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HomeMy WebLinkAbout010-224-00-0200-LUP-2004-065 Application for Land Use Permit o o � County of Sawyer � PO Box 676 -Haywazd 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. b , NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. ����p� �� PRINT-USE BLACK INK OR PENCIL � �en�ei-� /=/PE/� L-". Z���:��� SE�F � Owner Builder ~' S /ys�s w STATt Rol9D 77 SAMt o Mailing Address Mailing Address � � h'9/w�J��� w�' s yd'y3 `� ° City,Sta e,Zip City,State,Zip 3 � c �is 63y �-9�� � � Daytime Phone Daytime Phone � � Additional Information: Zone District �' `� /` ; � �l Lot Size ��3 X ��° � 3 � Date lot was created /9�'3 Acres � 6�� y Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river, 4 creek or stream) If yes,how faz from the shoreline&water name: S�� (3�G Xo���+ L k � a Is there wetland near the proposed structure?If yes,how far N O � � � Building Land Use � �, a ( )New ( )Filling � Floodplain:( )Yes ( )No # ;; (�Addition ( )Dredging � � ( )Alteration ( )Grading Chippewa Flowage: ( )Yes (�')No ° „��., ( )Moving On ( ) � ° � � � ( ) Driveway:( )State ( )County QC)Town Rd. � � � � Primary Structure Accessory Building Addition °' � ( )Dwelling ( )Garage-attached/detached ( )Deck G� L (� ( )Yeaz round ( )#of caz stalls OC)Porch � ,* ()()Seasonal ( )Storage Building (X)Enclosed (�O Frame built on site O Screenhouse O Living room � ( )Modular/manufactured ( )Greenhouse ( )Kitchen � ( )Mobile/manufactured ( )Other ( )Bedroom � O Other primazy structure O (X)Relocate/ nlarge � � ( ) ( )#ofnew > � � 0 Additional Information: , ro � � � �,. Type of Cos�struction � (X)Frame ( )Log ( )Pole/metal ( )Block ( )Concrete F ❑ ( )Other -- � Construction Cost:Primary Structure$ _ Accessory Building:$ Addition:$ S-o�o vo ;/ �l Z /�5� :��;, � Vol 35 4 Pg S 7 of Deed Certified Soil Test# 9�-3 9 3 0 CSM Vol `� Pg 3S Lot# � Sanitary Permit# `19 - b o 3 `� � a�,� srArE¢# �o�3'� � Plat Envelope Or: Condo Vol Pg Year Installed J 9 9 9 Aff of ex septic Vol Pg Owner When Installed: Gard Gazebo Vol Pg x�E 1'>��/�ov✓t ,d J����o3 Ins ection Date: Previous Variance: L�� �`.' . p � � � � lo1'�N 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 �r ft. wide ft. wide ft. wide ft. wide ft. long ft. long ft. long ft. long Floor area sq. ft. sq. ft. sq. ft. sq. ft. Hgt.from gade /6 � to peak ft. hgt. ft. hgt. ft. hgt. Stories / stories stories stories # ofbedrooms o Lot Line or LakelRiver name� �Q� E R�� N o �AKt� " I 3 " — ------ --� : �, n o (42'� �, y �y-IY'�pp4 ; ��' r�'-�� Z 'cm T I /lowt ;�,1 , ;w_ �o� � ; � YX�� � 2�1r3a i � � r ---y �____ .> �� � _�, �� , , �Tt ,T i Two SToRy � !,<i � L_. �,�°" � _ � 1 sraP4 I wELL�p _ 1� _ . . . �i�8 � " o1cF�ct �4 � - _ '_ ,� �� �bxa � � o �X,Sr,N9 e�s�N = 51a'0 �NR � o p � �ch'::'N ,per�eN ' I `� � _ I oe _-- — c�c.o TvTA� : '�40� N,� I � �� '- � sEvi�� YA � �r ��.✓ �atluitiouo : '. � . _ --.�-._... _ .. . ,. ._.�._-----�— � , - �� n1`� w T��N� L dma � � �t�VN � i I � 3 sys��,�, ; � � i � � , Q � i �� �` I u _ _-- � ( I �5 ' �--- _- - . y Fire Number and Name of Road /,��So W So u Tf/ S'fl o R E R o R � 1. Fill in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent: 2. Indicate location and size of existing and new structures. � J J�t��{f 3. Indicate location of well, septic tank, drainfield. y:'' �� 4. Indicate distance to existing structures, lot lines, septic system. 5. Indicate distance to the ordinary high-water mark of any lake, pond, river, stream, creek, and name the body of water. P�niName: F/�� {� '- ' ' � "' The above ceNfes that the listed information and intentions are 6. Indicate any grading or clearing in excess of the construction site. a eess m�me Pr�o�erry roo�s c rsns�ecao eby 9�Ye Pe`m'ss���ror 7. Indicate distance to any wetland. Permit Fee: April 15, 2004 ' G9• � Issue Date Signature of Issuing Agent April 15, 2005 Expiration Date Office Comments: Inspection Date: 50%Rule Applies: Avg. Setback: Within Reservation boundaries: Restrictions and other information: . ' ���� 1 `\ .� � �. x I 513 ��� � �. 5502 • 5512 •\ / . / • . 5511 � i \ % . � 5510 \ : �� . \ j' S509 �\ \ • 5508 �\ � \ �� 5574 ' � , • 5507 � \ --'-- /' �F 5506 � �� � ' \ 2404 5619 � � 5505 ; 240� • sso, • Z�D2� .� � GL-5 5;04 , � �.� � �� /►� � :� 5401 ��"�� � � • 2�� 5402 "' — 3304 ��t� ��� r G 47� � � V C� � � �LS�� S�(C��j � ' s+oz � ���L'�5 � (7��d ;� �eoo 1 � ; , �� � +��q �� �� . I ,- ��oo ; . , �� � � � , � �1000 � �'`ry �7400� n � �os \ te ^ � ERRQt ]N OEED 360/276.BEMIMG �� S�� J� i . REfERENCE NI•19'E SIQLD BE / 1'j� �..�� N'149'V PROI PoIN( � � , �� � COENCICNT.(13106) 4 Q0900 �.` // OB00 ii� /� \ u 3�3 , ��, ��oo a,� � �. o. �� osoo °�°°„ /� GL— : . �°v4�" 0 � `�' /� Ts � \ o� � '� � yQJ ❑. 0700 �� �\.�` ! ��/ 300 • ��e2 0600 '❑ 5412 ��._'"_._ m I .\ /• I �Q4irpQQ� (, 0200 • :407 5408 � • � 0 00 • 5409 = • � �r � � � 5410 � 01� �SWTH SHORE RD' / 3303 � ; z SHONN AS 60� 1MDTFi FOR p �'��_ � � MAPPINC PURPOSES. • 5413 ��- �Q---' � ' • G L—4 • 6900 � - . � � � GRAPHIC SCALE aoo 0 20o aoo soo � .��,�. . J �� � R �''� \\\\��N� � \ �q�F � P b � M % .--`S �23\\ � I v � o t�l �6�0 �` �` � � o � � a ti � \ �,.._\\ r,� w N � �2 3j 3\ ��\\_. C�T M N C - . 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HAYwAytD iron Pipe�CountYCor. \ �. ��, �' OQ� Reat. V-19) AUGUST 19,1983 \ . '<� -�r��v�'� �