HomeMy WebLinkAbout008-937-21-2101-LUP-2004-126 �-
Application for Land Use Permit(*Non-shoreland*) o 0
County of Sawyer �
PO Box 676 -Haywazd 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. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL
�.�
����/,�� i L��c.v r� ����% �N�m iI> �. ,'.���a �
Owner Builder <�
lv C��5 /�w y S3 S ��.c��o' ��0� � ��,� �: w�
Mailing Address Mailing Address � �11
�/
EA�v ������zi�.�J1—S�� /�UK��i/a, �✓/� h ��S 7 � �
City,State,Zip Ci?y,State,Zip �
>i s- �-� � ��/B 7/ � =2 � �f s f�oo �
Daytime Phone Daytime Phone �
Additional Information: Zone District: —� r
�
Lot Dimensions �\
Date lot was created: Z GU Z� Acres: �� v_� o ��
Is there wetland near the proposed structure?If yes,how faz � �'
Building Land Use Floodptain-( j Yes O No i/ �D t�
(�j'New ( )Filling '� �
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration (t)Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy (��State Hwy r,`'', �
( ) ( ) o S
r
Primary Structure Accessory Building � � °
(.)Dwelling (<`j Garage-attached/detached Deck W n��
(�Y'�'ear round (�}#of caz stails Porch = I �
( )S�asonal ( )Storage Building ( Enclosed � �
(�)Frame built on site O Screenhouse ( Living room `
( )Modular/manufactured ( )Greenhouse ( Kitchen
( )Mobile/manufactured ( )Other ( edroom "
( )Other primary structure ( ) �Relocate/enlazge ;
O O O#ofnew E
Additional Information: p
�
�
�
Type of Construction: '' �
(���'rame ( )Log ( )Pole/metal ( )Block ( )Concrete �; —
( )Other � �
q� � ro
Construction Cost:Prnnary Structure$ ���(�Q > ,:/ � �d � �
Accessory Building:$ Addition:$ � �
� ���
Deed:Vol 7`l 0 Pg r:��! l(L Certified Soil Test# � a - ��0 � Iz
CSM:Vol ��- Pg Iq=� Lot#�_ Sanitary Permit# 6 2 - �3�� � 7�
Plat Envelope Or: n, �
�
Condo Vol Pg Yeaz Instailed: -�b o 3 co
� �
Aff of ex septic Vol Pg Owner When Installed:
���i�cL `S
Previous office approvals/actions:
Variance:# LUP:#! ; � 'o SP:# CUP:# \a
Inspection Report:# Change of Zone District: a\r��1�
�1��
&&�S
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.��ou•��� #2. r/�.L/�"li #3. #4. �
Size��ft.wide 2$r ft.wide ft.wide ft.wide
�{0, ft.long ��ft.long ft.long ft.long
Floor azea/2.ea +—sq.ft. _.�sq.ft. sq.f[. sq.ft.
Hgt.firom gade 1�to pealc��ft.hgt. ft.hgt. ft.hgt.
Stories / stories stories stories
#of bedrooms .2-
Rear Lot Line
�
�Gc;D�
_ -
c��,i z�-�v� ;
� . ,.
� ,,
1� .
` w�� � . —. �(
/�.� 6�i2wciu�e-, `-i�i
- I`�
,� �Ji<�—
.,¢� e
5��/l�- � � � ___ _ �i ."�: �� S Z
�
,�— '��c C, -- __ �-- 7/-�'�s
� /X'�5�i� ',
/ %;'—�N
(
i
%�'/Si/iu/ ��i��,
� r .�c titi — �b�
r (
/>;/% — /bD I
� _
{.
� 9tr; ��`�
Fire Number and Name of Road 'S 9/SL-c� �f�-(�)/ �j`�'
1. Enter lot dimensions and indicate north by arrow. �
Si na of Owner or Autho ed A ent:
2. Indicate the location and size of the requested construction �' �e__
���
activities.
PrintName:��1• d✓YIs?S E. ��8C..7�--�
3. A150,1ndlCate tlle IOCatlon anC�d1StaIlCC to tlle Well, The above ceRlAes that ihe listed information and intentions are
true and conect.,that all work shall be peAormed in compliance
septic tank and drainfield,wetland azeas,lot lines and to the wan me req��rements or me sawyer co��ry zoom9 om��a�ce
and the laws and regulations of the Shate of Wisconsin,and if
CeritCi�lriC Of Y.I1C IO2d. acting as owneY(s)agent,has the permission of the owner(s)to
perfortn Me work 2quested on this applicalion. The above
personsls hereby give permission for aceess to ihe property for
� onsite inspedion.
Permit fee:$ �t'�•
May 4, 2004 �������,Q,L� ` '���
Issue Date Signature of Iss i nt
May 4, 2005
50%Rule: Average Road Setback:
Expiration Date
Office Comments:���� �� a G��tJ�t��5 G2 Y'� ���t �i � � �u C �_
C r��s � N SPv f v'ri�l �r`�lU'S, ��aq�l ��
TOWN OF EDG�'
SEC.21 TW P 37 N. R.
S.T.H 48
O Z z
6� 6.3 s.�z 5.z 2.
.6.Q.
, .6.5
s `
3
6.01 �
6.6 .5.�
6.I
.7.I
.7.2 .8.2 .3.2
�
75 8.1
.7.4
7.3
.10 I .9.1
.I I.I .12.1