HomeMy WebLinkAbout032-539-15-3302-LUP-2004-214 C�
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� Application tor Land Use Permit ��T r ��/�
Counly of Sa�vyer � � '
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PO Box 668 - Hayward �VI 54843
71 5/634-8288
The undersi�ned hereby makes applica�ion for a Land Use Permit and agrees that all �vork
shall be done in compliance with the re.�uirements of the Sawyer County Zoning Ordinance �
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and the laws and regulations of the State of Wisconsin.CONSTRUCT!ON MAY NOT �,
BEGI:�1 UNTIL THE PERi�IIT IS ISS�iED. 1
,� PRINT- USE BLACK IivK OR PENCIL �'
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Owner —� Builder T- `� c�
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Mailing Address Nlailing Address
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City, State, Zip City, State, Zip
7/S � �S�_ y� c/i; ...�r"�/ - � 2 �l 6 �
Daytime Phone Daytime Phone �
Building Land Use
� Ne�v O Fillin� Zone District /4 l ,
( ) Addition ( ) Dredging �
( ) Alteration ( ) Grading Lot Size �-� � � � �
( ) �loving On ( ) c ,�
( ) ( ) Acres --� ^ �'�
r Il;
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Primary Structure Accessc.�� Building Additian O �
�Q Dwelling ( ) Gar����e-attaclled/detached ( ) De��:
O Year round O r �f car stalls O Po�ch �
Q� Seasonal O Sto,a�e Building O E�:closed w I
� Frame built on site O Sc::enllouse O Li��ir�� room �;o �
( ) Modular,'manufactured ( ) Gr��nhouse ( ) Kirchen � �
( ) �tobile/manufactured ( ) Otl.;�r ( ) Beuroom � '
( ) Other primary structure ( )__ ( ) R�iocate/enlar�e (,� '
( ) ( )_ ( ) #r of ne�v b �
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Type of Construction -
�SQ Frame ( ) Lo� ( ) Pole/meta: ( ) Block ( ) Concrete r:'
( ) _ � ���
Othe�- � �
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Construction Cost S ,3S U � c� • '� �
_�i�'�4� ' '�"
Vol Pg of Deed Certified Soil Test # _� I �
CS�I Vol Pg Sanitary Pernzit # _�-0� z
Plal Envelope - Or: i�
Condo Vol Py �"ear Installed i '
Aff of ex septic �' P O��ner When Installed: . �v�
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. � Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration. �
# 1 . #2. #3. #4.
Size Z !� ft. wide ft. �vide ft. wide ft. wide
,36 ft. long ft. lon� ft. long ft. long
Floor area /�h o � sq. ft. sq. ft. sq. ft. Sq, �}.
H�. from gade _� to peak �t. hgt. ft. hgt. ft. hgt.
Stories �_ stories stories storics �
# of bedrooms Z
• rear lot line or waterline of lake/river
In the box sketch in:
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Location and size of all �
existing and proposed stnictures.
Location of septic system.
Indicate distance to: �
�Vaterline/�Vetlands ?
Road / , ��,r�
Lot lines i �a�k;
Septic system/privy �� i
�l'el1 � ,�
Distance between structures. ` y b
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Indicate �'orth. � � i ry� C4.h ���
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Fire �'umber: � �� �
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Signature of O��•ner ' (
"rhe abo� e certitizs that the liste� ;
infurmation and intentions are true and
correct. The abo��e person.'s! hereby
�.:i� z permission for access to the
property for onsice inspection. ------- centerliile of L q �.'� v �� i�<<
road-------
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[ssue Date May 25 , 2004 Expire Date May 25 , 2005
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REF : AERIAL PHOTo lOb - 1950 SCALE : I INCH = 400 FEE
U. S . G . S . I. AKE W � NTER QUAD. 1972 COLON B 1. NDIGATES GO