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HomeMy WebLinkAbout010-941-26-4416-LUP-2004-554 Application for Land Use Permit (*Non-shoreland*) o 0 County of Sawyer � � PO Box 676 - Hayward WI 54843 715/634-8288 *Property that is not located within 300' of a creek, river or stream or within 1000' of a , t- 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 PERMTTS HAVE BEEN ISSUED. � � PRINT-USE BLACK INK OR PENCI� �i � I I�' � �'-�C� Pv 1 t `� � ..-: �- - � ':,�.,r, t��l� 1 r �LEN1 ►�1�� - - - � Owner Builder �: .--L � (��� � - �1y w��D L a �� , - �. Mailing Address Mailing Address N l i ��C�r��'+ ; << � O _I���/l��l �O (l� l S`-4���� -�� � � Ci y, State, Zip City, State, Zip � � I� (nj - � `1 ' � IS- � � ` �-___ ,_.� `-E�-�= �!U I C� Dayti��Phone Daytime Phone 'Additional Information: ;- � Zone District: � '' ` � ��L ' � ; � t�.. �- � ����• � � ` Lot Dimensions: ' j�� n I ate 1 e : /9�l � Acres: 2 , 7.� o — Is there wetland near the proposed structure? If yes, how far �l7 � � �. r Building Land Use Floadptain:( j Yes O No :; (T` (`�New ( ) Filling � � (�) Addition O Dredging Driveway access off of a(Check one): -- qa � ( ) Alteration (�Grading (JjPrivate Rd ( ) Town Rd. o �� ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ti, � � ) � ) o � � r Primary Structure Accessory Building Addition � ° � Dwelling ,, Garage-attached/detached (}� Deck W (�() Year round ( ) # of car stalls ( ) Porch � ( ) Seasonal ( ) Storage Building ( ) Enclosed � ( ) Frame built on site ( ) Screenhouse ( ) Living room � (�� (� Modular/manufactured ( ) Greenhouse ( ) Kitchen �� ( ) Mobile/manufactured ( ) Other ( ) Bedroom p ( ) Other primary structure ( ) ( ) Relocate/enlarge � " � � ( ) ( ) # of new �' �� � AdditionalInformation: � ; i � � � Type of Construction: � ( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � � ( ) Other � tj►`�v L...� '� Od � y Construction Cost: Primary Structure $ ���5 �D. � � � Accessory Building: $ Addition: $ � � �- 3�`��1 v�) � -_. Deed: Vol Pg Certified Soil Test# /'���T/�� � z CSM: Vol��Pg i y I Lot#�� 5anitary Fermit# �:�y� ;�/(C � N Plat Envelope Or: �, �'� Condo Vol Pg Year Installed: � Aff of ex septic Vol Pg Owner When Installed: � � Previous office approvals/actions: � Variance: # LUP: # SP: # CUP: # � Inspection Report: # Change of Zone District: �C��'p�1 1� �/� Describe the construction using these columns.List the dimensions of each structure in a separate colum List each story,each addition,each alteration in a separate column. _ #1. G �S� #2. G C�C #3. #4. Size oi ft.wide �l-�ft.wide ft.wide ft.wide �SL ft.long �7 ft.long fr.long fr.long Floor area�`I�sq.ft. 57$ sq.ft. sq.ft. sq.fr. Hgt.from giade to peak ft.hgt. ft.hgt. fr.hgt. Stories�_ � stories stories stories #of bedrooms�_ Rear Lot Line ' , / ' �" ; , ,3`�'% i � 3'�' I� X ,, / � a^��phe'��c �� a�,�3�d• , o � � , �, , r� - --a '� _'•'�?J,. ��� � ��� a�; � �U � ,� °� � � �- i �ao� � �',�s �j � --��\� �--� OI J ^ �� N Cc ♦� ` � z k.:, ,:i. `��,3�� � � �'''`� ) ,�<��L • � � R� Oo o �'� � p ����. �\. � L ol ` �,i o �s 0„�; ; \��, �� 9i�., 1 I�_._— �',.. . ....... C /, . 3O2�.00' c N89°3I'Sq't,.) Fire Number and Name of Road !n � (��. N ('��� t �,1 DC1 l 1. Enter lot dimensions and indicate north by arrow. Si n t[i� of Own or A t rized Agent: 2. Indicate the location and size of the requested construction /� Si naNre activities. PnntName: 3. Also,indicate the location and distance to the well, The above certifes that Ne listed Information and intentlons are We and corteQ.,ihat all work shall be performed in compliance Sept1C taI11C a(la dralnflela,wetl3ild 3Teas,lot lines and to the with ihe requiremenLs ot the Sawyer Counry Zoning ordinance and the laws and regulations of the State of Wiscronsin,and if COTItCiliriE Of YhC i08d. acting as owner(s)agent,has the permission of the owner(s)to peAortn the work 2quested on this applicalion. The above personsls hereby give permission for access to Ne property for onsiteinspec0on. ��_ Permit fee:$ .��•� 0_rtober 5,_7004 ` "�—���� Issue Date Signature oflssuin Ag October 5, 2005 50%Rule: AverageRoadSetback: Expiration Date Office Comments: � V7U-`J41. ..�v o�� ._.. ...,.. ..... .... __ � -26 240).". 2 010-941 1 010-`3�1 I ,. . ;;z6a� _ � ,� _ - -z�3,s -z6 ��o, I� PL, , .._ ,:_��. 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" � p Survey Adju 1.64AC. 1.01 AC. � 1.53AC. Drawing Cr� Drafter and Drawing Mc Drawin Fil GRAPHIC SCALE TAX ASSESSMENT PURPOSES ONLY Disk: Com� aoo 0 200 +oo soo ieoo Information contained on this map is Tax Roil D< .. �r,.. . . � I . . . .. _ . _ __ 1_J L.. LL...