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Home My WebLink About032-538-04-3408-LUP-2004-647 , ' � Application for Land Use 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 ' the property's boundaries. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. — PRINT—USE BLACK INK OR PENCIL � 1'�D�t'e. (' 1 . � '' r�� i ' 1 -t 1 r � � Owner � ,, ` Builder < � > �. �+ `� `J �, � � l C `� � � ._ _ �. < y � �,.� �.. � Mailing Address Mailing Address � � �. ;�� . -. .,., _ , i , . ,..1_,,, ,.� ,a� � ;` - � City, State, Zip City, State,Zip , - - , . .� ` �, _ ;� v � `., - , � � i `� .. �- Daytime Phone Daytime Phone Additional Information: /Lone District: � � � Lot Dimensions: � � � � '` - �% � Date lot was created: Acres: ` t � 1 r'. = i<-- i o � Is there wetland near the proposed structure? If yes, how far �`��', �a _ � Building Land Use Floadptain:-� j I'es (�No � � �( New ( ) Filling � ` Addition O Dredging Driveway access off of a(Check one): �, ( )Alteration ( ) Grading (� Private Rd ( ) Town Rd. o ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy N � � ) � ) o � � r Primary Structure Accessory Building Addition � ° � Dwelling ( ) Garage-attached/detached ( ) Deck W ( ) Year round ( )# of car stalls ( ) Porch � ( ) Seasonal ( ) Storage Building ( ) Enclosed � ( ) Frame built on site ( ) Screenhouse ( ) Living room � ,J-� ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �, ��' , ( ) Mobile/manufactured ( ) Other � Bedroom ;;. � O Other primary structure O O Relocate/enlarge � � � ( ) ( ) # of new � v �, r ( yl Additional Information: .� ,:� , v, i � � Type of Construction: �- ( ) Frame (� Log ( ) Pole/metal ( ) Block ( ) Concrete � :.N ( ) Other ' ,� � `' Construction Cost: Primary Structure $ � ,� � c� Accessory Building: $ Addition: $ �-, � �� '' � - � �. �30 �oy , � ,,� Deed: Vol 1 �-' ��- Pg i `� ! Certified Soil Test# �— IS� � z CSM: Vol Pg Lot# Sanitary Permit# 9y-Z3 9 0, � Plat Envelope �r� N ' Condo Vol Pg Year Installed:<,p6-9�� ia�1r� � Aff of ex septic Vol Pg Owner When Installed: `-' � Previous office approvals/actions: � <<'. Variance: # LUP: # b3� 7ie SP: # CUP: # i � Inspection Report: # Change of Zone District: �`I 2,�, � � y . 33 ��'l T ' , � � 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. lon� Floor area .-�I "; s q. ft. s q. ft. s q. ft. sq. ft. � + Hgt. from grade I ;' �� to pealc ft. hgt. ft. hgt. ft. hgt. Stories _� stories stories stories # of bedrooms �.. ?,�l,� , . _ � _ _ .,_ _ _ _ G� �;�; 1�/ Rear Lot Line v� _ � r IIVj ." t i1 � . t � 1 � �t7'✓ � \ � ��i : N � � �, � ! ' tJ , Z�� ;l � j ^1 �`. � �, � � � � ��fQQ �% r _ � :_ ' u . � � � - -- �_ri� ;`,- � � � . '_ "� � b u�-f ! � �� 1�• � ,. \ . y � . \ � � �'z] � -�� ; ; , �` � �`,� ;� �, a�� , � � ; �' (�'�w �' , I `-- ` — w � � � _ -- �� ,�`1 / � "---� � I � 1 I � , 7.'' � � Fire Number and Name of Road �_, < <. �,. , , � , , � �. � • 1 . Enter lot dimensions and indicate north by arrow. Si�natur pf Qwn 'or Authorized Agent: 2. Indicate the location and size of the requested construction , ��.� i { . f`` d1 � Si nature - activities. � -, ; 9 „� .- - � . � Pnnt Name:� /i1s�c� /�` � f- t� -J 3. Also, indicate the location and distance to the well, The above certifies thafthe listed information and intentions 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. act��9 as ow�er�s� a9e�t, has the permission of the owner(s) to perform the work requested on this application. The above persons/s hereby give permission for access to the property for . � �'� onsite inspection. Permit fee: $ �� November 10 , 2004 � _ Issue Date Signature of Issu g A nt Novmeber 10 , 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: i i � /� � I� 2. � ��` / \ ' ' ��17J � �, _, , 5. I 6� 1 } � � - � 1 i 2 .2 � 5.2 � ,� 2.3 �' � r , . � _ - � � -� , '� 7. 2 � � 8• ' i , � � Woodland 74x . 8. I � zi ` �� io.2 � � 10. 1 q. l .12.7 .12.4 J2J ��25 � �•� 12.3 .I�.B � r; I2.2 .12,6 .