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HomeMy WebLinkAbout012-740-06-5201-LUP-2004-066 �ent 8y; r+P �aser�et ;��GO; 1156383277; Apr-�-Ua � t :�3A����; �;�:i� '� ; � �Dw.{� ��� �•.lk � �� . ... � .. � - .• � _.i_� �� . • � � ,\• Application for Land Use Permit (*Shoreland*) o o � � , County of Sawyer c� � � PO Box 676 -Hayward VJI 54843 �' /�+ 715/634-8288 � *Property tt�at is locaied within 3U0' of a czeek,river or stream oz'within 1000' of a � , flow�age, Iake or pond or has any of the above waterbodies l�cated within � C the property's boundaries. CONSTRUCTION SfiA1,.L lYQT�BGIN L�IV'I'IL ALL�tEQT1IRED�'ERNIITS HA�'E BEEN�SSUED, � PRINT—US�BLACK INK OR P�NCIL � � �� g- � `� �-� � �' L.� �'j � G c ,�,n Buildez � 2 sfi ' �J I qy 9 �'�, Rd, � a: � 'iing Address Mailing Address o os e � o I y ' .5 .� ` � C.� r S � � City, State, Zip ity, S e,Zip p � -� �D�b l�- 66 - 9 Daytime Phone Dayti.me Phone (���„�, L�l�Z-870y � Additional Information: Zone District:�'pr'P � _ Lot Dimensions: �e �p � ��-P Date Iot was created: D"' — � Acres: �� � 1 Is there wetland near the proposed structure? If yes, l�ow far n � Building Land Use Floodplain: ( ) Yes �No � ( )I•Ie�v ( ) Filling Chippewa Flowage: ( ) Yes Q� No �" ( ) Addition ( ) Dredging Driveway access off of a(Check one): , ^ ( )Alteration (1��'�ading �Q Private Rd ( ) Town Rd. � ( ) Moving On � � ( ) cou�cy xWy ( ) s��xwy o � � � � � N � Primary Stru,ccure Accessory Building Addihon o � ( )Dwelling ( ) Garage-attached/detached ( )Deck �`' ( ) `Iear round ( ) # of car stalls ( )porch � ( ) Seasonal { ) Storage Building ( )Enclosed ; O �rame bvilt on site O Scieenhouse O Living room fi ( }Modular/m�nufactiu�ed ( }Greenhouse ( }Kitchen " ( ) Mobile/manufactured ( ) Other ( )Bedroom ` ( ) Other primary structure ( ) ( )Relocate✓enlarge a � � � � ( )#ofnew J � � Additionallnformation: � � � � � A f ?ype of Constcuctian: C/1 ( ) Frame ( ) Log ( )Pole/metal ( ) Block ( ) Concrete N' �� ( ) Other ! .-� Cons�uction Cost; Primary Structure$ b � Accessory Building; $ � Addition: $ ro '� "�.�I�l�1�Ci�% z� Deed: Vol Pg Ceriified Soil Test# ro z � � CSM: Vol,�y - - Pq3Y / _Lot# S Sanitary Pezmit# _ _ �. � Plat Envelope Or: � Condo Vol Pg Year Installed: c� I� , � "Loads and Flows": Vol Pg Owner VJhen Installed: � .._. s y Previous office approvals/actions� � � Variance: # LUP:# SP:# CUP: # Inspection Report: # Change of Zone District: 4- -- a, �:.r� i �� ��� ������ ��.i��i2�� -�i ° � t�"�ic,� ���r e'?�ml�. �,..>���5`'J 4 . .V...�. t �� 1��1� Sent By: HP LaserJet 3100; 71563B3277; Apr-B-04 1 � :3aA4.1; Paqe 2!2 Describe the conatruction using theae columns.Liat the dimensions of each structure in a separ'ste � column.List each story,each �dditlon,each alteratfon in a separate column. - #1. #�Z. #3. �. Size R, wide ft. wide _ft. wide ft. wide ft. long ft. long R. long � ft. tong Floor azea sq. ft. sq. ft sq. fr. sq. ft. �,��e m Peak ft. hgt. ft, hg[. ft. hgt. Stories stories stories stories # of bedrooms L on lowa iverlS m s Fire Number and Name of Road 1. Enter lot dimensions and indicate north by arrow, g�9 p�o er�Aut orized Agent; 2. Indicate the location and size of the requested construction s�'�� �+� sgnaare activities. Q �� �� R _�j PrYilName: ir- A,� e.r our 3. Also, indicate the loCation aad distance to the well, rn�anwe cerow�mec ma Reme n�a�and�+�u�,+a� p�e md m�ecL,Ta�ell rnrk ahaN Ee perfarmad In oorripllance septic tank and drainfield,wetland areas,lot lines, �+ ��a��+ a u�se.ye�cowh z«�� oa�nancn era a+e�a ana �,mua,s a me smm d w��s�, em n centciline of the road and waterbodies. e��+�(a)�M�^B'm�p°""e'i°" °'me owneqa�m perfpm !ie woA reCuesled on mb epplkaUori. TTe above � paryaufe heieDy gMe FertNveion lor aaess to t�a ProD&b fa e p �a,alte Inspacaa,. Per[nit fee: $ �5 ✓ Total land area within 300' of the waterbody: (A) Total impetvious surface area[inciudang this projectj (B) (B)!(A)x 1 GO=%Used (Shall not exceed 15%[or 25% with a condirional use permit].) Shoreline Vegetation Protection Area: Mitigation Required7( )Yes ( )No ! � April 16 2004 l' Issue Date Signaturc of Issuing Agent April 16, 2005 50% Rule: . AverageRoadSetback: Expiratian Date Office Comments: �� ��z,1',.�p� �����-C�1tij , Sep 02 03 11 : 4la �Totld Gooltl 7156349ti2z p . � . ` ' PAUl.n CHISSER • � SAWYCR COUNSY, WT . R£GTST�.FI OF DEEDS ' • 319710 08/28/7.Oo3 1;a5 pM RECOADING FEE �17.00 Pages 4 SAWYERCOUNTYCERTIFIEpSURVEYMAP , LOCATED!N GOVEfMINEM LOT7, SECYlCW Q,TIpN.R7W, 70WJy pF MUNTER ANO�NCLf/qNC AN EASEMEJJT LOCATED/N 1HC S W 7/.1 QF SEC7]PV 37, T01N,R7w, TOWN OF ROWJD 1AXE SAWYER COUMY, W1SC0.�cSlN. taras' I �a.a1•,u cra. 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