HomeMy WebLinkAbout032-540-28-4203-LUP-2004-160 Application for Land IJse Permit (*Non-shoreland*) o o � - �,
County of Sawyer � �
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 g
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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Mailing Address Mailing Address � �y:
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City, State, Zip City, State, Zip s � �
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Daytime Phone Daytime Phone
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Additional Information: Zone District: � �-- �
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Lot Dimensions: ����� � � d
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Date lot was created: 1 1`� Acres: �- o
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Is there wetland near the proposed structure. If yes, ho �
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Building Land Use Floactplain:( j Yes �)No `�
w �7 Filling � �
( ) Addition �Dredging Driveway access off of a(Check one): �
( ) Alteration ('�Grading ( ) Private Rd ()(J Town Rd. o
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ,,, �
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Primary Structure Accessory Building Addition � °
( ) Dwelling �Garage-attached/detached ( ) Deck `, W
( ) Year round (� # of car stalls �Porch _ �t� ���� �
( ) Seasonal ( ) Storage Building ( ) Enclosed �
( ) Frame built on site ( ) Screenhouse ( ) Living room � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen ' �
( ) Mobile/manufactured ( ) Other ( ) Bedroom
( ) Other primary structure ( ) ( ) Relocate/enlarge j' '
� � ( ) ( ) # ofnew
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AdditionalInformation: � �
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�Ty e of Construction: Q' �
Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
( ) Other y
Construction Cost: Primary Structur � � � �
Accessory Building: $ ��f�a Addition: $ � '�
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Deed: Voi � 3 w Fg �t��� Certif�ed Soil :est� ��`��`r � �" z
CSM: Vol g Pg �O Lot# ( 2 Sanitary Permit# 3U �Q��' 9'8 '�'�S�P o� �
Plat Envelope � �� �r� N �I
Condo Vol Pg Year Installed: 9� �
Aff of ex septic Vol ��37Pg� Owner When Installed: `-' �
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Previous office approvals/actions: —
Variance: # LUP: # 9B -0�$9 SP: # CUP: # � �
Ins ection Report: # Change of Zone District: �
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Describe the construction using these columns. List the dimensions of each structure in a separate
lumn. List each story each addition, each alteration in a se arate co umn.
#1. oi,�Se #2. FiG�ye #3. c��L <, '.t� #4.
Size ft. wi e v� �_fr• wide __�` �_ fr. wide fr. wide
3 ft. ong� ��ft. long a,� fr. long ft. long
Floor area sq. ft. �fr.� � �� Sq• fr• sq. ft.
Hgt.from e to peak !�- ft. hgt. ft. hgt. fr. hgt.
Stories ( stories stories stories
# of be ooms 'a�_.
Rear Lot Line
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Fire Number and Name of Road I,J b L 7 9 �v�iter Lfcke +"�•
1. Enter lot dimensions and indicate north by arrow. Si e of Own�eyr or}��orized A ent:
2. Indicate the location and size of the requested construction ��i1v�. d6=�
Signature
activities. i��tPrL- S�a.��s
PnntName: �
3. Also, lndic3te t}le loCation STId dist2SlCe t0 the well, The above certifies that the listetl Infortnation and intentions are
true and conect.,that all work shall be pedormed in compliance
septic tank and drainfield, wetland areas, lot lines and to the w�m me r���remeou ot me sa�,yar co���r zoo��9 ob'��e�ce
and the laws and regulations of the State of Wisconsin, and if
Centerline of the road. acting as owner(s)aqenL nas the permission of the owner(s)to
pedortn the work requested on this application. The above
personsls hereby give permission for aozss to ihe property for
' O� • OC onsiteinspection.
Permit fee: $
May 11 2004 -
Issue Date Signature ofI uin gent
May 11 , 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
OF WI NTER
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Registers Office �� o,w` n
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Sawyer County ; �h y
Received for record this Sth day of ' �.°�,e° N �
December 1980 at 10:40 AM and �Q N�, '� p,
recorded�in Val. 8 rf �2°�' w m' z I '
Certified Surveys on 3�"� � `'m n�, a
page. �'O. yo m I � .s
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Register of Deeds �� �d �m p �
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, o0 9 99 I� Charles Offerman� Iand
o. e O e� Surveyor of the State of Wlscon-
4 'a 5.O4xACRES APsin� do Mreby certify that I have
'�-+ °� � � made the follwlnv, s�rvey of part oT
0 oeF� Government Lot 1��Gwernment Lot 2�
°" o� r z the NF3d of the 5
F3d and the NW� of the
�°`�' m�'"$�� all in Sect3on 28� T. LO N.�
i� R. 5 W.� Sawyer County� Wisconsin�
„ m- more partievlarly described as
'o m £ollows:
�o, � Cononencing at he East q corner of said Section 28;
thmce 5 Bly°08'S3' W� lli�.7.�'7 thence S 60°00� H�
0 775.00� to the point of real beginning) thence continuing
�°��tSGe�'NS��'4 N 6�05�13" E78al�onj thenSoutherlsOri'htWoflwa7•of'antFence
`��v�\��..........,�J �i�� � g p g o Y
"••.,� „� existing Tocn Road� 135.40 ; thence S 82 $L 08 E� along said
� %� CHARLES ��1 :� m right-of-vay� 228,1J�; thence N 87°O6' E� along said right-
f OFFERidAN E .= °q�'u of-way� 913.57'f thence N 57°02� E� alonQ said right-of-
�'�l� S�926 E��`� o.o, way� 1j2,98�f thence S L5°02'06^ E� 9L9.99' to the said
�`� MEWisno, t point ot real beginning.
`i 9`•. I Said parcel heine subject Lo hi¢tnray� utility or
��i�tiQ'�.........•••".������-�� other easements in use or of record.
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