HomeMy WebLinkAbout030-737-23-5513-LUP-2006-160 Application for Land Use Permit(*Non-shoreland*) o o �,
County of Sawyer �, �,
PO Box 676 -Hayward VVI 54843 O
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 within �
the property's boundaries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL '
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wner ' � Builder �'
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Mailing Address Mailing Address O
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Ci ,State,Zip City,State, ip �
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Daytime Phone Daytime Phone �,�, �—? �� �/���-/
At7dfiional Information: �-� P���b�^� Zone District: f�-� �2{Z,-a
3ipb Yi{c.ar�d4
/(p,. ��7yN g�, �'d �a LotDimensions:
� BXeb.n�, WZ 54Bas_
Date lot was created: J`��` �� Acres: � o
Is there wetland near the proposed structure?If yes,how far �
Building Land Use Floodplain:O Yes (}U No :4
New ( )Filling '�
(�Addition O Dredging Driveway access off of a(Ch�ck one): `D
ti�c
O Alteration O Grading O Private Rd O Town Rd. o
O Moving On O (�County Hwy O State H�nry N �
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Primary Structure Accessory Building Addition � °
4Q Dwelling O Garage-attached/detached (�Deck W
�Year round O#of car stalls O Porch =�� U'
( )Seasonal ( )Storage Building ( )Enclosed :=
0
O Frame built on site O Screenhouse O Living room �
�Modular/manufactured ( )Greenhouse ( )Kitchen '��
Mobile/manufactured ( )Other ( )Bedroom �
( )Other primazy structure (,t) tl"�f' �',y��� ( )Relocate/enlarge \
� � ( ) ( )#of new �
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AdditionalInformation: �eP�qe����.{ �WLll�ny �� '
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Type of Construction: , �;
(�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � �,�
( )Other (� y
Construction Cost:Primary Structure$ �/� /'/)j5 � �
Accessory Building:$
Addition:$ sk u'
Deed:Vo1 ?S"�`' Pg Z�% Certified Soil Test# ��-�'�J` °O z
CSM:Vol�Pg /�l� Lot# �� Sanitary Permit# Q�O '0810 0, �
�+ 7.>3 7
Plat Envelope �r� N �I
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Condo Vol Pg Yeaz Iostalled: cc
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Aff of ex septic Vol Pg Owner When Installed:
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Previous office approvals/actions: �
Vaziance:# LUP:# SP: � CUP:#
Inspection Report:# Change of Zone District: 5/��lj�/„
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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. #2. �,K #3. #4.
Size_��_ft. wide �Z ft. wide ft. wide ft. wide
.�i",�" ft. long Zo ft. long ft. long fr. long
Floor area��{$�_sq. ft. Z Yo sq. ft. sq. ft. sq. ft.
Hgt.from g�ade��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 � C"�L��� (� � ����C. i Lt_ t��.�r��r'��� l�
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1. Enter lot dimensions and indicate north by arrow. $i nature of C>wne�or Authorized Agent:
2. Indicate the location and size of the requested construction - _,�.�t�� c� .
Signature
activities.
Print Name�,
3. Also, 1nC�1CaY8 tlle �ocation and dlStanCe to �le well, The above certifes that the listed intormation and intentions are
true and covect, that all work shall be performed in compliance
� SeptlC tari1C 3Tld dLalnfield, Wetland 2Seas, lot 11nes and to the with the requiremenGs ot the Sawyer County Zoning ordinance
and the laws and regulations of the State of Wisconsin, and if
C0riL0I�lri0 Of t110 T03d. acting as ownel(s) anent,has the permission of the owner(s)to
perform the work 2quested on this application. The above
personsls hereby give. permission for aaess to the pmperty for
onsite inspection.
Permit fee: $ Z��
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Issue Date Signatuce ofIssu g nt
�„ �� Zpo � 50% Rule: Average Road Setback:
Expiration D te �
Office Comments:
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' ` � PAULA CHISSER �
SAWYER COUNTY, WI
REGISTER OF DEEDS
338823
OS/18/2006 8:15 AM
RECORDING FEE 13.00
APEX
Pages Z 6IIAyl]7N(i
1362�1 Rywdlzo�d SLeet,Y201
733�343433 F�A7(;773A34-2739
SAWYER COUNTY CERTIFIED SURVEY
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