HomeMy WebLinkAbout030-737-01-3303-LUP-2004-177 " � Application far Land Use Permit(*Non-shoreland*) o 0
County of Sawyer �, � �
PO Box 676 -Haywazd WI 54843 � �
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 boundazies.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
PffiNT-USE BLACK INK OR PENCIL
I�1��� � 1
/��, _n �
p�e1'�,l�.� �(2�.n���— Builder a �
ID�`ile U.1 C�c1�IZ- ����-��r.�� Wl�b�l ��a�� �:
Mailing Address Mailing Address O
��vo ln�„� ��1� �,'���5� �—�G�S/'Yl iT"(-i r �✓�- <<���C� �
City,State,Zip City,State,Zip �
C�is��3-3a�iS �� s--�3� - 3.��1
Daytime Phone Daytime Phone
Additional Information: Zone District: /-1 �a
Lot Dimensions:
Date lot was created: Acres: � o n
Is there wetland neaz the proposed struchue?If yes,how faz (1 G
Building Land Use Floodp}ain:� j Yes (Xj No =R 5
�New ( )Filling �
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd �Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy �,`'', �
� ) � ) o �
t�
Primary Structure Accessory Building Addition � °
�Dwelling ( )Gazage-attached/detached �Deck(�� W
�Year round O#of caz stalls O Porch �
( )Seasonal ( )Storage Building ( )Enclosed �
( )Frame built on site ( )Screenhouse ( )Living room ��'r`.
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �N`�
( )Mobile/manufactured ( )Other ( )Bedroom a
( )Other primary structure ( ) ( )Relocate/enlarge � U� �
( ) ( ) ( )#of new J � ��
J �
AdditionalInformation: � >
�
�
�
1 �
Type of Construction: ��J
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other � ,�
�v
Construction Cost:Primary Structure$�(lc� � �
Accessory Building:$ Addition:$ �
� ��
Deed:Vol ,�4� Pg�_ Certified Soil Test# Oy-�7� tlQ z
CSM:Vol Pg Lot# Sanitary Permit# Q y'Og� o, '7�
Plat Envelope Or: �, �I
Condo Vol Pg Yeaz Installed: o I
Aff of ex septic Vol Pg Owner When Installed: `-' �
Previous office approvals/actions: �
Variance:# LUP:# SP:# CUP:#
Inspection Report:# Change of Zone District:
s��fa�
315�1
Describe the wnstruction using these columns. List the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a se arate column.
#1. Q. �f� #2. K #3. ��C #4.
Size a�J..s ft. ide ft. wide ft. wide fr. wide
S�F' ft. long �� fr. long � ft. long ft. long
Floor area �531 sq. ft. �v sq. fr. �( _sq. ft. sq. ft.
Hgt firom grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories�_ �_stories �_stories stories
#of bedrooms�_
� � , - -- i
�
— .. .. _.__ ._..
3 a"• �---�IFear Lo-�irie—"
_ �
Q,��S�e��' �
i� , �
; 1_1--- N'SS,� ' ^ �
p IV
`10 — � ----�-� �
\5� _�_L��_X.`�J�-�r � /�
_ �- , 'I
i
^,., � ,
E---3� � —� .� � d ' _ . .
�1�� � 5(�' --� �; �L
, __ __.____ _____ �,rL,
'; ��,
� 3 �
_
00
(!J
�i
; �
�,' —
Fire Number and Name of Road �C�
1. Enter lot dimensions and indicate north by arrow. Si natu[e o�wner or uthorized Agent:
2. Indicate the location and size of the requested construction �/,=j �,� /,�- `��% �E
Signature
activities.
PrintName: I��J, C�I�n[I � ��fan ;cq
3. A1S0, 1ndlCatC the IoCatiOn and d1StanCe to t110 well, The above ceNfies Nat the listed information and intentions are
We and cortect.,Mat all work shall be peAormed in compliance
septic tank and drainfield, wetland azeas, lot lines and to the wan me req��reme�c� or me sawye�co��ry zoo�o9 om��a�ce
and fhe laws and regulations of the State of Wisconsin, and if
CCRtCI'llri0 Of t}1C IOad. acting as owner(s)agent has the pertnission of the owner(s)to
pedorm the work requestetl on ihis application. The above
personsls hereby give permission for aceess to the property for
onsiteinspectlon.
Permitfee: $ ��J, ��
May 11 , 2004 -
Issue Date Signature of Is i g gent
May 11 , 2005 a
50/o Rule: Average Road Setback: _
Expiration Date
Office Comments:
030-737-01 2201
9 <OAC
¢
N - NE- NW
030-737-01 2202 �
eainc. 030-737-07 2101
P 85AC
030-737-01 2203
9.a�qC-
030-737-01 2303
9 6]AC
030-737-07 2301
9b5aC
030-737-07 2401
3972AC
SW- NW SE - NW
030-737-01 2304
9 59AC
�
030-737-01 2J02
9b0AC
;;r� ib^
�y ',
�_
; , ^` � j
:n
i;i -.
i.` �` ��
, _�
, A 5
� I V tY — J t1�
030-737-01 3201 N E- S W
SA 32AC
, 030-737-01 3101
79 4 AC
030-737-01 3301
3 6CAC
� 030-737-01 3304
a sen�
a J VV — J yV 030-737-01 3404 030-737-01 3402
9.ssac 030-737-01 3403 esanc 030-737-01 3�
9.ssnc � ssnc
030-737—Ot 3305 030-737-01 3303 � � � • '
030-737-01 3302 oe3n�..
H91AG 4.63AC
'". _ __."_ ""' _ —__— " —_ '_ .' � i54r
I � .... "GORDON RD
SHOWN AS 3
MAPPINC PUI
�