HomeMy WebLinkAbout014-941-04-5709-LUP-2004-213 / . \
Application for Land Use Permit o o �
County of Sawyer V �
POBox676 -HaywazdWI54843 �C�- ���?-�-.';;�. i_;,,,;i�,ii�;�,� ,�,
715/634-8288 � �
The undersigned hereby makes application for a Land Use Permit and agrees that all work
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin. 1
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. �
PRINT—USE BLACK INK OR PENCIL
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Owner Builder �
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Mailing Address Mailing Address � �
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City,�ate,Zip City,S ate,Zip ~
_Ct�_ C 3Y 5���
Daytime Phone Daytime Phone
Additional Information: Zone District J� R`�
Lot Size
Date lot was created Acres y��
Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river,
creek or stream) If yes,how faz from the shoreline&water name:
Is there wetland neaz the proposed structure?If yes,how far �
Building Land Use '�
(�New ( )Filling Floodplain:( )Yes ( )No # ;;
( )Addition ( )Dredging � G�
( )Alteration ( )Grading Chippewa Flowage: ( )Yes ( )No �
( )Moving On ( ) o
( ) ( ) Driveway:( )State ( )County ( )Town Rd. �^
I f
Primary Structure Accessory Building Addition �!
(�Dwelling ( )Garage-attached/detached (�Deck
�Year round ( )#of car stalls ( )Porch
Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room C�l �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �l
(�Z Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlazge
( � O O#ofnew a
�
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Additional Information: ����1 "
�jC�S-€`��1C��h��\� � �'L��- �
Type of Coqstructiofi �
(�rame � ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other
Construction Cost:Primary Structure$ � ��' � o
Accessory Building:$ Addition:$ z
7�
Vol 813 Pg a/(� of Deed Certified Soil Test# O�— �Z�� ���3�
CSM Vol Pg Lot# Sanitary Permit# O� — �`+1 79-iUq � �
i-:_�_:
Plat Envelope Or. � �
Condo Vol Pg Yeaz Installed
Aff of ex septic Vol Pg Owner When Installed: �
Gard Gazebo Vol Pg �
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Previous Variance: LUP: Inspection Date: �\\��`"
I"1591
Describe the construction using these columns.List the dimensions of each structure in a separate
column.List each story,each additi4�,each alteration in a separate column.
#1. #2. \—�-C-� #3. #4.
Size �r ft.wide /� ft.wide ft.wide ft.wide�
��s' ft.long �ft.long ft.long ft.long
Floor azea � sq.ft. , C� sq.ft. sq.ft. sq.ft. , '
Hgt.&nm grade �y�' to peak ft.hgt. ft.hgt. ft.hgt.
Stories�_ stories stories storieg
#of bedrooms�_ �
Lot Line or Lake/River name:
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Fire Number and Name of Road ��� � � � S � � 7 7
1.Fill in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
2.Indicate location and size of existing and new sh-uctures.
3.Indicate location of well,septic tank,drainfield.
— 4.Indicate distance to existing structures,lot lines,septic system. ��`�"'��� - ��.�
5.Indicate distance to the ordinazy high-water mazk of any lake, /
pond,river,stream,creek,and name the body of water. P"°t"ame:, :�, �\ C-�' �--�\�
The above c�sYthztthe 6sted informaUon and inten6ons are
6.Indicate any grading or clearing in excess of the construction site. we and coRe�Tne ato�e Persons�s ne�eby 9�ve Pe��sS�o�to�
access to Ne property tor onsite inspedion.
7.Indicate distance to any wetland.
Permit Fee: ����
May 25, 2004 _
Issue Date Signature of Is ing ent
May 25, 2005
Expiration Date
Office Comments: ��5��t�� Y`{��rJi�'e �C�'r\�, �tt�� YZ�-u�c1�U�EQ �c.t ��13D�0.5
Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries: �•
Restrictions and other information:
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NOTE� A GA EXISTS BETVEEN
NOTE: SUPPL[ED COORD[NATE D[STANCE S M � T H L A K E P�CEL NOL -941-04 52�3 L
FROM THE NV CORNER TO V V4 CORNER O14-94t-04 5202. AODIiiONAL .i1�C
IS 41. 21 FEET SM�RiER 7HAN 1992 PLAi RESEARCH A D MAY BE
OF SUR4EY BY R. L. PETERSpN. REOU[RED.
THE SURVEYS US[NG PE7ERSON'S
POS[i[ON FIT THE CURRENT LAKESHORE
LOCAT[ON, CENTER�CNE LOCAT[ONS, AND
MAPPED DATA BETTER THAN TFiE SUPPL[ED
COOR➢[NATE POS[7ION FOR THE L I/�
CORNER. H[S POS[T[ON 4AS USE➢ FOR
MAPPING PURP�SES ONLY AND AD➢[7[ONAL
RESEARCH.
NOiE: LOT 4 CSM 5/178 APPEARS TO
HAVE BEEN DIMDED IN HALf N-5, BY
DEED, BASE� UPON THE TAX RDLL dt
PREVIOUS PARCEL NM. MORE
RESEARCH qNp�pR AIRVEY WORK MAY
8E RE�UIRED.
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NDiE� SUPPLIED OEED F�R D�i R/V �OES NOT MATCH E%[ST[NG SECTION BREAK�OVN. THE
R/V BOUNOARIES YERE ADJUSTED SLIGHTLY TQ MATCH THE SDUTH LINE Of SECTION 4 BY
BEST FIT METHOD, FOR MAPPING PURPOSES ONLY.
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