HomeMy WebLinkAbout032-437-13-3401-LUP-2004-556 P 1,�4 _ -
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A lication for Land Use Permit (*Non-shoreland*) r ,��- -
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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 nat have any of the above waterbodies located within
the property's boundaries. � �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMTTS HAVE BEEN ISSUED.
^^T""' _iTSE 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 City, State, Zip
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Daytime Phone Daytime Phone
Additional Information: Zone District: ��+� k�. F�� �
Lot Dimensions: � 1''�� k ! ' "�� } " '' '°
��..}� ����:r..�t.� '�� �`o r R�t� �•l�"' " I t"� ? '
Date lot was created: 3 ts' y rs , Acres: �/r - o s
.
Is there wetland near the proposed structure? If yes, how far ��� �
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Building Land Use Floadplain: ( j Yes Q�No � -�
(�New ( ) Filling � �
O Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading O Private Rd f�(J Town Rd. o
O Moving On (x) t�o��� O County Hwy O State Hwy N �
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Primary Structure Accessory Building Addition `� °
� Dwelling ( ) Garage-attached/detached ( ) Deck W
( ) Year round ( ) # of car stalls ( ) Porch �
X Stora e Buildin O Enclosed CD v
� Seasonal ( ) g g � �
(� Frame built on site ( ) Screenhouse ( ) Living room � (� ' ,
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen Q � `
( ) Mobile/manufactured ( ) Other (� Bedroom �
( ) Other primary structure ( ) ( ) Relocate/enlarge � � �.,�
� � ( ) ( ) # of new .,t � 'r
t�
AdditionalInformation: � �
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Type of Construction: � .� ��
(� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete W
( ) Other ..� 't
Construction Cost: Primary Structure $ �� ��-:';" '�` - ^,�.r� ='` � � v
Accessory Building: $ Addition: $ � 6�i
�33/88 - 6 3��33a `° �
va �
r�PP�: �oi �96 pg �/Bb Certified Soil Test# � z --
CSM: Vol Pg Lot# Sanitary Permit# L��-}- L'��� ��� o, � -.,
Plat Envelope �r� N '� ti %
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Condo Vol Pg Year Installed: � .�, �
Aff of ex septic Vol Pg Owner When Installed: '-' � = �
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Previous office approvals/actions: -
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Variance: # LUP: # SP: # CUP: # -� .�,
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Inspection Report: # Change of Zone District: y
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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. n�t�a �rc�',,, #2. #3. #4.
Size 7 y ft.wide ft.wide fr.wide ft.wide
��ft.long ft.long fr.long ft.long
Floor area ,%.'/2 sq.fr. sq.fr. sq.fr. sq.fr.
Hgt.from giade/�/� "to peak ft.hgt. ft.hgt. ft.hgt.
Stories_�_ stories stories stories
#of bedrooms�_
Rear Lot Line
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GF" C'�';r ,90�
o �C�p �� � 0
$6 �
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Fire Number and Name of Road � � a b � �`
1. Enter lot dimensions and indicate north by arrow. Si natu�e of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction �,,T,�,,,�-� (��,.�/,�`..i
SignaNre
activities. 1
PnntName:kPA/AIP�N C��Ah-1�',[t5
3. Also,indicate the lOcatlon and dlstaTlce t0 the well, The above cerli5es ihat the listed intormation and intentions are
hue and cortect.,that all work shall be performed in comp'iance
septic tank and drainfield,wetland azeas,lot lines and to the with ihe requirements d the Sawyer Counry Zoning Ordinance
and Ne taws and regulations of the S�ate of Wiscronsin,and if
CBIlYeI�IDe Of the CO3d. acting as ownef(s)agenL has the permission of the owner(s)to
peAorm the work 2quested on this application. The above
personsls hereby give permission for access to�he propery(or
onsite inspection.
Permit fee:$ /1 s•�
n�tober 6, 2001� '
Issue Date Signature of Issui g A nt
October 6, 2005 50%Rule: Average Road Setback: _
Expiration Date
Office Comments:
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24 SCALF: I INCH= 40� FEE