HomeMy WebLinkAbout024-741-32-3405-LUP-2004-271 Application for Land Use Permit(*Non-shoreland*) o o.
County of Sawyer � ��
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PO Box 676 -Hayward WI 54843
715/634-8288 r��
*Property that is not located within 300'of a creek,river or stream or within 1000'of a �J
flowage,lake or pond or does not have any of the above waterbodies located within � �
the property's boundaries. p`
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ,
PRINT-USE BLACK INK OR PENCIL � �
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Owner Bui� �. �
I�I��o�J C ut,<-,�y 9-c a.w�_ ��o rvt,�l �1. �� `
Mailing Address Mailing Address �
� S�f��4 �wt�1 e�rs7' t,c.J i S 4 YUk., �
City, tate,Zip City,State,Zip R
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Daytime Phone Daytime Phone r
�AdditionalInformation: ZoneDistrict: �Q—r
Lot Dimensions: Sr � 57J � ��5 �
' Li,(�GG � �
Date lot was created: � -��� �( Acres: o C
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Is there wetland near the proposed structure?If yes,how far y./� � }�
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Building Land Use Floodplain:( j Yes (�o �
( )New ( )Filling �, �
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd O Town Rd. o p�
O Moving On O O County Hwy O State Hwy i."'i
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O O o S
Primary Structure Accessory Building Addition � °
( )Dwelling ( )Garage-attached/detached ( )Deck "'
( )Year round ( )#of car stalls (;�orch�3��'�4��'�-'� =
Stora e Buildin ( )Enclosed CD
( )Seasonal ( ) S g �
O Frame built on site O Screenhouse O Living room " �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen G `�I
( )Mobile/manufactured ( )Other ( )Bedroom [V �
( )Other primary structure ( ) ( )Relocate/enlarge -� �
� � � � ( )#of new � �
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AdditionalInformation: , p
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Type of Construction: w w
(�'F'rame ( )Log ( )Pole/metal ( )Block ( )Concrete � �
( )Other ,� .�
Construction Cost:Primary Structure$ — � �
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Accessory Building:$ � Addition:$ /O �Z.Z � '�
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Deed:Vol�b2- Pg i'3U Certified Soil Test# °0 z
CSM:Vol 23 Pg "�`� Lot# i Sanitary Permit# o, 7'
i��� Or: N c'
Plat Envelope J
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Condo Vol Pg Year Installed: cc
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Aff of ex septic Vol Pg Owner When Installed:
Previous office approvals/actions: N
Variance:# LUP:# SP:# CUP:# �
Inspection Report:# Cbange 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 ad t'o , each alteration in a se arate column.
# 1. #2.��. h 0� #3 . �� is #4.
Size 1 �t. wide - ft. wide its ft. wide ft. wide
ft. long r(oK ft. long l Z ft. long ft. long
Floor
sq. ft.sq. ft.
Hgt. from ^de to peak /.2, ft. hgt.
sq. ft.
ft. hgt.
Stories I stories — stories
UtAvL- rt n �P ND1s1G
pWNER GSM
sq. ft
_ r � 44 �3 Poe
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4.42 ?e 0, 92 �2
�24422.
N04'44'18"W�
Fire Number and Name of Road f 1(2 p Lo (�A.c /tti � -y �[�� � �, 7Q1
Enter lot dimensions and indicate north by arrow.
2. Indicate the location and size of the requested construction
activities.
3. Also, indicate the location and distance to the well,
septic tank and drainfield, wetland areas, lot lines and to the
centerline of the road.
Signature of Owner or Authorized Agent:
J jt<
Signature
Print Name:
The above certifies that the listed information and intentions are
true and correct., that all work shall be performed in compliance
with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin, and if
acting as owner'(s) agent, has the permission of the owner(s) to
perform the work requested on this application. The above
personsls hereby give permission for access to the property for
onsite inspection.
Permit fee: $
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31
SCALE: 1 INCH=400 FEE
N � �� SAWYER COUNTI' CERTIFIED SURVEY � �
D � \ � LOCATED IN THE SE 1/4-SW 1/4 SECl10N 32,T4/N,R7W, �
W � TOWN OF ROUND WCE,YIWYER CWNTI;WISCONSIN.
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BEARINGS ME REFERENCEO TO \ �/N� �
h1E SOUTN LNE OF THE S4 1/�
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OR LE55 TO THE ft/W LINE OF C,T.H. 'B� M!0 IS SUBJECT TO HL ��4r�����������„` �� k' $� /
FlSEMEHTS AND R6ERJATIONS OF RECORO. � �QR '-� 4��2' � � �
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WISCONSIN STANTES, AE-7 OF iHE WISCONSIN AOMINI5TMTiVE COOE SEC ]4, T47N-q7W 7�,�p' ��--� O
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HAVE SURVETED, IXVIDED NIO AIAPPE➢ iHE LM1O HEREIN OESCPoBED, 1�
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