HomeMy WebLinkAbout002-940-23-4207-LUP-2004-205 �,�� c�5�.
Application for Land Use Permit(*Non-shoreland*) L
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County of Sawyer y �
PO Box 676 -Haywazd WI 54843 , O
715/634-8288 '
*Prope r t y t ha t is no t l o c a t e d w i t h i n 3 0 0'o f a c r e e k,ri v e r o r s t r e a m o r w i t h i n 1 0 0 0'o f 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 � t
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Owner Y Builder �
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Mailing Address Mailing Address �
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City,State,�ip City,State,Zip ( �
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Daytime Phone Daytime Phone
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Additional Information: Zone District: r �
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Lot Dimensions: i 'c— ! '
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Date lot was created: - ,���- '_ -� Acres: I ;, o
Is there wetland near the proposed structure?If yes,how faz _ �
Building Land Use FloodpYain:� j Yes .(X)No =°
,(Xf New ( )Filling � _
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd Q?j Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy � � �I
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Primary Structure Accessory Building Addition � ° �,,
�Dwelling ( )Gazage-attached/detached ( )Deck W
�XjYeaz round ( )#of caz stalls ( )Porch =
( )Seasonal ( )Storage Building ( )Enclosed � �
O Frame built on site O Screenhouse O Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen `,
( )Mobile/manufactured ( )Other ( )Bedroom � '
( )Other primary structure ( ) ( )Relocate/enlarge '
� � ( � ( )#ofnew �: ����
Additional Information: �� >
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T e of Construction: ".
;(/�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete i.� '+
( )Other ..j
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Construcfion Cost:Primary Shucture$ .`.� 'i .'�� � I�
Accessory Building:$ Addition:$ x�
�t ctc� 3 I 9 3�`� � �� ,
Deed:Vol Pg Certified Soil Test# (>y-�02. tl4 z
CSM:Vol � Pg i ' _,l Lot#�_ Sanitary Permit# �y'� 'J y o, �
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Or: N���l LCC��r. A�nUm�����1
Plat Envelope \ N 4�
Condo Vol Pg Yeaz Installed: o �
Aff of ex septic Vol Pg Owner When Installed: "
Previous office approvals/actions: '
Variance:# LUP:# SP:# CUP:#
Inspection Report:# Change of Zone District:
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Kos��
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 � fr.wide ft.wide ft.wide _�ft.wide
fr.long '-_-, ft.long ft.long 'ft.long
Floor azea�.l sq.ft. �, r sq.fr. sq.ft. sq.ft.
Hgt.from gacie 3'�� to peak y ft.hgt. fr.hgt. '' ft.hgt.
Stories_�' stories stories stories
#of bedrooms �
Rear Lot Line : � �
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Fire Number and Name of Road ���� ' �� u''`- '
1. Enter lot dimensions and indicate north by arrow. Sign o er or thorized Agent:
2. Indicate the location and size of the requested construction
S1 naNre
activities. — —
Print Name:— '� �� ` � � �����-�
3. A1So,indicate the location and distance to the well, The above certifes that the listed intormation and intentions are
frae and conecl.,that all work shall be performed in compliance
Sept1C ta[IIC anCl CITalTlfield,Wetland 2ieas,lot 11nes and to tlle wiN ihe requirements ot the Sawyer County Zoning Ordinance
and the laws and regulations of Ihe State of Wisconsin,antl if
CCrit8L11RC Of tI1C I'08C1. acting as owner(s)agent,has Me pertnission of the owner(s)to
perform ihe work requested on ihis application. The above
personsls hereby give permission for aaess to Ne property for
onsite inspection.
Permit fee:$ � � "
May 24, 2004 G�
Issue Date i nature of Issuing Agent
May 24, 2005 0
0%Rule: Average Road Setback:
Expiration Date
Office Comments:
Town of �{�S�j �_��
County of Sawyet
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Date
SUBJECT: Town Board Consideration of a Special Use Application for the Construction of a Year-
round or Seasonal Dwelling in the Forestry One (F-1) Zone District
TO: Sawyer County Zoning Administration ' �i
P. O. Box 676 ��
Hayward, Wisconsin 54843-0676
Owner: ��.� -1-�Ct�'�l ��Z-�1 YY1G,Yl ' ' , -
Address: ��CC� '�C'��-��-�J ���� i �,�55 �� —
Approval is desired for the construction of the dwelling(s) indicated oo the property owner's
Application for a Special Use Permit. (This application is to be presented to the Town Board for
review.)
By Action of the Town Board, use is: � Approved O Denied O Tabled
Comments: �e Special IIse Permit would not be contrary to the public interest and
vould be in comnliance vith rhr pirir a d inrr t f rh ' g ordinanre aad 6he
Town of Bass Lake Comprehensive Plan (Section 8.10). The Tovn's approval is with the
folloving conditions placed by covenant on the deed.
1) The lot cannot be further subdivided for additional dwellinec_ and
2) The placement of only one single family dwelling on the lot.
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_3) It wou7dhbe det im n al o Proln�+ vildlif rl d
4) It would not create traffic or highway access problems..
/� � /
Cha' i ���
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Supervis � \ �- ! -
Supervisor
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SCALE: I INCH=400 FEET FOR ASSESSMENT USE ONLY NOT
DRAWN BY: DATE : INTENOED TO SHOW CONCLUSIVE
COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS