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Home My WebLink About014-941-06-1301-LUP-2004-241 Application for Land Use Permit(*Non-shareland*) � � 0 0 . County of Sawyer �, � PO Box 676 -Hayward WI 54843 O 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. '� CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � , PRINT-USE BLACK INK OR PENCIL �/ � \ '��1 - � _ \ � �O�(�_�V�?�`� k�-c�'ri�(1rn�1"\ v h6.� �t1�� n�.. Builder � � 1�C1��I�l (11�11Y1 �jn�A � ��j�1=Kf� 61�OY1 1�CaCLr�J �� Mailing Address Mailing Address � �r��Mu��,�r! iu� �`-Ig�-I3 H«u(��v�<I wi �U�� City, tate,Zip City, ate,Zip �i�,- ��3u-�i�V�r `-1IS��( -��C� Daytime Phone Daytime Phone Additional Information: Zone District: � �'� - Lot Dimensions: J , Date lot was created: '_� ��I,�� Acres: -,iC` o Is there wetland near the proposed structure?If yes,how far (�l(� � C O Bu mg Land Use Floodptain:O Yes (� o =° LT �New ( )Filling � � Addition Dred in Drivewa access off o a Check one fD � � ) � ) g g Y � � )� qa - O Alteration O Grading O Private Rd Town Rd. o ( )Moving On ( ) ( )County Hwy ( )State Hwy �,`'', � � ) � ) o `,� Primary Structure cc ssory Building �Addition � °. ( )Dwelling )Garage-attach detached ( )Deck "' � O Year round #of caz stall�O Porch � O Seasonal O Storage Building O Enclosed � O Frame built on site O Screenhouse O Living room � ( )Modular/manufactured ( )Greenl�ouse ( )Kitchen ( )Mobile/manufactured ( )Other ( )Bedroom � ( )Other primary structure ( ) ( )Relocate/enlarge � ` � � O O#ofnew � � AdditionalInformation: �' p 6 � � � � Ty e of Construction: � �Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � ( )Other ,.d ..3 Construction Cost:Primary Structure$ � � �I�r�- Accessory Building:$ a�.��c� Addition:$ � � �3155 y5 `° Deed:Vo l Pg Ce r ti f ie d S o i l T e s t# 7 7 'z 5(o tlQ z CSM:Vol Pg Lot# Sanitary Permit# 7 9 '��g o, � Plat Envelope �r� N � Condo Vol Pg Yeaz Installed: � � � Aff of ex septic Vol Pg Owner When Installed: t Previous office approvals/actions: 9b ,pc� ` Variance:# LUP:# 77'3� SP:# CUP:# :� Inspection Report:# Change of Zone District: � — 5�°�' ��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. �� 1�;�� #2. �,�n�a #3. #4. � Size�(� ft. wide t�L- ft. wide ft. wide ft. wide �_��_ ft. long S � ft. long fr. long ft. long Floor area l �,� sq. ft. �� sq. ft. sq. ft. sq. ft. � Hgt.from grade to peak�fr. hgt. ft. hgt. fr. hgt. Stories� _�stories stories stories # of bedrooms� Rear Lot Line ��LI �,Lrz) / � I I 1��` �; � �/ � �� s�,zl�:�� s+��y� s ' --- �-a`�'> �-la�,� 3�;', � �� , s� �,�� , �—s a ---� �So --- , ,y s' T Tt�u ��' �_ � ( - � �l�f�p O+ NF� �. �_ � �_ ZJ��n✓� �e� — �� _ __ -�. ._' Fixe Number and Name of Road�J�;�f��i C>LS(`� {�OCZC�. 1. Enter lot dimensions and indicate north by arrow. Sign,�re of Owner q� nzed Agent: / i 2. Indicate the location and size of the requested constnzction �( /� � � c/ L��_ % Slgnature — activities. Z , \ / PnnWame: /J�� <..,,._��h .� V : U6;.;-��,� 3. Also, indicate the location and distance to the well, Tne a�o�e cert�ee5 m me i�5cad ��ror�aso� a�d �ma�so�5 are true and coned.,that all work shall be perfortned in compliance septic tank and drainfield, wetland areas, lot lines and to the wim me r��o-emB��S os me sawyer co�ory zooi�9 om��aoce and the laws and regulalions of lhe State of Wisconsin, antl if COriteTIlriE O�t110 T'08d. acfing as owner(s)agenC has the permission of lhe owner(s)to perform lhe work requested on this applicalion. The above personsls hereby give pertnission for access to the property for onsite inspedion. Permitfee: $ /U�� . June 7 , 2004 Issue Date Signature ofIssui g Agent June 7, 2005 50% Ru1e: Average Road Setback: Expiration Date Office Comments: =—NW NW—NE NE—NE 011-9Q—OE 1201 OH-941-06 1101 H1-06 2101 a.isnc. .znnc. >zaec. .ss�c. 014-84f—OB 2102 t0' ACCE55 EASEUENi _,�C__ PER DEED 5'19/�09 01�-9�1—OG 3�01 09�C. 011-911-06 1301 i I19�B�C. :—NW � SW—NE SE—NE � _ 41—OB 2101 011-9�1-06 1�01 e.vnc. I �e.�oec. 014-911—OB 1J03 19.�I�C. I I —SW � NW—SE NE—SE s 41-06 J101 I O1M941-06 �201 Olt-841—OC 4101 a.ssnc. I os.unc. �e..uc. I � a [ hW O <p K 1 OQ 1 V (� I 6 6 J�y3 � 00 O I � -SW _ n � o LL $ SW—SE SE—SE � <H I �n N W< -OB ]+ol 0� � o1J-9�1—aa aJot o��-9at—os awt �� p 60 SAC. � LL � ]53�AC. ]668R. �N �= I �3 I