HomeMy WebLinkAbout032-540-35-2105-LUP-2004-137 Application for Land Use Permit(*Non-shoreland*) o o �.
County of Sawyer � ' 'I .
PO Box 676 -Hayward 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. ��
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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 v City,State,Zip
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Daytime Phone Daytime Phone
Additional Information: Zone District: �' �
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Lot Dimensions: s 5�� `a +'�< -'
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Date lot was created: Acres: �G ;��C r��� �-- o
Is there wetland near the proposed structure?If yes,how faz � �'±
Building Land Use Floodptain:� j�es (�No �°
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(X)New ( )Filling
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O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd (y�Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy i,"'i �
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Primary Structure Accessory Building Addition � °
(T)Dwelling ( )Garage-attached/detached (X)Deck w
(y�Year round O#of car stalls (X)Porch =
O Seasonal (X)Storage Building (�Enclosed �
O Frame built on site O Screenhouse O Living room '�
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge � `�
� � � � ( )#ofnew �
J.
Additional Information: �
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Type of Construction: ���
(x�)Frame (�)Log (�)Pole/metal ( )Block (y�Concrete �`'1
( )Other ..� �
Construction Cost:Primary Structure$ o �
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Accessory Building:$ i:',: ,'` Addition:$ !r� ' � � 'P
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Certified Soil Test# ('1�) —�7�� °'
Deed:Vol Pg�_ " z
CSM:Vol Pg Lot# Sanitary Permit# � _'-' �'}c fJ�/`n�k� o, 7'
Plat Envelope Or: i� `'7
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Condo Vol Pg Year Installed: � �
Aff of ex septic Vol Pg Owner When Installed:
Previous office approvals/actions:
Variance:# LUP:# SP:# CUP:# `(
Inspection Report:# Change of Zone District: y���,
`F313"�
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 , .,,� � ,
#2 #�,,�; #3. etK'=� ?' ��� �/f''�� #4. t.>;< :.. , ;
#1. Nr;>: �`;
Size -�e� ft.wide ft.wide 16�4 ft.wide • S2 ft.wide
�ft.long �6 ft.long �-��' ft.long 1;� ft.long
Floor azea i��,��' sq.ft. I C c t Z- sq.fr.�:� _::ra �uc?C.� sq.ft. 3��:' sq.fr.
Hgt.from grade 3�� to peak ft.hgt.` �}�l o I � ft.hgt. 2_6 fr.hgt.
Stories�_ �. stories 2- stories �_stories
#of bedrooms�_ ��a�., '� �E;a7`��
�— � Rear Lot Line ��
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Fire Number and Name of Road
1. Enter lot dimensions and indicate north by arrow. Signat of�p�ner or Authorized Agent:
2. Indicate the location and size of the requested construction ' 3,,*LPJ I(�;�,���'--
�Sign re
activities.
PnntName: -Af�VI� 11 � r/�L��'1t
3. Also,indicate the location and distance to the well, The above certifies that the iistetl information and intentions are
hue and coned.,that all work shall be perfortned in compliance
septic tank and drainfield,wetland areas,lot lines and to the with the requiremenLs of the Sawyer Counry Zoning Ordinance
and Ne laws and regulations of the Stale of Wisconsin,and if
CenteT'llne Of ti1C Load. acfing as ownet�s)agent,has the pertnission ot the owner(s)to
perfortn the work reques�ed on lhis application. The above
personsls hereby give permission for access to the property for
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onsite inspection.
Permit fee:$ � �C' �--��
May 5, 2004 ' —
Issue Date Signature of I ui Agent
May 5, 2005 50%Rule: AverageRoadSetback:
Expiration Date
Office Comments: o���c V�(1pY�� `e,AC.'tf.Y�Sip/1 C�i V-�✓�,P�-b�-U'c�t-E' '2DC��t"�'a
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