HomeMy WebLinkAbout002-940-05-1115-LUP-2004-664 �-
Application for Land Use Permit(*Non-shoreland*) o 0
County of Sawyer �
PO Box 676 -Hayward WI 54843 �1
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 �� 1
the property's boundaries. , �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN[SSUED. r.
PRINT-USE BLACK INK OR PENCIL
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ST�IIE 5 W0 t30.A9 /1'1AC [v�'J�Ti�'ieC,����nr,Cr�a�n��� �, �
Owner Builder ��
Nz��3 W���Wvo.n R D �.l ql� !�j�8 AI/� °� �
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Mailing Address Mailing Address O
SAK.onlq� r,1J I ���7D �ic�r �1KE� Wl �48��K �
City,State,Zip City,State,Zip � ,,1
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?l5-73i�- 3bDD 715- Z3N-�I"73 � �
Daytime Phone Daytime Phone "'
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Additional Information: Zone District: �—� �
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Lot Dimensions: j�� X, Z-3� �
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Date lot was created: / ( 7 j I�7� Acres: /. n
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Is there wefland near the proposed structure?If yes,how faz N J G
Building Land Use Floodptain:� )Yes O(j No :° �"'
(}�New ( )Filling '�
O Addition O Dredging Driveway access off of a(Check one): �;
O Alteration O Grading (2()Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy N �
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Primary Structure Accessory Building Addition .'�'o °
(1O Dwelling (�)Garage-attached/detached (X)Deck W
(�Q Year round (2)#of caz stalls O Porch �
( )Seasonai ( )Storage Building ( )Enclosed :»
(jO Frame built on site O Screenhouse O Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other ( )Bedroom v
( )Other primazy structure ( ) ( )Relocate/eniarge �
( � ( ) ( )#of new � �?
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Additional Information: >
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Type of Construction: �
�O Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � ��
( )Other
-o �Construction Cost:Primary Structure$ �J��OP� �
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Accessory Building:$ Z C i � Addition:$ � � ��� � �
#31b�,� Ua:il �xk�:cix �i��:,,,«-- CD �
Deed:Vol Pg Certified Soil Test#��-}-�}5 U °O z
CSM:Vol��Pg(a 1-(aa Lot# 1 Sanitary Permit# �J y "`��S � %n
Plat Envelope �d-Ily� Or: ^, �
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Condo Vol Pg Year Installed: '�r� c,
Aff of ex septic Vol Pg Owner When Installed:
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Previous office approvals/actions: �
Variance:# LUP:# SP:# CUP:# �
Inspection Report:# Change of Zone District: , j
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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.DWCZLI�!I6 #2.�_^A (���ifk:�-ft7� #3. �� #4. .
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Size Z�3 ft. wide �f`t. wide �_ft. wide ft. wide �
,3� ft. long �ft long �ft. long ft. long "
Floor area U� sq. ft. �zy sq. ft. �Yl.� sq. ft. sq. ft.
Hgk from grade �0 � to peak �R • 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 ri..���i��. � r'+ +j� �-r' � � �t`L`_
1. Enter lot dimensions and indicate north by arrow. Sig� of Owne or' utho ize Agent:
2. Indicate the location and size of the requested construction � .� , �
SignaNre
activities. �,,� �
PnntName: %/fZrN� �� S/.LL�SSL/�.
3. Also, 1ndlCate the locatlon and CI15tanCe to tlle Well, The above cediLes that the listed information and intentions are
irue and coved., ihat all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the with the requirements of ihe Sawyer Counry Zoning Ordinance
antl lhe laws and regula�ions of the State of Wisconsin, and if
CCriYCTI1riC Of t110 L03d. acting as ownef(s)agent, has the permission of Ne owner(s)to
peAortn the work requesled on this application. The above
personsls hereby give permission for awess to the property for
^� onsiteinspec6on.
Permit fee: $ /y�(� ' `'"�
November 17 2004 '
Issue Date Signature ofIss 'ng ent
November 17 , 2005 50%Rule: Average Road Setback: _
Expiration Date
Office Comments:
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Regis[er's OEfice � C C � � O � 1
Sawyer Ccunty �' V � �
Receive�(or recwd thg �� .
� day oE
�!J� _--A D I9_3'at/.7.{o'clock
• �/� '-�}:.. ,:�C�.�.: recorded in vol�
ot 1.Fil.����( it'Vfi on Paqe �_�,5�
—� 2�`-�cc 7_'^ ,.-c��
Registet
._.--_.__-------_.....__----'---.--.— --Deputy_..._
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