HomeMy WebLinkAbout010-841-19-4107-LUP-2003-790 Application for Land Use Permit o o �
County of Sawyer �, �
PO Box 676 -Haywazd WI 54843
715/634-8288 �-
The undersigned hereby makes application for a Land Use Permit and agrees that all work �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance £
and the laws and regulations of the State of Wisconsin. Y
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. `J
PRINT-USE BLACK INK OR PENCIL � �
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Owner Builder °� �`_s,�
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Mailing Address Mailing Address � �Q
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City,State,Zip City,State,Zip
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Daytime Phone Daytime Phone r �
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Additional Information: Zone District L' '�
Lot Size `� �
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Date lot was created Acres 7�� '
Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river, �• J
creek or stream) If yes,how far from the shoreline&water name: N O L �
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Is there wetland near the proposed structure?If yes,how faz IU t"7 � �
Building LandUse 'c
( )New ( )Filling � Floodplain:( )Yes (�No # ;�
�Addition ( )Dredging � G�
( )Alteration ( )Grading Chippewa Flowage: ( )Yes (�No ,°�.,
( )Movin�On ( ) � o
( ) ( ) Driveway:( )State ( )County ( )Town Rd. � {
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Primary Structure Accessory Building Addition -<' I.�
( )Dwelling ( )Garage-atYached/detached ( )Deck �
( )Year round ( )#of car stalls ( )Porch �
( )Seasonal �Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room � �
O Modular/manufactured O Greenhouse O Kitchen d A
( )Mobile/manufactured ( )Other ( )Bedroom �
O Oth r rimary structure O O Relocate/enlazge
( ) �o� ��iP�ti� ( ) ( )#of new >
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Additional Information: I°
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Type of Construction x�
( )Frame � ( )Log (�Pole/metal ( )Block ( )Concrete �
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( )Other w
Consri-uction Cost:Primary Structure$ l��5r`� - �
Accessory Building:$ Addition:$ Z
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Vol��Pg 3� of Deed Certified Soil Test# YO- 1l�`I
CSM Vol Pg Lot# Sanitary Permit# RD'�31 9$-o as �
Plat Envelope Or: �
Condo Vol Pg Yeaz Installed Z�0,3
Aff of ex septic Vol Pg Owner When Installed:
Gazd Gazebo Vol Pg �l,l/�� (��E�.)�t�s
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Previous Variance: LUP: �1(�,3`t 3` Inspection Date:
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