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HomeMy WebLinkAbout032-540-30-3202-LUP-2004-039 Application for Land Use Permit o /o- � County of Sawyer � � PO Box 676 -Haywazd WI 54843 715/634-8288 p � The undersigned hereby makes application for a Land Use Permit and agrees that all work N � 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 PERMITS HAVE BEEN ISSUED. - ' PRINT-USE BLACK INK OR PENCIL � O � � _ �� d-l7E;uti5E�Em►mc� SELF' a Owner Builder N' � 3l C�1 5��1 C'puE V�ol�rt' �: Mailin Address � � Mailing Address g � ���o� �-K��rn,� s53�z � City,State,Zip City,State,Zip � �152-+-14D 311.�C`6 -o2-q52-OI�-II-IS13 Daytime Phone Daytime Phone �. Additional Information: Zone District R��` fn Z Lot Size � ZS2�x�250�x 1q5`x loBB G, m Aores L1,5�1 !'t�-� —� Is the property in a Shoreland Dish-ict?(within 1000'of a lake or pond,within 300'of a river, � creek or stream) If yes,how faz from the shoreline&water name: .tio Is there wetland near the proposed structure?If yes,how far 0 � m b r Building Land Use ry � (�New ( )Filling Floodplain:( )Yes ,h�)No # � ( )Addition ( )Dredging o O Alteration O Grading Chippewa Flowage: O Yes (JC)No C, � ( )Moving On ( ) ° � ) � ) Driveway:( )State O County QQ Town Rd. `� '" Primary Structure Accessory Building Addition G �Q Dwelling ( )Garage-attached/detached ( )Deck � ( )Year round ( )#of caz stalls ( )Porch QQ Seasonal ( )Storage Building ( )Enclosed � Q(j Frame built on site O Screenhouse O Living room i p" ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ^,� ( )Mobile/manufactured ( )Other ( )Bedroom �. � ( )Other primary structure ( ) ( )Relocate/enlarge � � � � � O#ofnew � � 0 Additional Information: ��� � ,��„y, 3-�`'�y ro � ---p ��f 'x30 ' � 0 � Type of Construction � -� Q�f Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � ( )Other p Construction Cost:Primary Structure$ 10 000 � Accessory Building:$ Addition:� z � Vol�Pg�_of Deed Certified Soil Test# N�� IO CSM Vol �� 2Z-1 Pg Z�-i( Lot#� Sanitary Permit# f (7'� "UL�:7�� ' N Plat Envelope Or: � Condo Vol Pg Yeaz Installed ' Owner When Installed: N Aff of ex septic Vol Pg .� � Gard Gazebo Vol Pg °Q Previous Variance: LUp. Inspection Date: 31�lb��„1 3�3���° . � , • , � ,. Describe the construction using these columns. List the dimensions of each structure in a separate j � column. List each story, each additian, each alteration in a separate column. - #1. ��n.� #2. t`��.��Y #3. #4. ' , Size ��� ft. wide �-{� ft. wide ft. wide ft. wide 3D' ft. long s � ft. long ft. long ft. long ; Floor area �0.'� sq. ft. Z� sq. ft. sq. ft. sq. ft. Hgt.from grade 15.5� to peak $ ft. hgt. ft. hgt. ft. hgt. Stories � � stories stories stories #of bedrooms 2 � , Lot Line or Lake/River name: (�j;n diM�tLSionS (�k'1�l.rl+d�i-to c� X� '�_ I�AI��� ��1 �f2M Mt� � e'�5 Lcrr [-�ti,L �— 1250`—� L ____ _ _.__ - . ___ _.. _ . _--- _ �c— /1 __._._. � \� 2 �— � `�:� ,� Ex�s��u4 DQwEcJhC��er�,�` � ��) 3 �1 �� `+�� p1 . �l�c� , � �°°t, � ,� � / ��,; �- -� � . %N �:; N �l- h � � ,a �/N � '� ��y� i� J -� 2 ? guLWa� �-/ �, ; � ac���E o� `J t- � �i� '�'l . i ' � � I, ; i-o�rLlNc �-to�g '—'� � �� i Fire Number and Name of Road �CmLoc�K �€��� �Q E N�rn6E'Q �PP�t E� �Q. 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. �/�,�p� ���yh� 3. Indicate location of well, septic tank, drainfield. � � 4. Indicate distance to existing structures, lot lines, septic system. I 5. Indicate distance to the ordinary high-water mark of any lake, `i���' Print Name: pond, river, stream, creek, and name the body of water. The above certifies that the listed information and intentions are true and correct The above personsls hereby givA permission for 6. Indicate any grading or clearing in excess of the construction site. access to the property for onsite inspection. 7. Indicate distance to any wetland. Permit Fee:��50,OO _ March 4 2004 Issue Date Signature of Iss gent March 4, 2005 Expiration Date i, � Office Comments: I 50%Rule A lies: Avg. Setback: �' Inspection Date: pp '� Restrictions and other information: ; � 6.1 .5.1 7.1 .8.1 / 2 J 4 5 6 7 B 9 „�/O // /P /3 /� /5 /6 /7 /B /9 20 2/ PP 3 . f0�t 5.23 5.52 5.0/ 3.0/ 3.0/ 3.0/ 5.0/ o ,G13 .26 29 5.32 5.35 38 5.40 5.43 S46 .48 S.S/ .53 5.32 5.46, <,.F� „ N M 'V' lf') �p ti OD �p O — — N M � O O O O O p O O � aj � � � � � aj � �j aj �t d' d' � .10•2 0 N 4 4.24 3. 337 .��.� �1.2 .�1.3 346 s.0 �, o...i Sz .�2.2 cv 12.6 12.8 / __��_` � .Ib.2 % /% � �/ � N .12.5 M. 11� � � � � `l / � : .15. NOTE! Deed gaps aqd ` SCALE: I INCH=400 FEE overlaps in this areu. 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