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HomeMy WebLinkAbout014-160-00-0100-LUP-2004-430 Application for Land Use Permit (*Non-shoreland*) o o .� 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 wrthin � the property's boundaries. �} � CONSTRUCTION HALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � t�'� �7' PRINT-USE BLACK INK OR PENCIL cn �� � R�N� B�KK� ���c�.���+�i�s � Owner j2,�,� 1�e��Ke �e�c.�b� Builder <: � A�� 1��. c.��T ~ i3�3 N. �� �t�+ �� . �� Mailing Address Mailing Address � � �t-�ot2-�-�,E� t�/11.� 5512� l-�A`��-17 1f�)� 54�4'� � � City, State, Zip City, State, Zip y � < � ��I.Q��z 7��� �iz �lo id�.� Daytime Phone Daytime Phone � C7 Additional Information: Zone District: FLR- j � � ' ' ' � � Lot Dimensions: ���x qo2 r=37�x 3-'�� � � Date lot was created: i�q7 Acres: 3.7�1 ��- o Is there wetland near the proposed structure? If yes, how far �� � � Bu�lding Land Use Floadplain:-( j IFes (�No `� � (J�New ( ) Filling � O Addition O Dredging Driveway access off of a(Check one): � ( ) Alt�ration ( ) Gradin�; (�Private Rd ( ) Town Rd. o O Moving On O O County Hwy O State Hwy �, G� � ) � ) o � � r Primary Structure Accessory Building Addition � ° (�Dwelling (,/S Garage-attache detache ( ) Deck W (✓jYear round (z� # of car stalls ( ) Porch � ( ) Seasonal ( ) Storage Building ( ) Enclosed � O Frame built on site O Screenhouse O Living room O Z ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen _ 1`3� ( ) Mobile/manufactured ( ) Other ( ) Bedroom , ' -- ( ) Other primary structure ( ) ( ) Relocate/enlarge � � � ( � O # ofnew � � 4 AdditionalInformation: � A ti � � G n Type of Construction: r� ( y�Frame ( ) Log ( )Pole/metal ( ) Block ( ) Concrete (1' ( ) Other Construction Cost: Primary Structure $ z�> o��.c>�� � � � Accessory Building: $ � ����G Addition: $ � �'' +� .zqa is y � N Deed: Vol 7 37 Pg�_ Certified Soil Test# Q y-�3� "•° Z CSM: Vol Pg Lot# Sanitary Permit# O�/-�7 r7 0� � Plat Envelope �r� c� � 'v, Condo Vol Pg Year Installed: � Aff of ex septic Vol Pg Owner When Installed: `-' � N i -P' Previous office approvals/actions: ,� N � Variance: # LUP: # SP: # CUP: # — � � Inspection Report: # Change of Zone District: us � -��� � S�q4� �1l 3�� 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. sr EwhfL #2. N° r t_..oa #3. &APW . #4. Size 'gip ft. wide ft. wide _ 2-A ft. wide ft. wide 40 ft. long 40 ft. long zS, ft. long ft. long Floor area i06a sq. ft. "737— sq. ft. O Z- sq. ft. _ sq. ft. Hgt. from grade 9S t to peak _� ft. hgt. ft. hgt. ft. hgt. Stories 2- 1 stories stories stories # of bedrooms 'J _ - - ---' f S43 °- 52 ' 58"E LA. r / 3 9. 2 8 Fire Number and Name of Road �l �►—l� 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. of Signature 0 Agent: Print Name: WN L -1 I " 1 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 personals hereby give permission for access to the property for onsite inspection. Permit fee: $ POWER OF ATTORNEY , i "? Know all Men by these presents, that I, �f�.,c� , ,, �,� �r e '�- k F' , � , property owner, Town of LF�;�c.:�c�� , Sawyer ounty, Part of Government Lot , i,l� 1/4, `��( 1/4, S i 3 , T q 2 ►v , R �`��� , State of Wisconsin, have made, constituted and appointed V�I+wo,M � t'i�_,2c.� of i-��(�i,�.�^v� in the County of �W�!�. , State of Wisconsin, my true and lawful agent for me and in my name, place and stead to do any and all things necessary for the application for, negotiation of, or obtaining of state, county and local permits with the County of Sawyer, Wisconsin, giving and granting hereby unto said agent full power and authorize to do so and perform all and every act and things whatsoever required and necessary to be done in about said premises, as fully to all intents and purposes as I might and could do if personally present, reserving full power of substitution and revocation, hereby ratifying all that my said agent of his substitute shall lawfully do or cause to be done by virtue thereof, In witness whereof, I have hereunto set my hand and seal this 3�� Day of vt, ��, , 2004. �� Owner Notary: ���, �. ' " � State of: �7h.�,�..�'� County of: Perse::al�y came �efo:e .^.:� this �'�- uay cf f�i..�-'-T,�-�-� , 2G'04, The above named �,��D� .� � , ��,�� to me to be the person who executed the foregoing instrument and acknowledged the same. ' � ' /) ,��� � ' sx-��-s-� �y � J N tary Public County State My Commission expires: •j� ��'O-'' $ ���nov��onrvw��� � rE`����` SYC.ViA I. HEIi�KtL.A � � ';��,�� tvOTARY Fl1BLiC-MINNESOTA � '�,�. � '� Mp Comm�aicn EzFiresJan.31,2045 __ s...: �-�:;:;,.�r# � _ �yac xs:e�+isN��% NW—NW NE—NW � z�o, • . 2,0, SW—SW SE—NW 2307 � 2401 xu�su ra�x� �1N0 12 � p�ga rn,v� 4� < 3 t 3 i3oo izoo � � oaoo . • SEELY HIGHLANDS �� � SUBDIVISION �+a� I �� LOTS 1 THRU 16 � R� iioo 14 • ❑UTL❑T 1 NW—SW „� � � . 5 �5 �' / ''� NE—SW a�o � a2� . / � , ,sQo ��',��/ 10 ,�oo //�~ "� 2 �soz � . � "' • .�'�„:` osoo 16 ��' � ��' /�` 6 9 �� � a,00 isoo oeoo o�oo ��/ / �� • . . . 8 zo� woe ew mN� 7 / / 1 EARI�ENT �l L�i M kl' ROAO � EASEAIEnf 2 �a�„a�_,- s.e�un.-. �� �S 3407 3303 3304 R�I II • 3�5 3408 • �� ���� 3409 340� • • 3406 • ya• woe Rono ��—� ' • S W—S W �,s�cr�r 3302 3301 . . 3402 3404 � 3403 � . C1 OF 70' w0E SKI iR�IL E�SD�LNT _ _ • __�� `OOUNTY HWY 00' SEWNN A4 66' MA01H FOR MAPPINO PURPOSES ��f �/or-f�i � !`�f c���,i r�c� �r.c ,�` 400 0 200 ,;,;;,;,. r