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Home My WebLink About026-939-09-3301-LUP-2004-047 Application for Land Use Permit(*Non-shoreland*) o o ,�' County of Sawyer � PO Box 676 -Hayward WI 54843 O � 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. �' CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � r PRINT—USE BLACK INK OR PENCIL �t1Eh Ann ccnd � � O �i rn.�I �1tz`-1- ��rk�,�'� I�i.�.� �c��r1c�5 �Yl l.. � Owner Builder —T �; Io`v�(rs A.� C�1e� 7—I F�c� 1`��n1�1 t�a,��roac��Iree+ �uiaelC�� Mailing Address Mailing Address � �+�,�� ,�� r.�t ��,� ►�«��..,; �;L��ti� � �1 Ciry,State,Zip City, tate,Zip �i`�-�'-'tq-Ot0 a -lls� 3y- lc:��G `J Daytime Phone Daytime Phone Additional Information: Zone District: �a q � � � Lot Dimensions: Yj� Qc.re� Date lot was created: Acres: �� 0 � Is there wetland near the proposed structure?If yes,how faz 1'1� � Building Land Use Floodpkain:�-j Yes (�No :R (�f New ( )Filling � Addition Dred m Drivewa access off of a Check one `D � ) � ) g� 6 Y � )� aa O Alteration O Grading O Private Rd (�}Town Rd. 0 ( )Moving On ( ) ( )County Hvry ( )State Hwy �; � � ) � ) o `,� t� Primary Structure Accessory Building Addition � ° ( )Dwelling ( )Garage-attaehed/detached ( )Deck W ( )Year round ( )#of car stalls ( )Porch � O Seasonal (�Q Storage Building O Enclosed � O Frame built on site O Screenhouse O Living room � � ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen C+ � ( )Mobile/manufactured ( )Other ( )Bedroom fi ( )Other primary structure ( ) ( )Relocate/enlarge � ' � � ( ) ( )#of new `" �� AdditionalInformation: y a r. � 0 Type of Construction: ,.� I �, ;( )Frame ( )Log (k)Pole/metal ( )Block ( )Concrete ��-� ( )Other � b � Construction Cost:Primary Structure$ � � :? �Accessory Building:$ `��{1CK-',GC:' Addition:$ � �3�9�5 3 � �' Deed:Vol Pg Certified Soil Test# °Q z' CSM:Voi Pg Lot# Sanitary Permit# �, '7y Plat Envelope Or: h, Lt� � Condo Vol Pg Year Installed: ��r�,('iY �-t�%��t�'T� �n � � Aff of ex septic Vol Pg Owner When Installed: Previous office approvals/actions: Vaziance:# LUP:# q5 SS�(t1'�p;# CUP:# � Inspection Report:# �iS' a``'�� Change of Zone Distriot: � �a �\��. a��o� 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 _��,fr. long ft. long ft. long ft. long Floor area " `��K sq. ft. sq. ft. sq. ft. sq. ft. Hgt.from giade�to peak ft. hgt. ft. hgt. ft. hgt. Stories � stories stories stories • # of bedrooms Rear Lot Line � , ,�, .___,. _.. �, � . ; � . ` � �,r�C`+ _-- , ` _�\ ';>f ]��C �1A�11C1�/�� .. � � � ^, �I r i� I t�� t� �� . ". . �� y,w ''_C"; I; � � Fire Number and Name of Road (�`�C�c �i E�\�l a-1 `t�ci 1. Enter lot dimensions and indicate north by arrow. Signatur�of Owner or uthorized Agent: 2. Indicate the location and size of the requested construction �, -�. ")��,�� Signature 8Ct1V1t1CS. PnnWame:_ �`�.�tj� ry - ��C��T� 3. Also, 1ndlcate the location and dlstance to the well, The above certifies thaYtne listed information and intentions are We and correct., ihat all work shall be pedortned in compliance septic tank and drainfield, wetland azeas, lot lines and to the wim me req��reme�� or me sawyer co�nry zon�n9 om�nance antl the laws and regulations of the Shate of Wisconsiq and if COriYCIlinC Of 1.110 i02d. acting as ownet(s)agent, has the permission o(the owner(s)to pedortn the work requested on this application. The above personsls hereby give permission for access lo ihe property for onsite inspection. <�„ Permit fee: $ �`�Y? march 18 2004 Issue Date Signature ofIs in gent March 18, 2005 50% Rule: AverageRoadSetback: Expiration Date Office Comments: ,..r Z.6. \ :3$ � '3.7 .�2 :3.6 Y � .�o� .9.z :3S � ;34 � •io.2 �:. �3•� . =3.10 � � 10.3 .�. � 3_�t :a.� k � � � � y�,�/ .14.! 3 � � � � � �o.� q.l :. : � � � � � � /�� _ � � � � :3.3 �` � � � ,l�r � � � � �.�s • � _ � �� / // :3.2 ( -��.� .�2.� 1 � i e � 3.ft I.i1 g � .�� i �Y � ' :3.1 •12.2 � . � SCALE: ! INCH = 4op FEET FOR ASSESSMENT USE ONLY DRAWN BY : �ATE = INTENDE� TO SHOW CONCLI COL�N (:) INDlGATES G�VT. LOT EVIDENCE OF OWNERSHIP OI � BOVNDARY LOGATIONS ,