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006-440-09-5511-LUP-2004-187
Application for Land Use Permit o 0 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. � NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. � PRINT-USE BLACK INK OR PENCIL FR�'J � ��1 T l�i y� � �� Ow/ner g�sL� Builder °� � 7 r� � o. Mailing Address C � Mailing Address � � � �X�`��J� � , wAy � � City,State,Zip City,State,Zip � � / o ,t./I'7� ���J�Gvl_ � '+� „ , �Daytime P_,jione � � r, �, ��4/Daytime Phone � ��5 �-�����o �� ��� R � �' � Additional Information: Zone District� ` f � � Lot Size ���� �, rl _ � � Date lot was created Acres ���� ls the property in a Shoreland District%(within i OGO'of a lake or pond,withiu.iOC'uf a river, creek or stream) If yes,how far from the shoreline&water name: A/✓ I Is there wetland near the proposed structure?If yes,how far /✓� o � � ' �- Building Land Use '� �'�-.\ �New ( )Filling � Floodplain:( )Yes (�)No # :; � ( )Addition ( )Dredging � L� � ( )Alteration ( )Grading Chippewa Flowage: ( )Yes (�No � ,°<_, ( )Moving On ( ) r" 0 ( ) ( ) Driveway:( )State ( )County ( )Town Rd. � c�Pa�va�'� IUl Pn ary Structure Accessory Building Addition 1�/�Dwelling �,Garage-attached/detached ( )Deck � (�Yeaz round O#of caz stalls O Porch 1 O Seasonal O Storage Building O Enclosed G�i O Frame built on site O Screenhouse O Living room p' (�Vlodular/manufactured ( )Greenhouse ( )Kitchen � ( )Mobile/manufactured ( )Other ( )Bedroom '�� ( )Other primary structure ( ) ( )Relocate/enlarge (?, ( ) ( ) ( )#of new \ > ^J�, � Additional Information: �1 r�,�!f��' 7��-�� lY ` � � ° �� � � � � c � �. Typ ofConstruction `,� (,,1 x� � _�rame ( )Log ( )Pole/metal �Block �oncrete ��,� � �:o�� � �Other /=0c1r'C�� /�1�9/6-.N ��� Construction Cost:Primary Stmcture$ �,'J� ' _ � � ` I Accessory Building:S Addition:$ Z �p 7y Vol %1�� Pg r// of Deed Certified Soil Test# �/����� 9 ry p r CSM Vol'��P�jC%��L,ot#"�� Sanitary Permit# � ��II� Plat Envelope Fk S 979 Or: � Condo Vol Pg Yeaz Installed Aff of ex septic Vol Pg Owner When Installed: Gard Gazebo Vol Pg Previous Variance: LUP: Inspection Date: �'�OIDN l�'\ — 1{(�� 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����,�Lgp #3. C�corn-�'�` #4. Size��ft.wide �_� ft.widY.'' �ft.wide ft.wide _��_ft.long o14 ft.long Z"1 ft.long ft.long , Floor azea �Z9 sq.ft. o� sq.ft. �sq.ft. sq.ft. Hgt.from gade � to peak ft.hgt. ft.hgt. ft.hgt. Stories�_ stories stories stories #of bedrooms� ______ ____ _ �D,yO/Lot Line or Lake/River name: � . ����� �xS' �N---�—�;� \. i�C.�� n .! YD n.�I,r�0 '� II i 2 � i �� � ;\ �,'�y' ' � ��.oL/ I I �a����- /jr� -- I . � d I'�'---P m� � �� �� �,� � �. � ' W;�`' cs� � � '�'ti<n _.,, �$�`� � � �� � � —�5 � -I`l� - I ` S� �, a �e� ; _ � , ��� __ _--_ _ �d-�� F" �' �'� w� - Fire Number and Name of Road ��/���✓/� �/1�j ���1�� �59 a x.�ic 1.Fill in lot dimensions and indicate north by anow.�- � �F� Signature of Owner or Authorized Agent: 2.Indicate location and size of existing and new structures��X�'/$ l 3.Indicate location of well,septic tank,drainfield. %�������`-"`U i 4.Indicate distance to existing structures,lot lines,septic system. `�L��j c fk� 5.Indicate distance to the ordinary high-water mark of any lake, `/"-" 1 �L ��LiIC-r pond,river,stream,creek,and name the body of water.�'��?�� PnnlName:i��Cr���ry�'z�E rq /�•K `� � The above certifies ihat the listed in�fohnaGon and intentions are 6.Indicate any grading or clearing in excess of the construction site e and wrrea.Tne a�o�e Persor,�s nereby 9rve Perm�s5�o�ror ccess to the property foronsite inspeclion. 7.Indicate distance to any wetland. �/�����j;��JuG%r��i Permit Fee:����Y,�6 May 14, 2004 m,f'��1� (�.L��`�C./ � �C�(.r�iJ ��- Issue Date Signature of Issui g A nt May 14, 2005 Expiration Date Office Comments:'��'�`P� C����-� ����0� � . Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries: Restrictions and other information: �_�S_��� ���� S'�`%�y���'r-2, �(/QJ l�i, �Gb sz-l-� - �,� s� �a x �4 � � ��gl ds . 1 � �, �. ��-�-� �-- - ;-� ., I . � ,.r 1 � ��`a f � Y ,� , � .. . . . .� . . . . r -.i � i � ,. . . .. ... . . . . _ .. .. . . _ ..� . . � . s r ��.Q?. �_ � � , � .. L y..N. ��i 4.� us. ,wc..♦ ' . � .. �� ��'� � � � i� � ���, � � � \,�� � '^ t� r.y�^+ n �h �..._ / , � � �.a.a'' . �,sc► . �:����t��.,da� �,t��,�* . �`++�'��i?: . n . - ;\- __ r�F !, , '� ��, �\ \ . ./^_ ...'r. . / � ' � . . . 1 1, ��.. 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