HomeMy WebLinkAbout030-737-20-1101-LUP-2004-521 Application for Land Use Permit(*Non-shoreland*) o 0
County of Sawyer � k
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 boundaries.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. '
PRINT-USE BLACK INK OR PENCIL
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Owner Builder �'
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Mailing Address Mailing Address �
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City,State,Zip City,State,Zip
Zis 2vz-.�3vv
Daytime Phone Daytime Phone
Additional Information: Zone District: rL���
Lot Dimensions: —
Date lot was created: Acres:�/� �•''`�% o
Is there wetland near the proposed structure?If yes,how faz n/C� �
Building Land Use Floodpfain�( j Yes (�f No `;
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�New ( )Filling
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. o
( )Moving On ( ) ( )County Hwy (�State Hwy ; �
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Primary Structure Accessory Building Addition � °
( )Dwelling �Gazage-attached/detached ( )Deck �,"',
Q�)Year round (�)#of caz stalls ( )Porch =
O Seasonal O Storage Building O Enclosed �
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen c;
( )Mobile/manufactured ( )Other ( )Bedroom '�" �
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( )Other primary structure ( ) ( )Relocate/enlazge '
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AdditionalInformation: ' „
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Type of Construction: � ' �
Q�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other
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Construction Cost:Primary Structure$ f(y,o o� � a
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Accessory Building:$ Addition:$ � �.;
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Deed:Vol 7 3�r Pg I/�'r Certified Soil Test# °Q
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CSM:Vol Pg Lot# Sanitary Permit# � 7�
Plat Envelope Or: N I _
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Condo Vol Pg Yeaz Installed: G/ry�f,y �h�', �� t �
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Aff of ex septic Vol Pg Owner When Installed: ���«}",d % �
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Previous office approvals/actions:
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Variance:# LUP:# SP:# CUP:#
Inspection Report:# Change of Zone District: �,�y
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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. /�r;,,�,:, #2. #3. #4.
Size�de f[. wide ft. wide ft. wide
�_ft. long ft. long ft. long ft. long
Floor area��sq. ft. sq• ft• Sq� ft• S4• fr�
Hgt.from gade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms
Rear Lot Line
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Fire Number and Name of Road //3Uc r � s T z�� 4�
1. Enter lot dimensions and indicate north by arrow. Slgnatu�e of Owner or Authoflzed Agent:
2. Indicate the location and size of the requested construction �j�,_/,,, ,� Uu-�.,L
Signalure
activities.
Ptlnt Name:
3. Also, indicate the location and distance to the well, The above certifes that the �isted infortnation and intentions are
true and correct.,ihat all work shall be pertortned in compliance
septic tank and drainfield, wetland azeas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and Ne laws and regulalions of Ne Shate of Wisconsin, and if
centerline of the road. ading as owner(s)agent,has the permission ot the owner(s)ro
pertorm the work requested on this applicatlon. The above
personsls hereby give permission for access to the property for
onsite inspection.
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Permit fee: $ �(,�
September 20, 2004 -
Issue Date Signature ofIs u�n ent
Septemaber 20, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
ON CORNERS POSI110NS WERE I
TED BY THE SAWYER COUNTY � `
=YOR'S DEPARTMENT. SECTION I
VISION WAS EXECUTED BY 1}iE MID P��� 030-373-20 1101 DEED REFERENCE
736/118 DESCRIBES ALL LANDS LYING NOR7H � g'p � •
DEFINITION. AND EAST OF HWY 48 AS IT NOW UES. THE � g � � -
PREE%ISi1NG PARCEL NAP SHOWS HWY 48 �15- � I
RUNNING PARALLEL 1N1H THE RAIL ROAD. � r��,
HWY 48 HAS CHANGED LOCA710N AND SAID �
DEED MAY NEED A CORRECiION. � �. �
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