HomeMy WebLinkAbout006-440-30-2101-LUP-2004-548 Application for Land Use Permit(*Non-shoreland*) o o ,,,_
County of Sawyer �, �
PO Box 676 -Hayward WI 54843
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 �
the property's boundaries.
CONST/R�UCTION SHALL NOT BEGIIV UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ,
�lnn �k�l�- PRINT-USE BLACK INK OR PENCIL �
�� �
`--/�'���.c! �,�/e:�� �'�s'C/r �
Owner - � Builder �' �
�/�c���_.�l/'2 N C,,�l�✓�2,� �:
�ailing Address Mailing Address O �
!�C�� ; �a ���`�'� �
City,State,Zip City,State,Zip _��
�/� " :��� - �/�S�
Daytime Phone Daytime Phone -
�
�s
Additional Information: Zone Disnict: �-1 �
Lot Dimensions: ��
Date lot was created: Acres: ��C� o >'
n
Is there wetland near the proposed structure?If yes,how faz �
Building Land Use Floodptain-( )Yes O No fD
( )New ( )Filling � �
Addition Dred in Drivewa access off of a Check one `D �
�l � ) B B Y � )� dc
O Alteration O Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy „"', �
� ) � ) o S
t�
Primary Structure Accessory Building Addition � °
�Dwelling ( )Garage-attached/detached ( )Deck W
O Year round O#of car stalls J�Porch .'=
( )Seasonal ( )Storage Building ( )Enclosed �.
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �,
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlarge � �
( � ( ) ( )#ofnew �
�_.
Additional Information: ;
J �
rn
�
0
Type of Construction: n� �
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �. �
n �_,
( )Other �'
.� ~�
Construction Cost:Primary Structure$ � �
m
Accessory Building:$ Addition:$ / /D c� o l; � T
� �
t�, ��•c� Ga
Deed:Vol -�.3.i Pg '-5 7� Certified Soil Test# [Z �ZJ z
csM:vol rg Lot# s�t�re��t# 9_5 -�� `r �, �
Plat Envelope Or: �,
Condo Vol Pg Yeaz Installed: � �
� �
Aff of ex septic Vol Pg Owner When Installed:
Previous office approvals/actions: ��_ 3c,� �
Variance:# LUP:# �;�� ,���.� SP:# CUP:# �
Inspection Report:# Change of Zone District:
�/�%�O�/
C�\
�yia
Describe the construction using these columns. List the dimensions of each structure in a separate
col List eacl�sto each addition, each alteration in a separate column. �
#1. T � �a � �i� #2. #3. #4.
Size_(� ' ft. wide ft. wide ft. wide ft. wide
,�G � ft. long ft. long ft. long fr. long
Floor area i,�v sq. ft. sq. ft. s4� ft• 59� fr•
Hgt.from grade to peak ft. hgt. fr. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms
Rear Lot Line
,
✓ ' ��L�
W�,15��
� "a/.�{�-.�� �T 1��� '�l
, �
S
,,,>,r r����-�
\ � � �n
y �
, ,aoo �
�� c �n� I�;] /n/
�'��
� .
:
�
- o�j _ ' -- -
_ � _ �� �i=?n,���;� �r#- �J
�, � � � ,. :
�
,
Fire Number and Name of Road �/�{v � �, , �'L�c��'c � �
1. Enter lot dimensions and indicate north by arrow. Si ati re of Owner or A�tfyerized�gent:
2. Indicate the location and size of the requested construction iti � _
Signature
activities. � _- I �
Name: �_ /K��'L--f�i,F b ✓/C°f�
3. Also, indlcate the location and distance to the well, The above certities that the listed infortnation and imentions are
true and corred.,thal aIl work shall be pedormed in wmpliance
septic tank and drainfield, wetland azeas, lot lines and to the with the requirements of the Sawyer County Zoning Ord'nance
and the laws and regulations of the Sfate of Wisconsin, and if
COritBillriB Of Y.I1C IO2d. acting as ownef(s)agent,has the permission of the owner(s)to
perform the work 2quested on this application. The above
personsls hereby give permission for atcess to ihe property for
onsite inspection.
Permit fee: $
September 30, 2004 � _ 7'�
Issue Date Signature ofIssu g ent
September 30, 2005
50% Rule: Average Road Setback: _
Expiration Date
Office Comments:
TOWN � F� = �
:
S EC. 30 T W P 40 N.
�9� ��
�
�
�
�
�
�
�
f
I
�
I
�
40 .40
0
� :A �� ,-�
�6.f � �5.1
;
�
�
i I
�
�
�
�
40 ; 40
o' � �
o'
rn ; ��
7. � � 'g.l
�
�
I
i
�
�
;
�
,.-- ;
, '
� 5 , __ - --- - -
-�--
�_ i � �
�
I
40. � 40. ,
� � � �. � �
/p. i .I �
i
i �i
�
� -% � f
,' ;
� �
;
� � �
I
\ �
�
_ ____ � ��_-�_ ------{--- -- -
I
�i. ,4 0 I
-J o ' I
_� 'I l.
,
� �
�
� o��- 40,
� � �
�"•i i �" t"•,� �'