HomeMy WebLinkAbout008-937-29-3401-LUP-2004-038 Application far Land Use Permit(*Non-shoreland*) o o •
County of Sawyer � �.�_
PO Box 676 -Hayward WI 54843
715/634-8288 O
*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. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ,a `
�{ PRINT-USE BLACK INK OR PENCIL O
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Owner Builder <'
\b 33'-1 �.J S?��1:�, 1-4u.. rZ•� �.
Mailing Address Mailing Address �
�r�\i�.vo� � l� S�-Y�17 .�,
City,State,Zip ' City,State,Zip
s - �-��32
D ytime one Daytime Phone
Additional Information: Zone District: /'T —� '
Lot Dimensions:
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Date lot was created: Acres: o�G'• C� o
Is there wefland near the proposed structure?If yes,how faz � ; :
Building Land Use Floodplain:� )Yes O No :; - '
( )New ( )Filling �
(�Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy i,"', �
� ) � ) o �
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 O Screenhouse O Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen R�,
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primazy structure ( ) ( )Relocate/enlarge �
� � ( ) ( )#of new � �
AdditionalInformation: � >
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Type of Construction:
(�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete o �;
( )Other � �
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Construction Cost:Primary Structure$ �
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Accessory Building:$ Addition:$ �-1�ooc � (,�
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Deed:Vol `�G 7 Pg� Certified Soil Test# 9`/-C`�'�5 tl° z
CSM:Vol Pg Lot# Sanitary Permit# 9y-67r7- � '�
Plat Envelope Or: n,
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Condo Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: � �
Previous office approvals/actions: c c -aF�. \
9(� y54� �
Variance:# LUP:# yy-�c3 SP:# CUP:# �
Insoection Report:# Change of Zone District: ��
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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.
#L dc* � #2• #3. #4.
Size � ft. wide ft. wide ft. wide ft. wide
�QL ft. long ft. long ft. long ft. long
5Z �
Floor area�Z sc�. ft. sq. fr. sq. ft. sq. ft.
Hgt.from grade i 3 to peak fr. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms�
Rear Lot Line
�tf ��r� ��
Fire Number and Name of Road �b33`-t w S���i ` N��l 4Z'
1. Enter lot dimensions and indicate north by arrow. Signature of Owne or Authorized Agent:
2. Indicate the location and size of the requested construction
ignature
activities.
Pnnt Name:
3. Also, indicate the location and distance to the well, The above cerlifies that the listed information and intemions are
hue and cortect., Mat all work shall be pedormed in compliance
septic tank and drainfield, Wetland areas, lot Ilnes anc�to the with ihe requirements ot the Sawyer Counry Zoning Ordinance
and Ihe laws and regulations of the State of Wisconsin, and if
CCriYCI�IIIe Of tI1C 20&d. acting as ovmef(s)agenC has ihe pertnission of the owner(s)to
perform the work requested on this application. The above
personsls hereby give pertnission for access to Ne property for
onsite inspection.
Permit fee: $ ��
March 4, 2004
Issue Date Signature ofI uin gent
March 4, 2005
50% Rule: Average Road Setback:
Expiration Date
Office Comments:
1200'
434'
200'
New Adtlilion
House �sting 1B'x24'
28'r 34' go' Garage 320'
32'x 36'
DrainFieltl
� 85'
I 153'
83'
2fi3'
_O a-'
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SCALE: I INCH=qpp FEE
DRAWN BY: D
COLON (:) INDIGATES GO