HomeMy WebLinkAbout024-741-06-3405-LUP-2004-195/
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Application for Land Use Permit (*Non-shoreland ) r � , �
fSa er ^ � ' �
County o wy � �
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 within -.
the property's boundaries. _ I
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
'�/�S K 7 PRINT-USE BLACK INK OR PENCIL �
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owen -- �r �� �n►� ..5� ��' �
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Owner Builder �:
,5��g �,-,��s �ue S � �.
Mailing Address Mailing Address �
M un n�4 p�.l�is , V�l i� S�S �-I� �
City, State, Zip City, State, Zip
(C.a ��Z�� z�- - ��Z3 1-��
Da i e Phone Daytime Phone
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A d ditiona l In forma tion: Z o n e D i s t r i c t: � �
Lot Dimensions:
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Date lot was created: Acres: -3: <�� � o
Is there wetland near the proposed structure? If yes, how far �leS �C;l s� �I-DT,� � �
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Building Land Use Floodptain:( j Yes �(}No `�
�New ( ) Filling �
O Addition O Dredging Driveway access of of a(Check one): � �
O Alteration . � Cirading �rivate Rd ('� Town Rd. ���,Q I�e(� o
( ) Moving On () ( ) County Hwy ( ) State Hwy N �
( ) � ) o S
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Primary Structure Accessory Building Addition � °
( ) Dwelling �Q Garage-attached/detached ( ) Deck W
""' � Year round (2) # of car stalls ( ) Porch �
� � Seasonal ( ) Storage Building ( ) Enclosed �
( ) Frame built on site ( ) Screenhouse ( ) Living room �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen R�
Other ( ) Bedroom �
( ) Mobile/manufactured ( ) .0 �
( ) Other primary structure ( ) ( ) Relocate/enlarge ; �
� � ( � O # ofnew � �C�
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Additional Information: ,.1 .�
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Type of Construction: �
� Frame ( ) Log ( ) Pole/metal ( ) Block (� Concrete `� ,�
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( ) Other � ,�
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Construction Cost: Primary Structure $ � �
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Accessory Building: $ � �j (��� Addition: $ �
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Deed: Vol c 5 Pg `��, Certified Soil Test# �1-��G'/ �" z
CSM: Vol I( Pg 15� Lot# h� Sanitary Permit# ��1� ���/�� o, �
� �� � 1 �
Plat Envelope � ��' � � Or: �,, �
'v,
Condo Vol Pg Year Installed: �
Aff of ex septic Vol Pg Owner When Installed: `-' �
Previous office approvals/actions: V
Variance: # LUP: # I%�- y .`�/ SP: # CUP: # �
Inspection Report: # Change of Zone District: �
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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.�i�Y��;�t, #2. #3. #4.
Size F`f ' ft. �5ide fr. wide ft. wide ft. widc '
_�_ft. long fr. long ft. long ft. long
Floor azea J7�a _sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from giade�_to peak ft. hgt. fr. hgt. fr. hgt. .
Stories � � 2 stories stories stories
# of bedrooms�_
Rear Lot Line
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Fire Number and Name of Road l�r'`�i��' �1 � � � �� F��� ����
1. Enter lot dimensions and indicate north by arrow.
Signature of Owner or A tf rize gent:
2. Indicate the location and size of the requested construction z c,� - �� '�'"'
ignat
activities. �) { � �
PnntName:_�Y,Z�ILd L - U���^
3. AISo, 1ndlCate the loCatlon and d1StanCe to the Wel�, The above cerlifes that th listed intormation and intentions are
true and conect., Mat all work shall be pedormed in compliance
septic tank and drainfield, wetland areas, lot lines and to the wrtn me req���emeoa or me sawyer co��ry zoo��9 om�oance
and the laws and regulations of the State of Wisconsin, and if
centerline of the road. ac6nq as owner�s)agent, has the permission of the owner(s)to
perform the work requested on this applicatlon. The above
personsls hereby give permission for atcess �o the propedy for
/� onsite inspection.
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Permit fee: $ ��
May 19 , 2004 - 1 _
Issue Date Signature of Issu g ent
Ma� 12, 2005 50% Rule: AverageRoadSetback: _
Expiration Date
Office Comments:
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� SCALE: I INCH= ¢00 FEET FOR ASSESSMENT USE ONLY N01
�_Z_.S DRAWN BY: .-SR.o DATE : �2/29/Bo INTENDED TO SHOW CONCLUSIVE
COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS
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,SAWYER COUIYTYCERTIFI�'D,S�IRVEYI��IAA
A DIVISIONOFCSM�1�99 LOCATED IN THESEI/4 5W!/9 OFSEC/70N f
T. 4!N R. 7 W„ 71UWN OFROUND LAKF SA K'YER COUNTY, WLSCONSIN.
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TOTAC ARFA = 656,801 SF.+/- ��` ,
iS.OB AC.+/- �
rn �
N 8T55'48' W 684.19' ,�-,�
�� 594.9J, ,s�i_,5ty By , CS 1/16
-I LOT 1 �� �' �
164,726 SF./- a
3.78 AC.+
� 596.87' �'� 65. �`
I`, N 8515'OS"f 161.40' / �
0
N ,g1 1'OT 2 j%�'1� � g i
� a 15J,638 SF.+/y stq. ' i ��
w `� 3.SJ AC.+� i �.,
a 796.30' 965.50' `� `=
� m
� .., � N 8Y25'05 �w 761.80' � sw ti '
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� � �� �� LOT 3 ,� ti ' N
� a � �� 169,293 SF./- Y'-+ �
� •� 3.89 AC.+ �
/6ARTCM' Tf�'ACRTN 40910' £ � JSI.9J' �
N 8975'05 E G 1 .l3' �`
LOT 4 �" ti �`
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169J44 SE+ - ' �
3.B8 AC.+/ � �
485.49' �274.97' �
N 8715'05 E 160.46 � PpB. �
�' = 200• �
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LLfi£ A4C LkZIA PMUS pKND LE)L'M pA'APO 0.�A4W' I �J
Cl 89.6J OS.19:76' 9/0.05 89.60 S 615Y3f�� nN�f�s t/4
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(I N p7JIL14'W iSJ.75 K�- 4
DATED THIS OF� :1997.
C£CENO CLIENL� ROBER7 BERCUM -��- . - . bF THE]�/ORTH
0 FOUNO 1-i/7 6PA55 GPPEO MON. JOB.�N0.11/9] [wMm Bn YV
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