HomeMy WebLinkAbout032-540-16-4404-LUP-2008-077 Application for Land Use Permit:(*Non-shoreland^`) o o ,/
County of Sawyer � �
PO Box 676 -Hayward WI 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 within � �
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL r I
I��NNrS L F��l�l�2 .��. /�i�t/�h�p � �
Owner Bui� er N'
���i�r �3 �E,P�.,4�c R���� �ss�9 L��e��, .p �� �
Mailing Address Mazli�ig Address O
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City,State,Zip City,State,Zip
�/S��,Z66-zG 65 �7L� - �`f' 7-- /a` ::`6
Daytime Phone Daytime Phone ro-
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Additional Information: Zone District: 2R'I �.
Lot Dimensions:
Date lot was created: Acres: /� n
0
Is there wetland near the proposed structure?If yes,how faz��(D �
Building Land Use Floodplain:O Yes �f No :° �/'
�f New ( )Filling L^. '�
O Addition O Dredging Driveway access off of a(Check one): s �
O Alteration O Grading O Piivate Rd O Town Rd. p o
O Moving On O O County Hwy O State Hwy N N �
� ) � ) N o �
Primazy Structure Accessory Building Addition S � ,°_�.
( )Dwelling (�Garage-attached/detached ( )Deck � "'
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( )Year round ( )#of caz stalls ( )Porch � .-.
( )Seasonal ( )Storage Building ( )Enclosed � �
( )Frame built on site ( )Screenhouse ( )Living room �� (/�
( )Modular/manufactured ( )Greenhouse ( )Kitchen � C �'
( )Mobile/manufactured ( )Other ( )Bedroom � "'� \
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( )Other primazy structure ( ) ( )Relocate/enlazge � � '
( ) ( ) ( )#ofnew � � �
AdditionalInformation: i �
I Ar
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Ty e of Construction: �
�Fr�rne ( )Log ( )Pole/metal ( )Block ( )Concrete �
�
( )Oth�r
ro �Construction Cost:Primary Structure$ �
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Accessory Building:$ �� �'�C�C Addition:$ � �
�ft�6�v � �.
Deed:Vol_ 7/(p Pg 3E L Certified Soil Test#�-//y p�/-157 °O �'
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CSM:Vol_ Pg Lot# SanitaryPermit# �]2_2ti7 OY-l78 �, �
Plat Envelope Or: ^,
Condo Vol Pg Year Installed: � �
A,`f of ex septio Vol Pg Owner When Installed: � �
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Previous office at�provals/actions: �
0`l• 'l{� �
Varianc�:,�.' LLJP:n�-�(� SP:#_ CUP:#
Insp�c,ion Report:Y__ Chaaoe oi�o:e l�istr;ct:_ _____ �\q\�;
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3CG�r/
Describe the construction using these colum,_.L,ist the dimensions cf e�ch structure in a separate
column.List each story,each addition,each alteration in a sr:parate colum:.
#1. #2. #3. #4.
Size.�2�ft.wide ft.wide ft.wide fr.wide
�/�ft.long ft.long fr.long ft.long
Floor area 5/�v sq.ft. sq.ft. sq.ft. sq.ft.
Hgt from giade 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 ��I! J�f �F���c,�' �c kv 2�c.c1
1. Enter lot dimensions and indicate north by arrow. Sigr�ature of Ow r o u o'ze Agent:
2. Indicate the location and size of the requested construction �J,v�„�y,�,,��� ,�-t
SignaNre
activities.
PnntName:
3. A�So,indlC2te tlle loCatlon and d1StanCe to the Well, The above certifies that the listed information and intentions are
We and cortect.,that all work shall be performed in cromplianc�
Sept1C tank and dralTlfie�d,wetland aze3s,lot lines and to the with the requirements ot the Sawyer Counry Zoning ordinance
and ihe laws and rec�ulations of 1he State of Wisconsin,antl it
CCritC111riC Of th0 IOad. acting as owner(s)agent,has the permasion of the owner(s)to
perform the work requested on this application. The aM�ve
personsls hereby give permission for access to the property for
onsite inspec6on.
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Permit fee:$ 7,5'
��, 9, zao a �
Issue Date Signature ofIssu g A t
i'///,9 ze�9 50%Rule: Average Road Setback: _
Expirat o�ate
Office Comments:
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