HomeMy WebLinkAbout020-638-01-2202-LUP-2004-436 Application for Land Use'Permit j r y
County of Sawyer � � � �
PO Box 676 -Haywazd WI 54843 �
715/634-8288 (3 �
The undersigned hereby makes application for a Land Use Permit and agrees that all work C-
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance ' -
and the laws and regulations of the State of Wisconsin. � �
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. �
PRINT—USE BLACK INK OR PENCIL ' �
�.�r,A�c�a- 32A�J i1 A������- �w f�C I �
c �Owner Builder °'
� �
553� � C�,� ��� G o�
Maiiing Address Mailing Address '� �
t�\v��.e!' t� S 5`�`ti I� �
City,State,Zip City,State,Zip �
'�.(�(-.-- ���>�� T-
9
Daytime Phone Daytime Phone t
n
„ - � �
Additional Information: Zone District .r
Lot Size g
�
Date lot was created Acres ��J, �J
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 far from the shoreline&water name: �1� �
Is there wetland neaz the proposed structure?If yes,how far o �
� r
Building Land Use � �p
(�New-S���-:�{- �( )Filling �� Floodplain:( )Yes (�.No # �
(�i}Addition ` � ( )Dredging I� o
O Alteration ( 1 Gradine Chipnewa Flowz�e: O Yes (�No � ,�
( )Moving On ( ) o
( ) ( ) Driveway:( )State ( )County �Town Rd. �
Primazy Structure Accessory Building Addition
O Dwelling �Garage ttac e c�lavi�+ed O Deck � �
( )Year round ( )#of caz sta ls ( )Porch O
O Seasonal O Storage Building O Enclosed i
O Frame built on srte O Screenhouse O Livmg room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Otherprimarystructure (,�'*�3�a_�;" `�+z"'�"� (�Iie:&�ete/enlazge
O O O#ofnew >
�
�
Additional I�formation: "
' �
Type of Co�jstruction x
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other
Construction Cost:Primary Structure$ '
AccessoryBuilding:$ .��t'G�-' - Addition:$ �s��:,-': - z
# 314�$� x
Vol Pg of Deed Certified Soil Test#
�
CSM Vol Pg Lot# Sanitary Pernut#
Plat Envelope Or: �
Condo Vol Pg Year Installed P,n,,;{ 191�8
Aff of ex septic Vol Pg Owner When Installed:
Gard Gazebo Vol Pg
q�-l��`� �J�✓\
Previous Variance: LUP:;�_ _ Inspection Date: `\
� ��UU�.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 columm
#1. #2. #3. �L! � ����'��h, #4. , ��r''i r'-
Size�f�4 ft.wide ft.wide �1 ft.wide �.'�'� ft.wide
�.;'� ft.long ft.long d� ft.long a� ft.long
�:
Floor azea -�;/� sq.ft. sq.ft. a3� sq.ft. �j�( ( sq.ft.
Hgk firom grade�_to peak ft.hgt. 1 5� ft.hgt. �5 ft.hgt.
Stories I stories I stories 1 stories
#ofbedrooms wxc� �ee�
,�.,r� /�. r ,�� �,� �
Lot Line or Lake/River name:
�� J��
P"�- � �.,._._�
�� a
:��=�'
Ioc�D t� p�es l000 � ,�
�
�
I , ` i V
1�
r Ci
. . � � �� ��� ,
�� 4� �
_ t :-
� � ���r�� # /fi F3b �'`r
x
- y�5�, `� -�' s�z f I�
_���f�X��D ' v �i-- �°/0 i� �
�-�50p�,_.��(j9rriJ � F�..�O6i�9��f a� 'Y�,os � --Y
L K�}1�)�' �. �� � �,�'T 4� i
i �i.
�- -- U'A'l 79r ' ��-
, _
,;�Ft � �``J ► 5a�' - _ _ . `�_� �
, �
, ,
� ,,_ , ,
..- - �� �-- - ---- - � ���� -- --�-- ---
!1pP�ya�e�
Fire Number and Name of Road �/g`�� ��o�(�p l e�
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 structures. j
3.Indicate location of well,septic tank,drainfield. v����
4.Indicate distance to existing structures,lot lines,septic system.
5.Indicate distance to the ordinary high-water mark of any lake,
pond,river,stream,creek,and name the body of water. P��t Name:
The above certifes that ihe listed information and intentions are
6.TI1dlCate any gi2ding OI C1e3i1Rg ln eXCess of t�1C COriS1211CYlon Slte. we and corred The above personsls hereby give permission for
access lo ihe property foronsile inspection.
7.Indicate distance to any wetland.
Pernut Fee: �/� '�
August 16, 2004 —
Issue Date Signature of Iss g nt
August 16, 2005
Expiration Date
Office Comments: � `� ��� � � �� � � � ��l . ,
Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries:
Restrictions and other information:
�1 v�e„� �2-QX�� , �€�.,n��n-w��Ft�Sika-6z� , �io�D�f
V
T 0 �/V N 0 F 0 �.� I
SEC. I TWP 38N. R. I
3b
.� 5; .2.3
.6,1
70
�Ay .5.1
�GN �
����E H � ��P�
3 T
b� .6.2 STp �
5,
S.
�y5
FP
a'� '
P (Q,� P .e.l
0�
�� �u.
, .��y .7.1 �
�.lu .�«r .
��Gr yVi. I
L
�t�/ ��
.10.1 .9.1 � I
�
k
L:,'i
L![:
,�i.,
�u.
�vi�
1
.II.I .12.1 .)5.�
��_�.