HomeMy WebLinkAbout014-941-03-4305-LUP-2004-196 Application for Land Use Permit (*Non-shoreland*) o o lk�
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
flowage, lake or pond or does not have any of the above waterbodies located within �
the property's boundaries. C�
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. '�" �
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PRINT—USE BLACK INK OR PENCIL '
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�r-�-�n Q.. �i I �� r,K /1�rll�r � �
Owner Builder �:
15�Ic1 Uv' �P i�Ye., � _ I��r7�% t�f 1�o�c,�i � ��cx,� �c%�.- o�
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Mailing Address Mailing Address �
t'�C{ W`r 1 ���� M/a i 1 i��7 1. � !��� �
Cit�tate, Zi �
Crty, ate, Zip Y� P
n ��- � -- zq�4 nr�- ����+--- 5qo 2 � �
Daytime Phone Daytime Phone �.��
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Additiq�nal Information: Zone District: � `" � � p
T�1� Id rr'e J �_ �ar-I- o� � �_ �-95' X l035. � P-
o I���4� �o`��43p.z Lot Dimensions: J,c 3 f "'`�=3�0'X ��3'
Date lot was created: 3' 3`Q` 2.�-'� � Acres: � Ea�`/� o ;�-'
Is there wetland near the proposed structure? If yes, how far � � _
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Building Land Use Floadptain:( j Yes (xj No `�
(�New ( ) Filling �
O Addition O Dredging Driveway access off of a(Check one): �
( ) Alteration ( ) Grading ( ) Private Rd ()C) Town Rd. o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy N �
� ) � � o �
� r
Primary Structure Accessory Building Addition � I o
( j Dwellin g ( ) Garage-attached/detached ( } Deck w
( ) Year round ( ) # of car stalls ( ) Porch �
( ) Seasonal (� Storage Building X �. ( ) Enclosed �
O Frame built on site O Screenhouse O Living room �
..^
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �',
( ) Mobile/manufactured ( ) Ot er . ( ) Bedroom � .-
Relocate/enlar e �
O Other primary structure (K) i�i n rL►�o�. O g �o A
� � ( � ( ) # of new � 't�
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AdditionalInformation: W �
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Type of Construction: � �
( ) Frame ( ) Log (X) Pole/metal ( ) Block ( ) Concrete
( ) Other ,.b �
Construction Cost: Primary Structure $ � �
I'���� �'�� Addition: $ �
Accessory Building: $ �/6,a�
,-.
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Deed: Vol 7 3 C Pg Y�/ � Certified Soil Test# � z
CSM: Vol � Pg a�-3 Lot# �•5 Sanitary Permit# o� �
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Plat Envelope �.��� �r� N
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Condo Vol Pg Year Installed: c�
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Aff of ex septic Vol Pg Owner When Installed: "
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Previous office approvals/actions: ��
Variance: # LUP: # SP: # CUP: #
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Inspection Report: # Change of Zone District: , I�I(�`�
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Describe the construction using these columns.List the dimensions of each structure in a separate .
colu n.List each story,each ad tion,each alteration in a sep rate column.
#1.�CC'P �(� �C� #2. �Cr'P�50V'r� �G�q #3. �1��(L2� #4.
Size CD .wide � ?,�ft.wide �J CoC� ft.wide ft.wide
4g-, ft.long q-C� fr.long ��fr.long ft.long
Floor area 1��`� sq.R. ��sq.ft. 7r�17� sq.ft. sq.fr.
Hgt.from giade 2� to peak 2�i fr.hgt. �ft.hgt. ft.hgt.
Stories � �E�rL� �_stories �_stories stories
#of bedrooms_�Q�
Rear Lot Line
V� �
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�``t� ' A.(c nc�- % ��_----$ ,
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Fire Number and Name of Road ��� 2 ��'�'C�"le.�C'>Yl QC�Cto�-
1. Enter lot dimensions and indicate north by arrow. Sipr�atur_ e�of Own A t ' e gent:
2. Indicate the location and size of the requested construction {�/��,d/1JZ---
�' Signa re/��
activities. MQV^�I/� LSC�1�
PnntName:
3. Also,indicate the location and distance to the well, The above cenifes that the listed in(ormation and intentions are
true and cortect.,that all work shall be peAormed in compliance
septic tank and drainfield,wetland azeas,lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and ihe laws and regulations of the Shate of Wiscronsiq and if
CCritOilinC Of t}10 f03d. acting as ownet�s)agent has the permission of the owner(s)to
peAorm the work requested on this application. The above
persons/s hereby give permission for aceess to the property for
— �(^ �.,�., onsite inspec[ion.
Permit fee:$ ��K 2 = �� �/C� ':.�--��-
May 19, 2004 � -
Issue Date Signature of Issui g Ag n
May 19, 2005 0
50/o Rule: Average Road Setback:
Expiration Date
Office Comments:
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MAPPINC PURPOSES.
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CORNER. PARCELS NERE LOC�IED US1NC iNE
MIDPqNT DEFlNIiION LOCq110N OF THIS
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MqiE RESEMdI MAY BE REpUIRED.
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Itcos Ro•
SMOMN AS 66''MDiX FOR
� I I M�PPINC PURPOSES.
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L.LL �OL50
SHON1
iMMPI
GRAPHIC SCALE TAX ASSESSMENT PURPOSE
�oo a zoo aoo eoa ieoa Information contained on this i
advisory. Map accuracy is limit
quality of the public records fr
was prepared. It is not intende
( IN FEET ) substitute for an accurate fielc
1 inch = 400 ft.
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Sawyer c«ma
Receivad�or racroN�nis_���my d
289923 �� ...AD 20�_x�lD:[Oa�i�'
A M end recaNeO in vol. 12 -
ol Cem�ietl Surveys on pape.733' �
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—rt Dep�Yy
SAWYER COUNTY CERTIFIED SURVEY N
LOCATED IN THE SW 1/45E 1/4 W � �
�SECTION 3, T41 N, R9W, TOWN OF LENROOT, p Q
SAWYER COUNTY, WISCONSIN. ��p
O= SET 5/B'd4�IRCN BAR 1'=200'
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APIX SURYEVING
VO BOX 607
w�v`�vnao vn 5+8+3 Cartified Survey No.6 Z2 S
7154343435
7158343B6/FAX
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