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Home My WebLink About026-938-05-6315-LUP-2003-222 S I��'C i � � ��'S� � � _ Application for Land Use Permit o O I , County of Sawyer � � - PO Box 676 -Hayward WI 54843 715/634-8288 ��, � The undersigned hereby makes application for a Land Use Permit and agees that all work y-_ shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance � and the laws and regulations of the State of Wisconsin. � NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMTTS HAVE BEEN ISSUED. PRINT—USE BLACK INK OR PENCIL � 1��'i9-/y �v.bro�� E/f.P y � ,� ' Owner Builder <' ��a53�i SSAdA/r-� /f?�fi ,li'�✓ �. � � Mailing Address Mailing Address � � � �Sj'oniG �.4�8 /.v.' � �-"i��f.�� City,State,Zip City,State,Zip �/-�.�/� 7 ,. � Daytime Phone Daytime Phone �.. Additional Information: Zone District F—� \� •� Lot Size Acres Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river, � creek or stream) If yes,how faz from the shoreline&water name: ; Is there wetland near the proposed structure?If yes,how faz � � •,, �c ``. Buil mg Land Use � - (�eW ( )Filling Floodplain:( )Yes ('j�No # :; Dred in � ( )Addition ( ) S B o ( )Alteration (XGrading Chippewa Flowage: ( )Yes ( �o � ( )Moving On ( ) c o � � � � Driveway:( )State (�')Counry ( )Town Rd. " ,� -� Primary Structure Accessory Building Addition � V" �Dwelling ( )Garage-attached/detached ( )Deck ,� �'Year round O#of caz stalls O Porch � ( )Seasonal Storage Building ( )Enclosed \ �Screenhouse ( )Living room � ( )Frame built on site ) ;�., ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � ( )Mobile/manufactured ( )Other ( )Bedroom `�� O Other primary structure O O Relocate/enlarge A � � � � ( )#of new � � � 0 AdditionalInformation: ,,y J ; �J i � I Type of Construction y ( )Frame ( )Log ( Pole/metal ( )Block ( )Concrete � ( )Other �- Construction Cost:Primary Structure$ /N 7„19 �-� � Accessory Building:$ Addition:$ '� z � Vol � Pg�. of Deed , .e -Certified Soil Test# .t�/f� � CSM Vol Pg Lot# � `�F Sanitary Permit# � � 'Il'y � 1�,.�.._.,^tvk- � Plat Envelope Or: Condo Vol Pg ' Year Installed � ' Aff of ex septic Vol Pg Owner When Installed: Gazd Gazebo Vol Pg � Previous Variance: LUp: Inspecrion Date: �� -� `' ��S�7 ' 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 . �rA�.�«= #2. �"lc��c= #3. #4. .- Size�_ ft. wide � ft• wide ft. wide ft. wide �� ft. long � ft. long ft. long ft. long Floor area , � � � _ sq. ft. 7�o sq. ft. sq. ft. sq. ft. �'". �, ft. h t. " Hgt. from grade to peak � ft. hgt. ft. hgt. g Stories _�_ � stories stories stories # of bedrooms �_ Lot Line o Lake/River name: 1�' � � �� :� � Ji - ` � � �� c� w� � � � � - --- _ ___ . ---- _ _----- _ _ _ �a �S,_ �,��s� � ° 3oi �� ; � , � � , : � � �� 1�a � l�/ �," , __----_`-�" ; -'_ _ 'i; . � � �� . �7�{ t f�_ � � �S �. ;�' � ` L S Fire Number and Name of Road �,�/ ��'SS�l�- �"�'-�-% � r<�''�, 1 . Fill in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent: 2. Indicate location and size of existing and new structures. 3. Indicate location of well, septic tank, drainfield. 4. Indicate distance to existing structures, lot lines, septic system. 5. Indicate distance to the ordinary high-water mark of any lake, pond, river, stream, creek, and name the body of water. P��nt Name: ,��G. SQ�,�iy�U G /�� The above ceRifies that the listed in ormation and intentions are true and correct. The above personsls hereby give permission for 6. Indicate any grading or clearing in excess of the construction site. acoess to cne proPe�y ror o�s�ce ��spe�c�o�. 7. Indicate distance to any wetland. 5 � < <'-%- Permit Fee: � + S � ,� .`� June 5 , 2 0 0 3 � �' "'��"��'�' � Issue Date gnature of Issuing gent ', June 5 , 2004 Expiration Date O ffice Comments: II Inspection Date: 50% Rule Applies: Avg. Setback: , Restrictions and other information: BLACK MALLARD CONDO . '�� . �� :I 3.5 1 .. I� SISSABAGAMA LAKE -0 �� W �� '�' W _ � 1 - ' ., � � —��-� ;- ��- .. .. -�,, � � �' � -' � �'a � � � ~ � (.!J �. , � w .w � �� N � � , � s.� / _ _ s .. �� :� w � � w � .p � �,,, . - / :� O � • Cn �14.9.1 :14.9 � .. D � :14. 8 � .n :� ( � � D .� � � � � D •• � � � ' r� n� :� w -p � � - � / � � w ~ � N (�•1 —