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HomeMy WebLinkAbout006-440-16-2204-LUP-2003-263 ffM E NaM Et�1 � Application for Land Use Permit(*Non-shoreland*) o o _ County of Sawyer � 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 boundazies. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � /� PRINT-USE BLACK INK OR PENCIL Ivi/�N� c��c�t,,s l�'�T`� ��r� ����-t�Ao-�Cs co�� '� Owner . � C;.J d'1� `? �T�c-�L'� �L'�r /�-/d(P�f3 S�1/�-7� �� �v �' Ma ing Address Mailing Address O f�ti�'1���s� �I��,S���y 6�l,�Z—�� U./����p�—?�� � City,State,Zip City,State,Zip � �! � �� --�Jc�/ '-- �/ � �-�`c �fL1/�' Daytime Phone Daytime Phone � Additional Informarion: Zone District: I'� � � ��-� S�� � Lot Dimensions: Date lot was created: Acres: ^ � �� '�`� o Is there wetland near the proposed structure?If yes,how faz o��r�� fJ L/3�J 9-2���-�f C c ~. Building Land Use Floodplain:� j Yes O No � ` ( )New ( )Filling � � O Addition O Dredging Driveway access off of a(Check one): � (�Alteration ( )Grading ( )Private Rd (�Town Rd. o ( )Moving On ( ) ( )County Hwy ( )State Hwy N � O O o S Primary Structure Accessory Building Addition � ° ( )Dweliing ( )Garage-attached/detached ( )Deck W � ( )Year round ( )#of car stalls �j(Porch � ( )Seasonal ( )Storage Building ( )Enclosed � � .. O Frame built on site O Screenhouse O Living room ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ( )Mobile/manufactured ( )Other ( )Bedroom � � ( )Other primary structure ( ) ( )Relocate/enlarge � ' � � ( ) ( )#of new AdditionalInformation: � p'' � � � ��- " �T e of Construction: � Frame ( )Log ( )Pole/metal ( )Block ( )Concrete ( )Other ro y Construction Cost:Primary Structure$ � I� Accessory Building:$ Addition:$ ,�(,��d/�C� � � 5�t9 c�� r� � Deed:Vol 1(�3 Pg� Certified Soil Test# Q 3 " C9 ! .3 00 z CSM:Vol��Pg�Lot# � Sanitary Permit# [� �� — I � � �, 7� Plat Envelope Or: �, � Condo Vol Pg Yeaz Installed: � �� � Aff of ex septic Vol Pg Owner When Installed: V � G 3-�3 �{-�-i�-Y�v S !/�i��Z �� UI-IKa. T � 3� Previous office approvals/actions: 99_�6a � Variance:# LUP:# 45'1,5v SP:# CUP:# � Inspection Report:# Change of Zone District: \\�;a ��q\=1� � l7' �� �1.���� , /' 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 ft. wide ft. wide ft. wide ft. wide ��ft. long ft. long ft. long ft. long _ Floor azea �-U� sq. ft. sq. ft. sq. fr. sq. ft. Hgk from gade 1�to peak ft. hgt. ft. hgt. fr. hgt. Stories stories stories stories #of bedrooms Rear Lot Line G � � � o � P r�es��� ��a� y���Q � �ti� t l �. J6s�- /i'� lgl�� D �� L` ` n1 TU 0 r�-� � f� � �� � _�,�� �o �'r �WST� S �� �d d- � � � c,��s �}-����`�� � �,�� � ,�. �C' �� � � � �� f Y � p,,P ,��.(.a �J (� ;�-- � �Gf i-S t�� ;a ��, pG c� < < � �v�� C �1��� Fire Number and Name of Road �%j �- � L�t,1 /� � �- �'� ��'��� �� 1. Enter lot dimensions and indicate north by arrow. Si pa re of Owner or thor' �9�nt: 2. Indicate the location and size of the requested construction �✓���--- ��b � Signature activities. �',��}y-�QLF s C lZ PnnlName: 3. Also, indicate the location and distance to the well, The above cerlifes that the listed informatlon and intenirons are true and correct., Nat all work shall be peAormed in compliance septic tank and drainfield, wetland azeas, lot lines and to the with the requiremenLs oi the Sawyer County Zoning ONinance and the laws and regulations of the State of Wiscronsin, and if centerllne of tlle road. acting as ovmer(s)agent, nas tne permission ot the owner(s)to perfortn the work requested on this appliption. The above personsls hereby give permission for access to the property for onsite inspection. nA,�;r fee: $ April 26 , 2004 _ _ � �/1 _ L�S Issue Date Signature ofIs �n ent June 13 , 2 0 0 4 50% Rule: Average Road Setback: Expiration Date Office Comments: . � �• � , 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 separ�te column. � � � #l. (� 2. #3. � }"Y #4. , Size � d ft. wid���'�-� � d ft. wide �a ft. wide ft. wide ��-P ft. lon ft. lon , � �(4 ft. long �� ft. long g g - Floor area �_ sq. ft. �v Sq. �. �9a sq. ft. sq. ft. Hgt. fitim grade_� to peak �� ft. hgt. ft. hgt. ft. hgt. Stories stories stories stories # of bedrooms ' _ Lot Line or Lake/River name: _1 "�' ` _._ ______._.,._____ V" � _ �---- .b � ~� �'' ._ � ` �� C^ ,d ��-i;ti �t , � C� - �-�, �. �;,- �, __„ � T �..--,� � �q ,� � � ___,_..-�4�, � � a � � �� a `� � � � � � � � � � , � � � � � � -� �-~ � �, �� x � � �' G � � ` � � ,� �► �b � z. �;' � � � � � `'�' � 7 � � � �, `�' � -�y � P' � _._. '� �c �" �' .r-�� r� � � � � ' sa �� � �___�'—= o'- _ _____ , --- - � _____ ._...�__--------- � - - � -o � � �, °� � Fire Number and Name of Road � (� 2. � GJ ^/• ��-c�t1E'i' � " 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. � . 3. Indicate location of well, septic tank, drainfield. � 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. Print Name: C� �rt � L� � �C��� The above certifies that the listed information and intentions are 6. Indicate any grading or clearing in excess of the construction site. true and correct The above persons/s hereby give permission for access to the propeRy for onsite inspection. ' ;" 7. Indicate distance to any wetiand. , , Permit Fee: -7 S . � � . June 13 , 2003 _ � Issue Date Signature of I in gent ; June 13 , 2004 ! � � . Expiration Date � _ I Office Comments: ��e V'�.�xQ p ' '�o ��� ��'�'"'��ia • ��'03 � Inspection Date: 50% Rule Applies: Avg. Setback: ! Restrictions and other information: ' = I � � � ; , , . W �- N1tlON NC'3B Ol o3w�ssd ' 3N/7 .�, SAWYER COUNTY CERT/F/ED SURVEY MAP NO. 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SCALE.' / inch = /DD �eet y O - Found '�" iron pip� . ��� O - DPnot�s 1"z30" lron p1pP r►lth p18st1C Cep � �o0 5o xs o ioo �� , atampod , "�CHMIDT 5-1059" , ��t this survPy. ���`�����:��r��u��i�� �. LinPal wpight - 1. 68 lbq . /ft. r,� �<�GOIV�� ��' (.. " � - D�notP� �xigting building � ���`� � �� ' w � - DRnotPs soil boring location �. �AlY1ES .1,� � ' i �:� - HPevy line dPnotp� boundary of thla �urvPy. j� � i sCs r�DT ` : � � z}c . i QZ � � �t YMiK /Au6. � (r = `� 00 � - � i o r .� •�• 1NI$• :Q 3 �: i, • ' ` :� 14, .) 2 }�✓O�'ti..w......•'�(i� � � ,�,,I.S U �� �,�o i\ti:: i , ���\ -:f -.'�, .�—j� � :,., ,__�.' � _;. , 3 � i 3 � ' � � � I � � . .................._._ ._"_._.___'_'"_.__.___"'_ __"__.'"_—___""—_' _""____. 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