � '�
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED.
PRIN'i'—USE BLACK INK OR PENCIL �
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�V''S,�MG�. �(....k�L. �O!�� L�c.l-�,�'�(.�AL� �L:t�L �.C:�f �_ C�.�
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Owner Build��r �'
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��D.�.�) l�tl. .�IJa�S.���r! �c_�•� r�S�� �, ��irSS�,' �oc��_ �
Mailing Address Mailing Address O
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,.�/r ya�,� tw;.i. 5"`-��'�/3 �� c.�.—�� � _ � c � w��
City, S ate, Zip City,�tate, Zip ►e � �
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�is- ��sy -�v�Z _ `71s-- �r3� S�Z � �
Daytime Phone Daytime Phone � �`,,, �
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Additional Information: Zone District: -1-� `' W j
' � F
Lot Dimensions: �
' r �
Date lot was created: Acres: �1C o .�
Is there wetland near the proposed structure? If yes, how far � r
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Building Land Use I'loodplain: ( j Yes (�)No � �
9
( )New ( ) Filling � �
�'jQ Additio�.i O Dredging Driveway access off of a(Check onf;): �,
O Alteration O Grading O Pr•ivate Rd O Town Rd. o
O Moving On O O County Hwy (Xj State Hwy �� �
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Primary Structure Accessory Building Addition � �
( ) Dwelling ( ) Garage-attachedi:ietar,llea ( ) Deck W
O Year round ( j # of car stalls O Porch �
O Seasonal O Storage Building O Enc�ased �
O Frame built on site O Screenhouse O Living room � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen , c.
( ) Mobile/manufactured ( ) Other ( ) Bedroom
O Other primary structure O O Relocate/en�arge A
� ����� ( ) ( ) # of new �
c.
Additional Information: ` ��� ��G9. �•,� ��t���,�, ��-�-}� c�,.c,1 .�
lJ�l�- G�I�Z .Vi�;�C�i n� t. (.,SCiY��o v,
C� �t1S'G �U�=�� c�c�.� .x� C�T� IXC �--�� � �
Type of Construction: � V'��
( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete S (�
(�(Other 1L�'�� ' �
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Construction Cost: Primary Structure $ c, �
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Accessory Building: $ �,.(1�� A��dition: $ � �
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L1P�ri; Vn� pa ( Prtif P�l Snil Tegt## -�/',3 -LZf ct�
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CSM: Vol Zcllr Pg S��v Lot# Sanitary Permit# �'�3���� o� %`�
Plat Envelope �r� m 6 �`s N
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Condo Vol Pg Year Installed: � �
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Aff of ex septic Vol Pg Owner When Installed: "
q�l-�� I � �
ab-�t6'� N �
Previous office approvals/actions: o�S- (�Q ' —
Variance: # LUP: #q y.-D 6 a Sp; ;# CUP: #
Inspection Report: # Change of Zone]�istrict:
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Describe the construction using these columns. Lis1;the dimensions of each struc:ture in a separate
column. List each story, each addition, each alteration in a separate column.
#l. �;t�P'��rw...�.,. #2. �{(�re �ivy. #3. #4.
Size ft. wide ft. wide ft. wide ft. wide
ft. long ft. long _ ft. long ft. long
Floor area .S�S��t%u sq. ft. ~7i ��U sq. ft. sq. ft. sq. ft.
Hgt.from grade to peak ft. hgt. ft. hg�. ft. hgt.
Stories � / stories stories stories
# of bedrooms
Re�tr Lot Line
p:� /Co�S7� cJ vs f-(w �3
Fire Number and Name of Road �i, �S � '
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1. Enter lot dimensions and indicate north by arrow. Si nature of 0 �J'�r or Authorized A ent:
2. Indicate the location and size of the requested construction g ; �/ir,�-- g
Signature
activities. , /
PrintName: !���(-�'�'—i �' �����/-���
3. Also, indicate the location and distance to the well, The above ceRifies that the listed information and intentions are
true and correct.,that ail work shall be performed in compliance
septic tanlc 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��9 as ow�er�s�aGe�t,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
C�S+�IiIS�:AvtiJ�.
Permit fee: $
-lv—�.�� . � ���
Issue te Signature �f Issuing Agent
�1 G US� �r oZo� � _ 50%Rule: Average Road Setback:
Expi ion Date
Office Comments:
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