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HomeMy WebLinkAbout024-741-19-5217-LUP-2004-341 Application for Land Use Permit (*Non-shoreland*) o o - . County of Sawyer � � �-� PO Box 676 - Hayward WI 54843 715/634-8288 j � � *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 HAVF' ";:EN ISSUED. H�,S PKT PRINT-USE BLACK INK OR PENCIL �' � � � /j � ``�c_��-T- ft C/-s o�I _ .s ti'� �, Owner Builder �: � � ,�/ � `�,�Z �.�' 13r�-�.��r���� �,.r. �r�--r�2-- � � Mailing Address Mailing Address O � � �/ 3 � �i�c_i 4 iZ i`1 (.�o� Isc, �`1$`1 �° City, State, Zip City, State, Zip � �i s�" �9`r' D�is 7� S ���� O_.3'is � Daytime Phone Daytime Phone ` Additional Information: Zone District: ��"� ' � Lot Dimensions: j/�/� �- G,�J � , Date lot was created: �, / C-' Acres: I �5 � o Is there wetland near the proposed structure? If yes, how far �l� � � Building Land Use Floadptain:( j �es ( j No `� � (�c)New ( ) Filling � ( ) Addition ( ) Dredging Driveway access off of a(Check one): �, O Alteration O Grading (i'�) Private Rd O Town Rd. o ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ,`; G� � ) � ) o � � r Primary Structure Accessory Building Addition � ° (x) Dwelling (x) Garage-attached/detached ( ) Deck W (x) Year round (�) # of car stalls �� O Porch � °� ( ) Seasonal ( ) Storage Building ( ) Enclosed � (� Frame built on site ( ) Screenhouse ( ) Living room � ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen ( ) Mobile/manufactured ( ) Other ( ) Bedroom ( ) Other primary structure ( ) ( ) Relocate/enlarge � ' � � ( � ( ) # ofnew y � / AdditionalInformation: "� � � � 9� `� � i Type of Construction: � Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete '�� ( ) Other ,.ti � Construction Cost: Primary Structure $5 C'/,2llJ � (�rH�� -�� S_UZ� �(}.��� � � Accessory Building: $ Addition: $ � � �t �;�c, y1 y � � Deed: Vol Pg Certified Soil Test# D�/-�93 � z CSM: Vol � Pg�Lot# y Sanitary Permit# b y- ILI� _ �, � Plat Envelope #- �°Y37 Or: R_1 c� --� 'v, Condo Vol Pg Year Installed: � � � � Aff of ex septic Vol Pg Owner When Installed: " 9� Previous office approvals/actions: ', Variance: # LUP: # SP: # CUP: # � Inspection Report: # Change of Zone District: ���� � ass3y . . Describe the construction using these columns. List the dimensions of each structure in a separate . column. �.ist each story, each addition, each alteration in a separate column. � #1 . L #2. #3. L�; �- �^ #4. Size �,,Z ft. wide � �_ ft. wide ft. wide ft. wide 3 � ft. long ��� .3� ft. long ft. long ft. long „ Floor �e�.��� sq. ft. //S.yZ sq. ft. � sq. ft. sq. ft. Hgt. from grade � to peak � ft. hgt. ft. hgt. ft. hgt. Stories �_ / stories stories stories ` # of bedrooms �_ ' ������ �`l`'� -��ie��e4�- -s� 7 � � ��rYt�:i�� � , ' �,'" ��� .- ;� � '� � _ 33 , �°� ' �9 , _ _ � � � � � a . � �; 3� - i�'o�P��� 3 . � - =�� � ' V � . S�`_ � \ � J� � � ` � �� � ,�. � � ` ' (��� .� ' ' ��w►£- 3a ' � 'J I � f �V �-----i��" � I I�f�,L _ I ,s;`t-�.� 1 U �� ' -� �8 ; '� _ , � Fire Number and Name of Road - � 1 . Enter lot dimensions and indicate north by arrow. Si f r, , Authorized Agent: 2. Indicate the location and size of the requested construction - 4� ` Signatu activities. ' Print ame: �-��T , � �-5�-� 3. Also, indicate the location and distance to the well, T above ceRifies that the listed information and intentions are �frue and correct., that all work shall be performed in compliance septic tank and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if centerline of the road. a�t��s as ow�er�S> a9ent, has the permission of the owner(s) to perfortn the work requested on this application. The above personsls hereby give permission for access to the property for U U onsite inspection. Permit fee: $ � � � � h�l ��.i 2004 ' Issue Date Signature o Iss 'ng ent July 12 , 2005 50% Rule: Average Road Setback: _ Expiration Date Office Comments: � � ;2..1 ✓ / -� � � 2.2 2.5 �� l :2.8 � � :2.6 i \ � .\ - ` � :2.7 . , t2.3 � � ,_a�_�� _"` --- :I:. , ����_ - i - - '2.13 � � � :2.14 2 �2.15 I. �2.1 I 4 �2.17 ,2.12 3 �2.1 � �2.9 � I.I 2 :2.10 � 3�� �. •.3.\.2 .- .,3�3 :3.1 ;3 2 ^ v .3�C` /� � I 4 ` � :3�5 5 �' �_ \s•,3�6 3.4 �•.3\? :3.1.8 i 5.3� 3 4 :3,9 3.7 .3.1 I z � 3g/���\\ ROUND :32 \ �4.1 � :4.12 L AKE , :4.2 �4.10 / �� �/i � � / / � / � i � \� z � / / � / / � �6.3 � 3 i 2 � �6.4 ti " :7.7 6 2 N �. � • ,�h , � 6.6 / ' r~ . ��� " .1�` �6.7 :7.9 ` I ' C�RTI �� �� S (�t.RV �Y M�� � z�k ►� o�crK�,u�k (,or2 h�,r�� ��.�a�a��� v�1 �owh o� �oha I�k� Sau� rr �Ounk WiSco si v � � �- � C r ,�/ �� �y S • '�'�'0� / ` � N � �O` I .a `9 0 1J.41�5�' � ` �1 nr i � D 1� . � op���i � � � m �� � ,�0•1� i: � � "'. � s� � � � � � � I � , �- � a . � � , o � � t � p �S "1 p i o � o. � c � �' � ■ • � � � � _ .s- U g � � � N � 5 S > o n g a � � � T �'� T C^ 1^ �' � -L�� ,�n y � ^' �_ ^ � P � N !� � � 7 � � � �1 2^ i h' o' K� � �J�-. � � s P � la • � o �' Nr- �. �. _ �',�'n � -1 � d - S +p `i� j � � 's r ^ c d°, ..7 S � • � 9 R� ry . � ^ i N 4 � � .� �' �' � •r.. s- -f. • � I •� � � � � s � � -a � � G.. cS x x• �- oi I T ..�. � I � � � � ..r� � � � �� .�~�` nS" S :.f� � aT .� ^- o S v � � c� C N J r ��+ ^- ' S r; f 3 � O t o� � .T � t . �_�� Z �F � +1 � 112.b9 ,`',. t �' _ ```���1111111117111!//�''''/' ` _, 11L.1''� —^ /�py`_ `� * S �jpti'p5�tq"E. 1� �05'.�1"E� ,� '� `�� �,,......».,,,� �i,� -_ 1 S �`�.a'`.�"� '.� �'•., N � � ;�f � :s � � - �oi � cn � y 'in= � ; �� � � � m � �0= «Lt O � s,��i i 2� � (0 111kl�irc��• �� � � f�\y� 1— ��� v ..� `` �..- i ��IO.Q�'`w...«* ```����` .���iq�iqm��n��t��`. z �- � v- � � �r � �`�'- a xsr � I �. 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