HomeMy WebLinkAbout002-106-01-0200-LUP-2004-201 r
Application for Land Use Permit(*Non-shoreland*) o o .
County of Sawyer � � � ' �
PO Box 676 -Haywazd WI 54843 � �
715/634-8288 / , O
*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 boundazies. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. "
PRINT-USE BLACK INK OR PENCIL � 1
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Owner Builder �'
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Mailing Addr Mailing Address O�
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City,State,Zip City,State,Zi
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Daytime Phone � Daytime one �1
Additional Information: Zone District: C'� �
Lot Dimensions: � �
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Date lot was created:��.A Acres: �� � hc • �'�*3 7 �
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Is there wetland near the proposed structurefi If yes,how faz Y�� �
Building Land Use Floodptain:� j Yes (�No'�,
( )New ( )Filling �
'�Addition O Dredging Driveway access off of a(Check one): `D
ao
O Alteration O Grading O Private Rd Town Rd.
( )Moving On ( ) ( )County Hwy )State Hwy "°
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�%n �
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Primary Structure Accessory Building Addition �� °
(�Q Dwelling ( )Garage-attached/detached ( )Deck W
(j�Yeaz round O#of caz stalls O Porch �
O Seasonal OQ Storage Building O Enclosed �
O Frame built on site O Screenhouse O Living room
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge �
( � ( ) ( )#of new �;
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Additional Information: „
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Type of Construction: v
( )Frame ( )Log �Pole/metal ( )Block ( )Concrete �
( )Other �
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Consriuction Cost:Primary Structure$ 1 �
. �
Accessory Building:$ Addition:$ � �
c�e. ��5fi5r> � C�
Deed:Vol (c.�� Pg�� Certified Soil Test# �%�2—�(c;� `1:,7/$'�'•° Z
CSM:Vol Pg Lot# Sanitary Permit# ��l -/f'I o, �
Plat Envelope Or: N �
Condo Vol Pg Yeaz Installed: �
o �
Aff of ex septic Vol Pg Owner When Installed:
Previous office approvals/actions:
Variance:# LUP:# SP:# CUP:# 1
Inspection Report:# Change of Zone District: ('�j � ,{I.���o�n
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Describe the construction using these columns.List the dimensions of each structure in a separate
column.List each story,each addition,each alteration in a separate column.
#1. #2. #3. #4.
Size � ft.wide ft.wide ft.wide ft.wide � �
��,�� ( ,`ft.long fr.long ft.long ft.long
{i —��
�i� Floor azea��sq.fr. sq.ft. sq.ft. sq.fr.
Hgt from giade�to pealc ft.hgt. ft.hgt. ft.hgt.
Stories � stories stories stories '
#of bedrooms ,.� ,,�
�. ��
� Rear Lot Line
� ��„ ��.s.� �1����g��u 4u�;J�_ �,�-sja�'/o`I
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Fire Number and Name of Road �•
1. Enter lot dimensions and indicate north y arrow. S' natu e of Owner�horized Agent:
2. Indicate the location and size of the requested construction
activities. �
Prin Name: � �-���}�E��
3. Also,indicate the location and distance to the well, The above certifies that Me listed infortnation and imenti ns are
true and cortect.,that all work shall be performetl in compliance
Sept1C tank ancl ClTalnfield,wetland areas,lot 11nes ancl to flle with the requirements oi ihe Sawyer County Zoning Ordinance
and Ne laws and regulations of ihe State of Wiscronsin,and if
centerline of the road. acting as ovmer(s)agent has the pennission ot the owner(s)to
perform the work requested on this application. The above
personsls hereby give permission for aaeu to ihe property for
onsite inspedian.
Permit fee:$ ��
May 21, 2004 �-P�,..��/_-���/ ��P �p Jp�� �-
Issue Date Signature of Iss i g A ent
May 21, 2005 0%Rule:�__ Average Ro d Setback:
Expiration Date J�j �/,,�� c�l�o,�2.vwo*;►v�
�n.w�q• —�
,OvO = . 7d�1 .�ao7,0U S.
Office Comments: �'��'� V�'� �3�/oo` _ � _ �4�a o 3
/�$.6o,�/G�Oc3 z 1``'�
c�-Y «
6 5 4 3 2 I 6 5 4 3 2 1 6 5 4 3 2 I 6 5 4
7 44 7 44 7 44 7
8 43 8 43 8 43 8
9 42 9 42 9 42 9
10 41 10 41 10 41 10
I I 40 II 40 II 40 II
12 39 12 39 12 39 12
13 38 13 38 13 3B 13
14 37 14 3 14 37 14
IS 38 15 36 15 36 16
i6 36 16 35 �6 36 16
17 3 IT 34 IT 34 j 17
iB 33 j 18 33 W IB 33 a IB
19 32 al9 32 Q19 32 19
20 31 20 8I 20 31 20
21 30 21 30 21 30 21
22 29 22 29 22 29 22
23 28 23 2$ 23 28 23
24 27 24 27 24 27 24
25 26 25 26 25 26 25
GRANT STREET
i ao i ao i ao �
2 3g 2 39 2 39 2
3 38 3 38 3 38 3
4 37 4 37 4 37 4
y 36 5 36 5 36 5
g 36 6 35 6 35 6
7 34 7 34 7 34 7
g 3.3 8 33 8 33 8
g 32 32 9 32 9
10 31 10 31 10 31 10
�� 30 il 30 II 30 11
12 29 � 12 29 X 12 29 � i2
13 28 � 13 28 � 13 28 a 13
14 27 14 14 27 14
15 26 IS 28 15 26 IS
16 25 IB 2S 16 25 16
17 24 17 24 17 24 17
18 23 18 23 18 23 18
18 22 18 22 19 22 19
20 21 20 21 20 21 20
LINCOLN STREET