HomeMy WebLinkAbout012-740-36-1304-LUP-2004-509 Application for Land Use Permit(*Non-shoreland*) o o .
County of Sawyer �
PO Box 676 -Hayward WI 54843
715/634-8288 r� �
*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. t
PRINT-USE BLACK INK OR PENCIL
� �{��I,✓�"�*tl�L4�/ �✓.�'-�?!t- ��'� <-,4��--rf i£'� a
�wner —� Builder ��
����w 6-.��� a-� iv 3� a�� ;��t �I�� �7Z� �� �
Mailing Address Mailing Address � O
�7 f✓�� Gr/1 �'-f��� �C�l,S,-��--�1���iJ�-�����D`� � �
Ci�State,Zip City,State,Zip � �_�
�_���y �p tS-�a r� �I < <
Daytime Phone Daytime Phone � �
�
Additional Information: Zone District: �K'/ � � ��
Lot Dimensions:
� �
Date lot was created: Z-�4-4Z Acres: I $S o
Is there wetland near the proposed structure?If yes,how far G �
Building Land Use Floodp}ain:� j Yes O No `; :
�
( )New ( )Filling
O Addition O Dredging Driveway access off of a(Check one): � �,
O Alteration O Grading O Private Rd O Town Rd. o
�oving On ( ) ( )County Hwy ( )State Hwy i."', �
� ) � ) o �
t�
Primary Structure Accessory Building Addition � °
( )Dwelling ( )Garage-attached/detached ( )Deck W
( )Yeaz round ( )#of caz stalls ( )Porch =
( )Seasonal �torage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedxoom �
( )Other primary structure ( ) ( )Relocate/enlarge i �
� � � � ( )#of new I,�
o f
AdditionalInformation: �� >
�
� �
�.
Type of Construction: � c�+
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � �
( )Other ,.d �
Construction Cost:Primary Structure$ � �
�
Accessory Building:$ 1 LF����� Addition:$ � ,C
� C
Deed:Vol (ot(o Pg z 8(o Certified Soil Test# �� tlQ z
CSM:Vol Pg Lot# Sanitary Permit# �'o- %�c� o, �
Plat Envelope Or: ��'� ��_ Z� ��Z- yY� N �7
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��Y
�s�r� \
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 ` o fr. wide ft. wide ft. wide ft. wide
�ft. long ft. long ft. long ft. long
Floor area ��v sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from gade l/ to peak %'Z- ft. hgt. ft, hgt. fr. hgt.
Stories � stories stories stories
# of bedrooms
Rear Lot Line '
S'� i
���
Fire Number and Name of Road 9$3$�, ) �-CLm� �hc�a 1
1. Enter lot dimensions and indicate north by arrow. Signat�er uthorized Agent:
2. Indicate the location and size of the requested construction �
Signa ure
2CtivitiOS. ���,� y-.�'v�R P
Print Name: �_.
3. Also, IriCIlCate�le IoCa2lon anCl d1StanCe to the Well, The above ceRifes that the listetl Information and intentlons are
We and covect,that ail work shall be peAormed in compliance
Sept1C tank and di'3infielC�,wetland azeas, lot 11nes ancl to tile with ihe requiremen4s ot me Sawyer Counry Zoning Ortlinance
and the taws and regulations of the Sfate of Wisconsin, and if
COritCIliriB Of Yt18 703d. acting as owner(s)agent, has the permission of the owner(s)to
pedorm the work requested on.this application. The above
personsls hereby give permission for access to ihe property for
onsiteinspection.
Permit fee: $ r7S�
September 15 2004 ' —
Issue Date Signature of Iss i g ent
September 15, 2005 50%Rule: AverageRoadSetback: _
Expiration Date
Office Comments: Building is NOT to be used for hvman habitation.
�q n� P� i� o �t- �
�6' I 70 �
�'
� ��F�
�o��D
._ �, _____---
HO�st �Ace� = 5F�3 s'�a
��� v
89 � � - _
��a.� Cg �
,�3
5
16' Avn�
_ �9' s
� it � -�•}
�0+
�-- 20 --�-r
�
50� sroaR�� '
� �
;
-- �
2�9 �
�3,5 �
�
, �
.. _.
.. � . . . . . .. . . .. .. .{ . . . .
w -
� .
L
�1 � ,Q �
�� � � s ,o �J � � w3
. N � � � � �
N
� A
N N ,;yf •� � �s O � Q .
D �� • � S C7 w •A
, � � �L,
� -< 4'3, � • � -�Oo
Eh � f'l c° .
MARGA,eE? ,pO,oD ? �' � �
�
ti
.� �I �q �
^ ' X r"' .g � �.o � -rl �3
� � � Z Z � � �1 �
..o
C -`_" '$' � •`" .g � a .,�Do
`r�� �• � Cl �' (,� 4,
- � � A
A
C w36o � �
9�� '� � I 4. ;A
� 1
c "� ..�o
—I t„3 A �' �86 A g w oo r--1 �3.
� s � '� p � � � � �--� N .
'T �. �' Z; .
x
, � � �36�
80,6 S7', � L�
,�
< -
P
.,�3 s � ���:�f - �. o
� A 'h � � � � o��% S�. N
_D �,o '��, �• � �'C
� i
i
.�36A - - � .� �
NoL o � RQ .x36A ����i� � � A oi c
7 �Z ^
s o��• � £ � A
� 3 • �� rY 'A O .+�A �1 '�
'�� "1 N
N �� �s 36�� � �� � ��I
�p � I
\\o � -o IZ �3 /
��0 o r-' � G L' s L o �
y� � i
� ` (��3G� .�-� = J i
� ,� o� w s
m �a� � -A � � � � .o
p � 36
��o � � c� i� A
� . W ��, ~ � . � : w yL.o
2 � � � �
n
r- o-L C�
Z , �G$ 7 -0 `r`�-�ti �C0 D w��