HomeMy WebLinkAbout010-839-01-5304-LUP-2002-404 Application for Land Use Permit o o '
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
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin. P `
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERI�ZITS HAVE BEEN ISSUED. � �
PRINT-USE BLACK INK OR PENCIL
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Owner
T Builder �'
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Mailing Address Mailing Address �
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City,State,Zip City,State,Zip
s�3-s�r '7� a��i
Daytime Phonr Daytime Phone
Additional Irformation: Zone District ��� �
Lot Size
Acres 7 �- �
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: G�::1 l.r��
Is therr,wetland neaz the proposed structure?If yes,how faz � �
Building Land Use � �D
( )New ( )Filling Floodplain:( ) es ( )No # ;;
E j'Addition ( )Dredging '� �
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( )Alteration ( )Grading Chippewa Flowage: ( )Yes ( )No �
( )Moving On ( ) o
� � ( ) Driveway:( )State ( )County ( )Town Rd. �
Primary Structure Accessory Building Addition '
�Dwelling ( )Garage-attached/detached ( )Deck �
)Year round O#of caz stalls O Porch �'
( )Seasonal ( )Storage Building ( )Enclosed '
O Frame built on site O Screenhouse O Living room � p'
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( )Modular/manufactured ( )Greenhouse ( )Kitchen Cr�
( )Mobile/manufactured ( )Other ( )Bedroom i.J� ��I
( )Other primary structure ( ) ( )Relocate/enlarge \
� � ( ) ( )#of new � ay
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Additional Information: �
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Type of Construction �
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other ^ �', t
Construction Cost:Primary Structure$ i��
Accessory Building:$ Addition:$ ' Z
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Vol J�`�Pg 3�� of Deed Certified Soil Test# G���C�� �
CSM Vol�Pg Cr� Lot# � Sanitary Permit# G� -c�r1��
Plat Envelope �r� �
Condo Vol Pg Year Installed
Aff of ex septic Vol Pg Owner When Installed:
Gazd Gazebo Vol Pg
Previous Variance: LUP: Inspection Date:
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