HomeMy WebLinkAbout032-539-14-3102-LUP-2004-092 Application for Land Use Permit o ,� '
County of Sawyer � "
PO Box 676 -Hayward WI 54843 �
715/634-8288 �
The 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 � �
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 �
�'�1 T"�5 ���(N i F cc�l C Z -J/`i�°I FS 1���.��UI�ZJI C�Z — a
Owner Builder �' O
/�6�3�1 �TA?"F aA� 70 1✓��/� +�D �v �� �
Mailing Address Mailing Address I �
�v�/ ti'/EJ�' /�li/ �'a'�6 �iLl/N/E/Z, �//. -����%F� „ �
City,State,Zip � City,State,Zip
��iS�� �C-63d I 7/S ..�6G -630 1
Daytime Phone Da ime Phone
q %�
Additional Information: Zone District l-�'�
n
Lot Size
Date lot was created Acres �� ' ��
Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river, s
creek or stream) If yes,how far from the shoreline&water name: — ;�
Is there wetland near the proposed structure?If yes,how far — � �=
�
Building Land Use c
( )New ( )Filling � Floodplain:( )Yes (?�No # ,�,
�Addition ( )Dredging � �
O Alteration O Grading Chippewa Flowage: O Yes �)No G �,
( )Moving On ( ) o�
� � ( ) Driveway:(�State ( )County ( )Town Rd. '
C'n
Primary Structure Accessory Building Addition W
(�Dwelling (?Q Garage-attached/deta� (�Deck �
�(Year round ( )#of car stalls ( )Porch ,. �
( )Seasonal f�Q Storage Building �'Enclosed �
O Frame built on site O Screenhouse J�1 Living room w W p'
( )Modular/manufactured ( )Greenhouse ( )Kitchen o �L �
( )Mobile/manufactured ( )Other ( )Bedroom w �
( )Other primary structure ( ) ( )Relocate/enlazge
� � ( ) (�,#ofnew >
�
�
Additional Informati � Nn � p�•K ) �
�a �a a r�s � 'ti
n
.. f} nl�l liONS � �
Type of Co�struction I�
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
\ �Du'1CI' lN
Construction Cost:Primary Structure$ - \ �D
Accessory Building:$ � Addition:$ ;� � z
�
Vol (�8� Pg �8'7 of Deed Certified Soil Test# �'^r/���? (�
CSM Vol Pg Lot# Sanitary Permit# 11"�`/— %�/
Plat Envelope — Or: �
Condo Vol Pg Yeaz Installed �
Aff of ex septic Vol Pg Owner When Installed:
Gard Gazebo Vol Pg �
Previous Variance:�-0 39 LUP: C�-��W Inspection Date: `�9'6�l `�I I�(6�
I��
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. #2. #3. ['a��� #4. ti
Size �� ft.wide � � ft.wide !�X�'S ft.wide ft.wide
��ft.long �� ft.long I a K�� ft.long ft.long
Floor area �O� sq.ft. /,�v sq.ft. y� sq.ft. sq.ft.
Hgt.from gade /a-� to peak�ft.hgt. ft.hgt. ft.hgt.
Stories_� / stories stories stories
#ofbedrooms
Lot Line or Lake/River name:
�..__� �f i�' /� G/�r� i G' __ ,
J��,f�ic \2 A i AJ '�'I f l� �S!/
S"9/�
U— ydr —_
�_ _ —
� ��— ` � a� --— _
^ '
,�oQ/— — �� l � --�> _
' `l-� ,� ~ / ''�
I � � ,
G1if L C_._ --- � - -- � /�' '
.�. .�.1 � /�'� ,
��
a� �
E
Fire Number and Name of Road /1�6.�,3 y Sr;�T f ,�'c.E ;_ ��
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. � �
3.Indicate location of well,sepric tank,drainfield. ����-��>�ti���� f���ti'�`��"�t'`���
4.Indicate distance to existing structures,lot lines,septic system.
5.Indicate distance to the ordinary high-water mark of any lake, �1 ' '
pond,river,stream,creek,and name the body of water.
PnntName: —)�/}?,r� i:J!-,�J/;;�r!.. '�.�:-.
The above certifes lhat the listed informa0on and intentiors are
6.Indicate an radin or clearin lri BXCCSS Of tY10 COriSYIl1CYlOri Slte. �Ne and correct The above personsls hereby give permission for
Y g S 8 access to the properry tor onsite inspection.
7.bidicate distance to any wetland.
,�r
S�v/ Permit Fee: ��`=
Apri1 27, 2004 ' —
Issue Date Signature ofIss � g ent
April 27, 2005
Expiration Date
Office Comments:
Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries:
Restrictions and other information:
.�i,. —
�. _
�J��
.b.l .5.1 '
.a�.
,r.i —
— ,,�..
�X �
w
� � :�.3
u
�
tU .�r, .� Y �
IC = — W
� W
e o�
cA u
��lV
.Vli
�i� .7.� .8.� �Q
P
.72 � y
.
.,�
� _a„ —
�
.io.4 .10.3
9.1
.10.2 � 1.9.3 ��,�
� L4
0
.t0.1 P� .9.2
�-. ,� ,�,
� ,
,, � .i2.i -
�
� �
i i.2 _..•
.11.3 1 .12.2
�
_ �
-�
/
.Ii.� '` ,
� � v
��i
22 23
REF: pER�At PHOTo - P II - 1970 SGALE. I INCH= `+-o�
U.S.G.S LAKE WINTER QUAD 1472 ORAWN BY: D.M.E .
COLON (:) INDIGATE