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Home My WebLink About014-842-09-3401-LUP-2004-293 � Application for Land Use Permit (*Non-shoreland*) o 0 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. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � � �� @� PRINT-USE BLACK INK OR PENCIL ;� 1 � � ��s�a� I� P�6��- s�� m �* �, sT � � Owner Builder c: /� � ��>/�'�� T��S�Yl I'\� �t`��7��r��.a-e�-, o. � � Mailing Address Mailin Address � A y�y� �:� �� ,5 � � � 1 S 2 �. � .cl .� City, tate, Zip City, St te, Zip �/ ��- � ;� 'y- / �l S �' 7/'�-- lr 3 '`/` '``�Y� �— � � Daytime Phone Daytime Phone � � a � �2_j �; � Additional Information: Zone District: s (~ Lot Dimensions: � p � Date lot was created: Acres: �� o � Is there wetland near the proposed structure? If yes, how far �� Building Land Use Floadptain:( j IFes ( j No � � ti (}�New ( ) Filling � � O Addition O Dredging Driveway access off of a(Check one): � O Alteration O Grading O Private Rd �T'own Rd. o ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy N � � ) � ) o � � r Primary Structure Accessory Building Addition � � ( ) Dwelling � Garage-attached/detached ( ) Deck W � ( ) Year round (3) # of car stalls ( ) Porch � 1;� ( ) Seasonal ( ) Storage Building ( ) Enclosed �° � O Frame built on site O Screenhouse O Living room �-- ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � ( ) Mobile/manufactured ( ) Other ( ) Bedroom -z. ( ) Other primary structure ( ) ( ) Relocate/enlarge � ' ( ) ( ) ( ) # of new � � Additional Information: ,� .� � � w � � � Type of Construction: '? � �Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � ( ) Other b � Construction Cost: Primary Structure $ � � � � Accessary Building: $�� , ��./�.� ' Addition: $ � � " � Deed: Vol �� Pg �'� Certified Soil Test# 8 7-�3/ °Q z CSM: Vol Pg Lot# Sanitary Permit# 8 7- z z y � � Plat Envelope Or: �, � � 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: �/��,6Y � � S �y 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. #4. Size ft. wide ft. wide ft. wide ft. wide ft. long Floor area [ r" sq. ft. Hgt. from grade to peak Stories # of bedrooms Fire Number and Name of Road ft. long sq. ft. 1. Enter lot dimensions and indicate north by arrow. 2. Indicate the location and size of the requested construction activities. 3. Also, indicate the location and distance to the well, septic tank and drainfield, wetland areas, lot lines and to the centerline of the road. ft. long ft. long sq, ft. sq. ft. . hgt. Tories Si i'�hjre l ( win7i,9rr Authorized Agent: Signature Print Name: a m The above certifies that the listed information and intentions are true and correct., that all work shall be performed in compliance with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if acting as owner'(s) agent, has the permission of the owner(s) to perform the work requested on this application. The above personsls hereby give permission for access to the property for onsite inspection. Permit fee: $ i NW—NW I NE—NW zzo, z,o, � Zb' I 2:01 I 2W4 I SW—NW SE—NW z.o3 i ' I . 3302 I, � zws I I 'JAUES RD' I � SNOMN AS 88'NIDTH fOR NAPPWG PURPOSES I / I / I I � NW—SW NE—SW � �zo� I • 3f 0f I • I I I I �hl I �yt i J.01 �� I 3JOJ JS02 � � I I ��I� � I ' SW—SW � � , SE—SW �� I I 3J01 � I3J05 yw� $� &�a I �+ � I ��Qg I o�i J1p2 q �a I �� I 3J06 II �o I ��3 II �— 1 ------'_' — I�_�------- _ — — �1� -- 'PElER50t1 RD' vioN++tis sa•woni voa MAPVING PURPOSES