HomeMy WebLinkAbout032-538-09-2101-LUP-2004-307 Application for Land Use Permit(*Non-shoreland*) o � � � �
County of Sawyer �, �
PO Box 676 -Haywazd WI 54843 O
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. �� I
PRINT-USE BLACK INK OR PENCIL
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Owner � Builder //�' N"
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Mailing Address �(c4 3 C`�}tf�'V �I��i�mg Address � O
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City,State,Zip City,State,Zip
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Additionai Information: Zone District: �-�
Lot Dimensions: �Z S � x I 3 ZO' �
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Date lot was created: �'f�)7 Acres: �5 /y '� o�
Is there wetland near the proposed structure?If yes,how far n� G
Building Land Use Floodplain-( j Yes ('�Q No � �:l
( )New ( )FiLling �� �
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(�S Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. o
( )Moving On ( ) (�County Hwy ( )State Hwy ; �
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Primary Structure Accessory Building Addition � °
(�(1 Dwelling ( )Garage-attached/detached ( )Deck y �
�( )Year round ( )#of car stalls ( )Porch `�
O Seasonal O Storage Building 4(j Enclosed SG u�t o o/y �
O Frame built on site O Screenhouse O Living room
( )Modular/manufactured ( )Greenhouse ( )Kitchen (-��
( )Mobile/manufactured ( )Other ( )Bedroom rJ �
O Other primary structure -�- 3��i O Relocate/enlarge
� � � � ( )#of new ��
Additional Infomation: p
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Type of Construction: ' �
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete J
( )Other ,�
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Construction Cost:Primary Struciure$ �� CG � �
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Accessory Building:$
Addition:$ � { '�
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Deed:Vol 37(p Pg�__ n� Certified Soil Test# 85-C�8 _ z
CSM:Vol Pg Lot# Sanitary Permit# 85-Uz.3 0, �
Plat Envelope �r� N �\
Condo Vol Pg Year Installed: �CI�f S � �
Aff of ex septic Vol Pg Owner When Installed:
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Previous office approvals/actions: i1/q i o� �
Variance:# LUP:# n2_�/�5 SP:# CUP:# lJt
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Inspection Repor[:# Change of Zone District: � ,1\`^0�
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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. #4.
Size ft. wide ft. wide ft. wide ft. wide
�:-" ft. long ft. long ft. long ft. long
Floor area��sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade /C� to peak ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms n/�
Rear Lot Line
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Fire Number and Name of Road ��p��S C�_�+'� �
1. Enter lot dimensions and indicate north by arrow. Signa ure of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction � ,�'.�����G ��'1����---'
Signature
activities. �I
Print Name: �1 ��� � �1 �
3. Also, indicate the location and distance to the well, The above ce i ies that t e listed information and inte ons are
true and correct.,that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin, and if
centerline of the road. a�t��9 as ow�er�s>a9e�t, has the permission of the owne�(s)to
perform the work requested on this application. The above
persons/s hereby give permission for access to the property for
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onsite inspection.
Permit fee: $ � -
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June 28, 2004 ����������?� ���
Issue Date Signature of Issuing Agent
June 28, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
ZUNET RIVER HE �GHTS �
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