HomeMy WebLinkAbout010-275-00-0700-LUP-2004-157 Application for Land Use Permit('�Non-shoreland*) o o .
County of Sawyer ; ��
PO Box 676 -Hayv��ard��TI 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 w-ithin �
the property's boundaries.
� �
CONSTRUCTION SHALL N P�T US BLACK INK�OR pENCEL MITS HAVG BEEN ISSUED.
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pwner ��
1`����.�. �` ., ���, �<<�� i� 1`�'7�i,�� C� �tc-� �', o - -
Mailing Address Mailing Address I�'� f ,
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City>S ,Zip ' �
City,S e,Zip -
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Da}nime Phone
Daytime Phone � ���' 1
Zone District: ��� t �
AdditionalInformation: � '�
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Lot Dimensions: ~
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! ��� ('�"�t�Ct:l;�, \ Q �
Date lot was created: 1'�.A��� Acres: e ,�
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Ts fliere wedand near the proposed structure?If yes,how far Sv'� — � J
Building Land Use Floodplain:f )Yes t �N° � J
(�New ( )Filling � �
O Addition O Dredging Driveway access off of a(Check one): �
( }Alteration (x)Grading (X)Private Rd ( )Town Rd• o I
( )Movin�On ( )l
( )County HwY ( }State Htivy � �
v, O
� � � I v <_
Addition `P �
Prima Structure Accessory Buildinu� �„
ry (ti)Garage���cl/.detached (�Deck �=
(y�Dwelling Porch " �
(�)Year round (L)#of car stalls �`� cc
( )Seasonal ( )Storage I3uilding ( )Enclosed � '
Screenhouse ( )Living roam '"' Ic�`
(x)Frame built on site � ) Kitchen �; �`
( )Modular/manufactured ( )Greenhouse � �Bedroom �' '� �``
Mobile/manufactured ( )Other �
( ) ( )Relocate!enlarge r' � z
( )Other rimary structure � � ( )#of new j:� �� F
( ) ��.�-�- �' � �
v A
AdditionalInformation: �; � �
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Type of Construction: Block O Concrete �� �� I_�,
(y)Frame ( )Log ( )Pole/metal ( ) �
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( )Other , �
Structure$ .� ��� �1h�� -�-�J f- �
Construction Cost:Primary �
Addition:$ - �
Accessory Building:$ o
`-� —p�' � °° z
Certified Soil Test# � ` �
Deed:Vol�pg� 11 �p� -' ;,,
CSM:Vol Pg Lot# Sanit Pernlit# 0�'�'— (�� D`-►� °`
Or: � r 42 r, I'�
Plat Envelope `^
Year Installed: � �
Condo Vol_���g�� ...
Owner When Installed: �
Aff of ex septic Vol PS �
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Previous office approvals/actions: CUP:#___� a
Variance:#________
�,trn:�____-sr:#_ J
Change of Zone District: C1�1
Tnspection Report:#___________-- �
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Ioa°IS
Describe the construction using these columns.List the dimensions of each structure in a separ�te • ,
column.List each story,each addition,each alteration in a separate column.
#1. ' ��`\� J #2. l;(1�4- l9 #3. �sCL��C��. #4.
Size�ft.wide �y I y�ft.wide ��_ft.wide ft.wide
►1 �C ft.long 11 1 ft. long �_ft.long ft.long
Floor area J`;L`�i sq.ft. 1 CJ �1 sq.ft. `� �" sq.ft. sq.ft.
I-Igt.from grade ��I to P�____l�ft-h�• _��ft,hgt. ft.hgt.
Stories 1 �_stories � stories stories
#of bedrooms�_
Rear Lot Line
— ���- � '�-�-����;�� �
Pire Number and Name of Road �����C -� '�< < `}�����---�`= ����l
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1. Enter lot dimensions and indicate north by arrow. Signature of Owner ar Authorized Agent:
2. Indicate the location and size of the requested cons�uction SignaNre
8CL1VIUeS. o��tNam � �i
3, Also,indicate the location and distance to the�vell, 7he above ce e�r =listed information a d�ntent�ns are
true and correcL,th all work shall be performed in compliance
wiN the requirementr of tlie Sawyer Ccunty Zoning Ordinance
septic tank and drainfieId,wetland areas,lot Iines and to the e��Q�,�and regulations ot ihe State ot Wfsconsin,and if
acting as avmer{s)agent,has the permisslon o(the owner(s)to
centerline of the road. penorm me �mr� rewestea on this appficaHon. The above
persons/s he�eby give permission for access to the property for
onsite inspection. '
i
Permit fee:$
Mav 10, 2004 � �
Issue Date Signature of Issuinb 7e
May 1� , 2��5 _ 50%Rule: Average Road Setback:
Ehpiration Date
offi�e eomments:
c��x twGc�,� ���'`��on � . �'�'�
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:'HEvTOWN~OF~HAYWARD, SAWYERrCOUNTY, WISCONSIN.
S° E 2649.68� N 3/4,COR. �
-- LINE 9FARING DISTANCE
L1NE SEC. 29 ,j� �� S 89'38 40 E 83.00
'�}� � s�O �Z N 89'39 40 W 83�00
rj, �fi L3 N S9'05 46 W 110.00
HO LENCTH CHD BEARING � � lJ. 0�,, FLy �4 N 35'49 09 E 110,00
20,27 N 23'08 21 W 3 �9p� O��s�.. �� ,
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S 00'09'48" W 970,14' ��41
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NOTE� THERE IS A 20' UTILTTY EASEMENT CENTERED 6 t.aanc.
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