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HomeMy WebLinkAbout026-188-14-0500-LUP-2008-046 • r Application for Land Use Permit: (*Non-shorelancl*) r y �. � County of Saw�✓er � � � . � PO Box 676 - Hayward �VI 54843 . 715/63�-8285 ;� ��Property that is tiot located within 300' of a creek, river or stream or within 1000' of a - �J1 � flowage, lake or pond or does not have any of the above waterbodies located within the property's bounda.ries. a CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE��UIRED PERMITS HAVE BEEN ISSUED. � PRINT-USE BLACK INK OR PENCIL � , �.��- � .��.:�f� � .�1ti1� � Owner Build��r �� ��� � I�� � �� � �. Mailing Address , Maili�ig Address p ��`f� L��- �:.� ��LI� ,•� ���1S�h � City, State, Zip City, State, Zip � � � `7/S--��S" Zll� �58 - �-1�S � `'' c� Daytime Phone Daytime Phone —� � v� `1 Additional Information: Zone District: ��� � R ,� '� �a �o Lot Dimensions: � Date lot was created: Acres: � �'�` o .�there wetland near the proposed structure? If yes, how far �� Building Land Use Floodplain: O Yes (�)No � � �New ( ) Filling �^ O Addition O Dredging Driveway access off of a(Check onf.): �,�, O Alteration O Grading O Pi�ivate Rd �Town Rd. � o ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � N � � ) _ � ) � o � ^ � ; Primary Structure ticce5sort D'u`i�`��:�b Addition � � � ( ) Dwelling ( ) Garage-attached/�ietached ( ) Deck � �; � ( ) Year round ( ) # of car stalls ( ) Porch N� I ( ) Seasonal ) Storage Building ( ) Enclosed �� �° ( ) Frame built on site ( Screenhouse ( ) Living room ,�� � Modular/manufactured ( ) Greenhouse ( ) Kitchen '� � ( ) Mobile/manufactured ( ) Other ( ) Bedroom o�c � \ ( ) Other priznary structure ( ) ( ) Relocate/en�.arge o� � `� A ( ) ( ) ( ) # ofnew � � d � AdditionalInformation: � , A s � � � 8b " Type of Construction: ( ) Frame ( ) Log (�l Pole/metal ( ) Block ( ) Concrete � ( ) Other b � Construction i ost: Primary Structure $ � � c� Accessory Builciing: $ /� /�(�C'' A��dition: $ � W 3 y q y�3 a,,,d � Deed: Vol P (o � Certified Soil Test# °Q 5�l 8-.— g � — z CSM: Vol Pg Lot# Sanitary Permit#_ _ � 7� Plat Envelope Or: �; _^ � , �.n '�l Condo Vol _Pg Year Installed:�Y t1 1 r,� l�)ex���i c� Aff of ex septic Vol Pg Owner When Installed: `�� � � � � ----�---- � Previous office approvals/actions: � Varian�e: # -Qp LUP: # SP: �_ CUP: # C� — � '`` Inspectio�� Report: # Change of Zone llistrict: � - -� ��.`t J � � � 2,?z3Z �_ ' \� �P���•it�e the construction using these columns. List the dimensions of each structure in a separate - cola..m�n. List each story, each addition, each alteration in a separate column. ,#1. � �,�,� C-,Ra..�c-»t #2. �na sE #3. not� ,BAj:�1 #4. Si�:e aD ft. wide r'. k,,r '�" ft. wide f�r w�� .�D ft. wide ft. wide y �0 fi. long `'� �_�_ft. long �ft. long ft. long :i�loor area OD sq. ft. /��D sq. ft. �SDO sq. ft. sq. ft. Hgt.from�rade ;0'��''`, to peak / (o' ft. hgt. �3 ft. hgt. ft. hgt. Stories � 1 stories / stories stories t# of bedrooms —d --� �, Rear Lot Line �, 1�� �t � .C� .. ` 5� �-�, a° ,_".. �— r s' "d'/ _ _____.._.� `_ � � �d i fl 7'�v'' — ' 9�� � � s , ro� !� � � � N N -ry � � _ _ � _____��� N�t2.�W � ��, �„ _-� � ���t U�, � - . � ;��r�t� '�/Z __ ! �...y _� �_,.,r, Fire Number and Name of Road �QuS� /��;�N /3f 5T. c��+. 1. Enter lot dimensions and indicate north by arrow. Signatu e of w r r Authorized Agent: 2. Indicate the location and size of the requested construction Signature activities. Print Name: 3. A1S0, indicate the location and distance to the well, The above certifies that th 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��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 . personsls hereby give� permission for access to the property for onsite inspection. Permit fee: $ ��C� ,�.t" � D� " �-- Issue Date Signature of Iss in ent Q 50% Rule: _ Average Road Setback: _ Expiration te Office Comments: . 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