HomeMy WebLinkAbout032-107-01-2400-LUP-2004-017 ,'S c�
Application for Land Use Permit r y O
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County of Sawyer �
PO Box 668 -Haywazd WI 54843 v _ �
715/634-8288 �
T'he undersigned hereby makes application for a Land Use Permit and agrees that all work ,�
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance� � Z 1
and the laws and regulations of the State of Wisconsin. / �—
PRINT-USE BLACK INK OR PENCIL� � /o
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Mailing Address Mailing Address — :;
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City,State,Zip City,State,Zip � �
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Daytime Phone�)�o,3yj_3� �����, Daytime Phone Q
Building Land Use
( )New ( )Filling Zone DisVict �(��� n
(v9 Addition ( )Dredging '^ �
( )Alteration ( )Grading Lot Size � �
( )Moving On ( ) �
( ) ( ) Acres � (o�_ ,� �
Primary Structure Accessory Building Addition � �
( )Dwelling ( )Gazage-attached/detached ( )Deck �� S
O Yeaz round O#of car stalls O Porch � o
(�Seasonal ( )Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse �Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom �
O Other primary structure O O Relocate/enlazge �
( ) ( ) ( )#of new �� �
Type of Construction
P4 Frame ( )Log ( )Pole/metal ( )Block ( )Concrete , :
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( )Other "
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Construction Cost$ � ,DOO �
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Vol `]I� Pg 3�of Deed Certified Soil Test# �/�/L � �
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CSM Vol Pg Sanitary Permit# (�/- ,�0 0� Cj}
Plat Envelope Or: � z
Condo Vol Pg Yeaz Installed =k� � c�O U( � k�1
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Af�'of ex septic V P Owner When Installed:
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. � #2. �:��;r.�' , #3. #4.
Size �3 ft. wide � ft. wide ft. wide ft. widey
�� ft. long ft. long ft. long ft. long
Floor area 5� sq. ft. � sq. ft. sq. ft. sq. ft.
Hgt from grade to peak ft. hgt. ft. hgt. ft. hgt. ,
Stories stories stories stories
# of bedrooms p�N P f
reaz lot line or waterline of � S� lake/river
In the box sketch in: ��
Location and size of all ti
existing and proposed structures.
Location of septic system. �'�1 �'- �"��` �"� � �
Indicate distance to:
Waterline
Road
Lot lines
Septic system
Distance between structures.
Indicate North.
Fire Number:
A/ 3/ 3C� ��
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Si a �re of er
------- centerline of `—�n�t nJ So.tJ �;Y: r�' road-------
c�c.D oRD�n�a�e�
IssueDate January 30 , 2004 ExpireDate January 30 , 2005
(�=G�Fi�1V.' sG�JZU, COST� Cu�+r7xudtdr : '�S; u.m. , a3�/, cL4�/�61', � v9. d�la G�ae�
Office Comments: �,��� `'l�i.-
Sawyer County Zoning Administration o ^,
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Inspection Report � � -
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Owner(s) Gregory D. & Ellen C. Cernjar 715 332-5625, 715 878-4672 � � OO
Address 58415 Thrush Drive Eau Claire WI 54701 ^' �— �
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Agent/Purchaser '�
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Address � �
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Bldr/Plber/CST "
C7
Address �
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Inspection � Private ❑ Public Violation ❑ Zoning ❑ Sanitation �
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❑ Dwelling ❑ Mobile Home ❑ Commercial ❑ Gazage � Addition �,
� Setback - Lake ❑ Setback - Road � Setback - Lot Line ❑ Soils Verification �
❑ �
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WD Vo1719 pg 394 RR-1 Acres: 0.680 #3130 N Johnson Rd. � �
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Discussed with Mr and Mrs Cern�ar �
Date & Time October 20 20 3 /.?.'?4,Q/II. �
Signature ofInspector -�� �
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� - � SCALE : I INCH = �00 FEET FOR ASSESSMENT USE ONLY N�
DRAWN BY : CK � DATE : 1/18/ 82 INTENDED TO SHOW CONCLUSII
COLON (:) INDICATES GOVT. LOT EVIDENCE OF OWNERSHIP�R
�� BOEINDARY LOCATIONS