HomeMy WebLinkAbout008-174-06-0703-LUP-2004-538 t��-
Application for Land Use Permit(*Non-shoreland*) o o -
County of Sawyer ^ �
PO Box 676 -Hayward WI 54843 ;S�� 'y�' '�".-.� ; c:i`�i�
715/634-8288 1�
*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. r
PRINT-USE BLACK INK OR PENCIL '
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(,U�lLrAm �Uc'N�)u/`�,�rlis�c/��i,L L��iiN� f�ccmh7r.e �an/S��/�����/��ll �
Owner 7-�L.tsT Builder �'
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Mailing Address Mailing Address �� �
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City,State,Zi� City,State,Zip
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Daytime Phone Daytime Phone �
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Additional Information: �one District:1?(C - / n
Lot Dimensions: /OS �X �l�v
Date lot was created: Acres: 0 5�� n
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Is there wetland near the proposed structure?If yes,how faz /4/D � �
Building Land Use Floodptain-( j Yes 9Q No `; _
�New ( )Filling �
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd (�Town Rd. o
O Moving On O O Counry Hwy O State Hwy i.w,a �
( ) ( ) oy �
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Primary Structure Accessory Building Addition � °
( )Dwelling ( )Garage-attached/detached ( )Deck "'
( j i'z�;cand ( )#cf czr stals ( )Porch : ly'
( )Seasonal pQ Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom u�
( )Other primary structure ( ) ( )Relocate/enlarge
� � ( ) ( )#of new
AdditionalInformation: 1 <
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Type of Construction: � I`
�.�'rame ( )Log ( )Pole/metal ( )Block ( )Concrete- �I
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( )Other ,ti �
Construction Cost:Primary Structure$ �
Accessory Building:$ /7 SB� Addition:$ � �`'
$R7/2o � h�
Deed:Vol�Pg 96 Certified Soil Test# OZ-�/C�S °Q �Z
CSM:Vol Pg Lot# Sanitary Permit# �3-QS rl (L=2Yz b� �'
Plat Envelope Or: �;, �
Condo Vol Pg Yeaz Installed: o
Aff of ex septic Vol Pg Owner When Installed: � �
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Previous office approvals/actions:
Variance:# LUP:# p3-09/ SP:# CUP:# �
Inspection Report:# Cbange of Zone District:
9�z'���
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Describe the construction using these columns.List the dimensions of each structure in a separate ' _ '
column.List each story,each addition,each alteration in a separate column.
#1. #2. #3. #4.
Size 2�3 ft.wide ft.wide ft.wide fr.wide
k O ft.long ft.long fr.long ft.long
Floor azea i 1 z-O sq.ft. sq.ft. sq.ft. sq.ft.
Hgt.from grade 1�_to peak ft.hgt. fr.hgt. ft.hgt.
Stories / stories stories stories
#ofbedrooms �'> /acr�°y�� -f� n4a�,�
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Rear Lot Line
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Fire Number and Name of Road �y�0 fv 5 cr Lr S�� f'!,%E'�'�
1. Enter lot dimensions and indicate north by arrow. tu�e of 0 r Author' ed Agent:
2. Indicate the location and size of the requested construction � e
Signalure
activities. _ "1
Print Name: �L� t � � 1 5r/�
3. Also,1nd1C3te the IOCatlon and CI1StanCe to 111e Well, The above ceRifes ihat me listed infortnation and intentions are
hue and correct.,ihat all work shall be pedormed in compliance
septic tank and drainfield,wetland azeas,lot lines and to the wlth the requirements of the Sawyer County Zoning OMlnance
and the laws and reguta0ons of Ne State of Wisconsin,and if
CCIIi.BillriO Of 1.�1C I03d. acting as ownef(s)agent,has the permission of the owner(s)to
perfortn the work requested on this application. The above
personsls hereby give permission for access to Ne propeRy tor
onsite inspection.
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Permit fee:$ ��Q
SPn mt-�hPr 28. 2004 � 7�--
Issue Date Signature of Issu g ent
September 28, 2005 50%Rule: Average Road Setback:
Expiration Date
OfficeComments: CY\U..�� C`t1(��,��(1 Q '(`(���Y��YC��E.m (j� �{(� F—f�tr iC t;
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SUN SET BEACH _
SEC. I? TWP. 37 R 9 W. PART OF GJV
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