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Home My WebLink About014-842-15-4303-LUP-2004-598 , Application for Land Use Permit(*Non-shoreland*) , , , � .� , ��/ County of Sawyer �� M; " ` < :�, �, � �"� PO Box 676 -Hayward WI 54843 I� � !,� 715/634-8288 r k.J *Properiy 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 REQIDRED PERMITS HAVE BEEN ISSUED. O PRINT-USE BLACK INK OR PENCIL � � � �-� - � C�C;,1'��e ��--�CE'� ',r«� ��A,:,C�L a Owner Builder <' �ar� ��`�'�)1,.1 �La� �' C� �. � Mailing Address 1 Mailing Address �O ��1 w�� ~� � City,State,Zip City,State,Zip �- E��-�� Daytime Phone Daytime Phone � 0 Additional Information: �Lone District: � - � Lot Dimensions: � � J Date lot was created: Acres: ��• � n 0 Is there wetland near the proposed structure?If yes,how far � Building Land Use Floodplain:� )I`es O No :; �` �O New ( )Filling � � ( )Addition ( )Dredging Driveway access off of a(Check one): � � O Alteration O Grading (�j Private Rd O Town Rd. o � ( )Moving On ( ) ( )County Hwy ( )State Hwy �,"', � � ) � ) o `,� C" Primary Structure Accessory Building Addition � ° ( )Dwelling ( )Gazage-attached/detached ( )Deck W ( )Yeaz round ( )#of car stalls ( )Porch = O Seasonal �Storage Building O Enclosed � O Frame built on site O Screenhouse O Living room � U ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen n � ( )Mobile/manufactured ( )Other ( )Bedroom l � ( )Other primary structure ( ) ( )Relocate/enlarge �,, ( � ( ) ( )#ofnew � � Additional Information: p � � � r � Type of Construction: Q — ( )Frame ( )Log (�Pole/metal ( )Block ( )Concrete �, �^ ( )Other -c ~� Construction Cost:Primary Structure$ ��, �GC� � � rn Accessory Building:$ Addition:$ � �" �sz ,�j, � Deed:Vol �� Pg "l�� Certified Soil Test# �2,��9 q(�-3y�° z CSM:Vol Pg Lot# Sanitary Permit# C-Z - `�> �\ 9/�i6y'o, � Plat Envelope Or: ^, � Condo Vol Pg Year Installed: � Aff of ex septic Vol Pg Owner When Installed: � � 'l Previous office approvals/actions: - Vaziance:# LUP:# E;Z �� SP:# CUP:# —q��o— Inspection Report:# L"hange of Zone District: � ,�� 3q�,00 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.St��cU�� h�� #2. #3. #4. Size�f[. wide ft. wide ft. wide ft. wide �� ft. long ft. long fr. long fr. long Floor area�l sq. ft. sq. fr. sq. ft. sq. fr. Hgt.from grade I ��p� ft. hgt. ft. hgt. fr. hgt. Stories � stories stories stories # of bedrooms Rear Lot Line iC��, t'd�� l��r��\ � Snzt4 3�c7�'* ��c 1` � �m � �� \�'�`� C,� � Fire Number and Name of Road � ��;��L.; O 1_� ��' �o�d 1. Enter lot dimensions and indicate north by azrow. Signature of Owne�or Authorized Agent: 2. Indicate the location and size of the requested construction -'�_ �,.J.,,-�� Signalure activities. Print Name: 3. Also, 1ndlCate the IoCatlOn and d1StanCe t0 flle We�l, The above ceNfes that the listed information antl in�entions are true and conect.,that ail work shall be performed in compliance Sept1C t3[11C 311d dr31nf1e�d, wetlanC�3ieas, lot 11nes and to tlle with the requirements ot the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if CCritBillriC Of Y.hC IO2d. acting as owner(s)agent has the permission of the owner(s)to perform ihe work requested on this appliration. The above personsls hereby give permission for access to ihe property for onsite inspection. Permit fee: $ �,C�� October 20, 2004 Issue Date Signature of Is in gent October 20 2005 ' S0% Rule: Average Road Setback: Expiration Date Office Comments: N.O�' j O b'� �-5'e�' �Or Cpmv'n'e-r�-`-0.� S.'�-�� 1 D�.D/D� � NW—NE 2103 • 121Y j ' 1Pf4 / • 1313 �� - 3101 . /' • ire • ir� . z�os ixs iwi SW—NE I , ,.� �� ,�. z.a I\ � ,� � ,w� `\ • • 131I �\ 1]0P I `� .9,�;V,u,�„ �1313 S E—N E � �� ,s,o �ff j �---------- �k +ai x�m � iwa �� , �� I 1J(J1 �N i I • t]OY � I ' ' • �� . j � ' 1 ,3„ iai R i •couHn Hwr oo' am sworM �s se'vnon�ron YMPINO PUNPoSES I i s.01 I NE—SE i .,� NW—SE .i3� ' .zo, �«« . ��,. �,.' 4�a ,2 .s�a+.ma c�cttx. ' 32tJ � �� .�3.8 t101 4202 • • • � �1� {70J • ! ^ 1^--_____. ry � �;� lo ' ,,; ,�'� , . � __ �>'" � .la.ti� � 3 � ,�;:. \ 1 ,l�J: . � � 4]01 \ � .l N01 w,�� SW—SE �E—S ��u� '��,,�,� �'`-� `� .,o, S e� � `\ zo sn uss * `\ s�OP � `� • N01 �\` A P059RE OKRUP ]0'M�[ v IXISi BEIMEEN PMC4 g. E�sliFxi rs wot«os.s aws. ys F3 �� '�` � . �NOS i103 � \ MO6 •\ • GRAPHIC SCALE TAx ASSESSMENT PUF +oo o zoo aoo noo �soo Information contained on advisory. Map accuracy i: quality of the public recc wos prepared. It is not ii ( IN FEET ) substitute for an accurat 1 inch = 400 ft.