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026-939-22-5713-LUP-2006-293
_ ,_ - � Application for Land Use Permit (*Slloreland*) o o � . � r County of Savv��er � � � � �� PO Box <76 - Hayward VII 54843 715/634-8288 *Property that is located within�300' of a creek, river or stream or within 1000' oi,a �, flowage, lake or pond or has any of the above waterbodies located within � � the property's boundaries. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � PRINT-USE BLACK INK OR PENCIL � , ri¢�, L L C'_ _ 1,�1 S G�- G�/�'-c�-c,c�-', .,�,.+/;_ � Owner Buildf;r Q- p� / lv / �U i lo / �. o� Mailing Address Mailir�g Address � O �T� �� ��,c:� , C��' _ss���;� �a�� ti-�'-/� 1 l�J,� �y��� � City, State, Zip City, �State, Zip � ���- ��y- z�s��- �,5-- � 3 y.�y�t� Daytime Phone Daytirne Phone � � Additional Information: Zone District: ��l � Lot D:imensions: �a/�X �.j�' X g 3 � � Date lot was created: �Z��`� � Acres: �� �Z Is there wetland near the proposed structure? If yes, how far o Building Land Use � Floodplain: O Yes (h) No-55�q% 6.==�, -% � (�New O Filling Chippewa Flowage: O Yes (�') No � O Addition O Dredging Driveway access off of a(Check one;): � ( ) Alteration ( ) Grading �) Private Rd ( ) Town Rd. � ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy �" � ) � ) � o ci� r Primary Structure Accessory Building Addition o 0 (}�) Dwelling (Xj Garage-attached/d tacl ea (X) Deck � � (f� Year round (3) # of car stalls (� Porch W ( ) Seasonal ( ) Storage Building (sZj Enclosed � � OO Fran1e built on site O Screenhouse O Living room � ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � ( ) Mobile/manufactured ( ) Other ( ) Bedroom � .- ( ) Other primary structure ( ) __ __ ( ) Relocate/enlarge � � � ( ) ( ) # of new � _ i � AdditionalInf�rmation: �y /0�2��0� �-''��` � �� � � � � , � � Type of Construction: �, � (� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete r e� ( ) Other _ � �1 � Construction Cost: Primary Structure $ %�o.. a v c `'` ,.� � Accessory Building: $ Ac�dition: $ � � xt 3z�io�o � : r- �- � Deed: Vol Pg Certified Soil Test#__E;._��� - , ,_ � Z - -- - "° 7� CSM: Vol .2� _Pg23� -Z3`7t..ot#�_ Sanitary Permit# � � � Plat Envelope ��v� �N�P��i3v Or: ~ � � Condo Vol Pg Year Installed:_ N �, � "Loads and Flows": Vol Pg Owner When Installed: � � " os Previous office approvals/actions: a 0 Variance: # LUP:# SP: ;� CUP: # �J� Inspection Report: # Change of Zone ]�istrict: � ��Z 7���;% ��,};�.� ,��� Describe the construction using these columns. List the dimensions of each structure in a separate , . column. List each story, each addition, each alteration in a separate column. ,- #1 . N1=w �•�-.»€ #2. o��v o�u� ,cr,�r #3. ��,':=LcS�T� P^r�� #4. ���/i��� ��,. Size Zg ft. wide �_ ft. wide ��Y >�:� ft. wide � � ft. wide r �f`/ ft. long �4r ft. long � 'y" ft. long �_ ft. long Floor area / � 32 sq. ft. Z� sq. ft. 5� 3� sq. ft. 9�`' � sq. ft. Hgt. from grade Z� to peak � ft. hgt. � � ft. hgt. .� 2 ft. hgt. `�1- / stories / ���- stories Stories / > stories / # of bedrooms �_ Gr�h .t-z. �i s%3 C�-ff�e ' �; ��' ? '� a ��/Pond/Flowa e/River/Stream (Name) , � � �-.. ,3b � DP� �• b�4� ' �..�� � ,3 ,, ''! � � �--_.__._�_. �, \ �`� � ����'O 4 \ � �t�� �. . . o`` � - - - - - --- ��' � % y " � � ; �� ! �F f � ----- �3��/ I � 5 �° � � L „ 35z �� �i L� rn ���` ��g � r-'�\ �i a a �� ,-� Y � ' \\ - » ' �M (�'`� ,�o � s p � �e�„��' � � ' �-�o` \ -___. ___---� , �. ` � Fire Number and Name of Road ���,- , : � � � r i3;•�/ �'_.9-✓� ���U l� , 1 . Enter lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent: 2. Indicate the location and size of the requested construction �y���l �..�.�ct'L,�..� Signature activities. � ) -' PrintName: ��vBN �/�/C'�dS�/'�Zt /�1 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 perfortned in compliance septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if � acting as owner(s) aqent, has the permission of the owner(s) to centerline of the road and waterbodies. N perform the work requested on this application. The above persons/s hereby givE: permission for access to the propeRy for onsite inspection. Permit fee: $�,� ;, ��/G1� � �U� �yZs-`��' �'/ Total land area within 300' of the waterbod A ;'��� Y� � ) _. �, Total impervious surface area [including this project] (B) � � �=t� � G � (B) / (A) x 100 = % Useu `�-=' : _ (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Req�nired? O Yes O No �I �C�O C�% ` _ Issue te Signature of Issuing Agent �r , n � ,� � L� , �(�Q � 50% Rule: Average Road Setback: E p�on Date � Office Comments: . �. -SEC . 2 2 TWP 39 N . R. 9 W �� . CSM 7090 �v�� t � `! y �, �/ - � � _ _. .__ _-_ � y � 2 t , .5 : O. 5.3 . 5.4 /� .7.2 � .�,t1� , 6 . 7. 7 2 �; :7. 8 � , � / - ,^� g •� � • 9 � . 5.2 j � 7 .I. 10 - :7:1i�. � 6. I �� ? � .12 ' 5. 5 � '� �6. 8 � , ;�, �`� :7 .i3 WHITEFISH - �� v � 1 ' � �7 ,14 � _� ��23 �.zb : 7.i5 LAKE , 7.21 � 7_2 1 . ;7. l6 .� � 6.3 y.- � 7.3 �6.2 � 5 . I `. �6.4 � � �7.4 � �S 7. 5� �6.6 f � �` �' � � �7.6 � . 2 5.7 � 4 � - ��. 6 � �8.20 � . d �s.I ` 6. 5 � 5.9 �5. 8 � �� 3 �0� �a i :82 2 :8' � 5.1 ( � 5. 5 �a`� :8.i � �5.10 �5.19 O � � 8.3 = � � U � 6.7 � 5.12 y � : 5.4 � :e�°` ��� \ ..$?� F OL I F� ' 8.� 3 �8.7 `" • SAND � 5.14 �5.1 � � 2 ,,2 , ^ y .8. 11 � O � 8.5 � LAKE �5.1 -` � 5•3 UPPER 8�12, � ,Z :s.4 � 5.16 HOLLY ��.13 = � / �8.10 � 5 .2 y � 5. 1 . � .6� �5. 1 -� � LAKE \ �8.22 � .6 .�� �a.�5 :d-� 1 _ � � . 1 �� � : ' 1 . CERTIFIED SURVEY MAP Q�r�ok Govcrn�ae,�tk 10�7 5uk�.on 2z-'(39A•K�W 'Cown of�r►n3�, haw��r Caunkr WiSwHsivt ��lo '1� f l:s� . . �-� _#, E �£ ��� c ���� ssz �� � -� T T�� �£�m�It �6 �'� �� — st:i�E.,. I I 7,� N,r• i` S�R � �� ts.es I '14r' 1'�l..e' --�1 � 1 � se...� »� —,, � 3 Z �� "" W�o� ' e �� o � — _ � r� � � � �'� ��- � � � � �� �� �� �s � `aauwyuni���� � �" I ��> a�1�,.._.._..,. v'�''�'s�£ f = cJa �02� nrns ..-��s C 3 �_�O� �a _ �-.��' ;'�"t ��oa rtn� y �r ?��p'".-�.__. .,...�^f?+ � I - �' y4 �� �r / z �p�pnnnn�uaa`��`" i�� w �zm � � � ti`xw i � ���' ' -{ � m a� '�3 � �� � ,���-" s � i � � F� / \ � �,r � � � � l ..�F,,%, / � / �,w � —�— f "�.��:,�, ��. ��I� I �,� � : I ij-E •e�'.� / 4.,v�r PAULA CHISSER fy �.� '�'� �r SAWYER C011NTY� WI (� � REGISTER OF DEEDS F. \.> e e_ 327604 � �c� .:.:�. 12/28/2009 9:00 AM \ _�1. 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