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Home My WebLink About020-103-00-3200-LUP-2004-678 Application far Land Use Permit(*Non-shoreland*) o 0 County of Sawyer � x PO Box 676 -Haywazd 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 � Ll f E l.�A I��'►�v�i S �: ;<-�(,�'� ��. �'�� 1 Owner Builder N' � � � �� C'>.�N��13 h2?� ��`� '<� �/— /��`s �� Mailing Address Mailing Address � �,�,�-�-� a�,�; 5�l�9,5 �I� t.,� .S�f�v_� `° � City,S te,Zip City, tate,Zip �� s-ar� � - �i �_3 �is- s�.�s�-��y�� Daytime Phone Daytime Phone �' v �Additional Information: Zone District: � � � � � � Lot Dimensions: :�S`��( .Y��S X :i$`I J( � 91�y' �; Date lot was created: Acres: (R �5(� o Is there wetland near the proposed structure?If yes,how far �(;' � - Building Land Use Floodpkain:� j I`es ( j No `; �j New ( )Filling � Dred m Drivewa access off of a(Check one): � ( )Addition ( ) g� g Y . O Alteiation C�Grading O Private Rd QQ Town Rd. o ( )Moving On ( ) ( )County Hwy ( )State Hwy N � � ) � ) o � t� Primary Structure Accessory Building Addition � ° ( )Dwelling ( )Garage-attached/detached ( )Deck W ( )Year round ( )#of car stalls ( )Porch = O Seasonal 1,�)Storage Building O Enclosed � (�,Frame built on site O Screenhouse O Living room ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ( )Mobile/manufactured ( )Other ( )Bedroom � ( )Other primary structure ( ) ( )Relocate/enlarge � � O O#ofnew Additional Information: p � � � Type of Construction: � ( )Frame ( )Log (�Pole/metal ( )Block ( )Concrete ( )Other ,� ro � Construction Cost:Primary Structure$��CCC��T � :? I Accessory Building:$ i Addition:$ � s� � Deed:Vol ']J y Pg '-�1� Certified Soil Test# — kJ2— tlQ z CSM:Vol Pg Lot# Sanitary Permit# C�Z-�i52, o, 7' Plat Envelope �r� N � Condo Vol Pg Year Installed: � � � Aff of ex septic Voi Pg Owner When Installed: �� i Previous office approvals/actions: � Variance:# LUP:# �P:# CUP:# Inspection Report:# Change of Zone District: �\ \0� \ d�� O�l 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. #2. #3. #4. Size hG� ft.wide ft.wide ft.wide ft.wide < �_ft.long ft.long ft.long ft.long ' Floor azea /�, ��sq.ft. sq.ft. sq.ft. sq.ft. Hgt.from giade /.3, to peak ft.hgt. ft.hgt. ft.hgt. Stories�_ stories stories stories #of bedrooms �� ' � � Rear Lot Line 3� ` � , . - N � __ m , � � u l � e A J L'�� _j G � �,r L L ,�.'� � �S� � C� ��,_ � �\ � � v� 3 0 �� .; � � X y � yo �� ' �r JO ��. /�e�' \\ ✓ ,� � �-�;� i Fs;s�� ) s`e TI e � �s NI °.� r,�� L �g, _ j � t— _-�. t — Fire Number and Name of Road�/��'� (�� f��F� 1 R)1�, 1. Enter lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent: 2. Indicate the location and size of the requested construction _ � Signa i activities. - 'i �� l Pnnt N e: 3. AISO,1ndlCate tlle lOCatlon and d15taT1Ce to fl10 we��, The a certi es that the listed in ermation and imentions are Vue and correct.,ihat all work shall be peAormed in compliance Sept1C tanlc and d7alnfield,wetland 3Teas,lOt lines and to tlle with ihe requirements of lhe Sawyer County Zoning Ordlnance and the laws and regulations of the State of Wisconsiq and if CeritOT'llri0 Of t110 T08d. acting as owner(s)agenL has the pertnission of the owner(s)to pedortn Ihe work requested on this application. The above personsls hereby give permission for aaess to the pmperty for ��- onsite inspection. Permit fee:$�� S . December 7. 2004 � Mp�`"�^ �n� �`e-i-� - °��i "'7� — Issue Date Signature ofIss'�ng ent December 7, 2005 50%Rule: Average Road Setback: _ Expiration Date Office Comments: i � i i i � I -47 I � I o - 46 � i � � P� aP� y I � N�GN� S,� A-r � � �� I � � I g A � P`-� s � � P � ' QRgK F � I ? � gG� B` � —3,37 � � I I � 3.3b,1 3.36, i z 3:3�}3 �, -3.3S � y � r I ��. N � I � �1 � I 3,44 � i 3.34.! ` � �.3o I /3`'' �'PN� � �� o��R I � � - — -- - - - - -- - - -- - - - -- - �- -- - — — — — � — i � � � � � ,,�,;, I -3.33 -3.32 3?51 � � � � � � SCALE : I INCH = 2 0o FEET FOR ASSESSMEN DRAWN BY : D . M . E. DATE : ► - 2 7 - I 97 B INTENDED TO SF COLON (:) INDICATES GOVT. LOT gOIUNDARY�L Cv G�H��, 2