HomeMy WebLinkAbout002-106-07-3500-LUP-2004-260 . �
Application for Land Use Permit o o ��
County of Sawyer � �
PO Box 676 -Hayward WI 54843
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agrees that all work �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance (� �
and the laws and regulations of the State of Wisconsin. ��0
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. �
PRINT—USE BLACK INK OR PENCILJ �
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Owner+ ". Builder , �
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Mailing Address Mailing Address I.� O
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City,State,Zip City,SCate,Zip n �
Daytime Phone Daytime Phone
Additional Information: %Cr��f: 'hr�'• Zone District ����" �
�y i�.s-'--^ �,tr,>",,.:: . %��� �
r r� � � -� ��/5�� r Lot Size � �
�, ; �,°� J��*i/'- 'Y' ..���e � ,;_
Date lot was created/ ' ` Acres �o a� �
Is the property in a Shoreland District?(within 1 U00'of a lake or pond,within 300'of a river,
creek or stream) If yes,how far from the shoreline&water name: ,�t�'t
Is there wetland near the proposed structure?If yes,how far --� � �
Building Land Use �"
c.
( )New ( )Filling �� Floodplain:( )Yes (`�No # �
�)Addition ( )Dredging � �
O Alteration O Grading Chippewa Flowage: O Yes �;;j No I ,�<_,
( )ivloving On ( ) r
� � ( � Driveway:( )State ( )County �(�,Town Rd. �
Primary Structure Accessory Building Addition
( )Dwelling ( )Garage-attached/detached ( )Deck
( )Year round ( )#of car stalls- ( )Porch
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site ,fi�:}Screenhouse ,..; �r O Living room �
( )Modular/manufactured " ( )Greenhouse ( )KiYchen
( )Mobile/manufactured �, ( )Other ( )Bedroom
_ ( )Other primary structure ~�)-".. ( )Relocate/enlarge
� ) � ) ', r ( )#ofnew >
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Additional Infortnation:
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Type of Corlstruction �
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�rJ Frame �� ( )Log ( )Pole/metal ( )Block �1 Concrete—��-: � ,_ �
( )Other �
Construction Cost:Primary Structure$
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Accessory Building:$ �`�C�y Additio :$ � Z
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Vol '� �o Pg .-�(v`7 of Deed Certified Soil Test# -
CSM Vol Pg Lot# Sanitary Permit#
Plat Envelope Or: �
Condo Vol Pg Year Installed A�v �n�v
Aff of ex septic Vol Pg Owner When Installed:
�r,;
Gard Gazebo Vol Pg p` i "
PreviousVariance: LUP: InspectionDate:
�y8
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. `�sb-�2-5�`�'w #3. .,Pnn�,�li.�<.�.;-- #4.
Size ft.wide fC.wide f�/ ft.wide ft.wide
ft.long ��'� ft.long i'� ft.long ft.long
Floor area sq.8. �1 `/ sq•ft. i-' sq.ft sq.ft.
Hgt.from gade to peak ft.hgt. _� ft.hgt. ft.hgt.
Stories � stories stories stories
#ofbedrooms
Lot Line or Lake/River name:
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Fire Number and Name of Road
1.Fill in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
2.Indicate location and size of existing and new structures.
3.Indicate location of well,septic tank,drainfield. �
4.Indicate distance to existing structures,lot lines,septic system. � ���� �
5.Indicate distance to the ordinary high-water mark of any lake,
pond,river,stream,creek,and name the body of water. adnt Name:
The above cedifes that the listetl information and intentions are
6.Irid1Cd10 3Il}��aCllrig OT Cle3ririg lri 0XC8S5 Of t�10 COIlStri1Ct10Il SltO. accessloclhe pfopertyfo�onslle�nspeclloneby give permission for
7.Indicate distance to any wetland.
Permit Fee: ��
S�
June 10, 2004 � �r• /'�- ss?�
Issue Date Signature of Issuing Agent
June 10, 2005
Expiration Date
Office Comments: �;rrc,.cdc�� �j r�2I�•rJni;7`'� 12—�CJ-�Gd S�i�.c"�-�_
Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries:
Restrictions and other information:
� 40 I � 97 I
2 39 2 39 2 46 2
3 38 3 38 3 45
3
4 37 4 37 4 44 4
g 36 5 36 5 43 5
6 35 6 35 6 4P 6
7 34 7 34 7 4� 7
8 33 8 33 8 40 8
9 32 9 32 9 39 g
10 31 I 0 31 10 38 . 10
W
II 3 II 30 �� 37 Q ��
I 2 2 9 12 29 �2 36 12
13 28 W 13 W
28 Q 13 35 13
14 27 Q F4 27 14 34 � 14
15 26 15 26 15 33 � 15 ��V
16 25 16 25 16 32 P
17 24 17 pq 17 3� G
IS 23 18 23 18 30
19 22 19 22 l9
29
20 21 Zp 21 20 28 �
LEE STREET 21 27
� 37 � 2 7 22 14
2 36 2 2 6 23 �� �� I 3
3 35 3 2 5 24 �v 12
4 34 4 Z4 25 O�� 11 /
10
5 33 5 23 26 � 9
g 32 6 22 X O 8
7 31 7 21 � 0 �
6
g 30 8 20
5
9 29 � 9 19 q
10 28 � 10 18 3
Il 2T II �7 2
1^� 26 12 �s �
�g 25 13
� I
14 24 14 OJQ� � 18
15 23 IS � 17
16
16 22 ��
I ? 21 G 14
16 20 v I3
12
19 II
ib
8 9
6 7
5
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