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HomeMy WebLinkAbout032-539-27-4102-LUP-2004-688 Application for Land Use Permit /I�on -���� o o �' County of Sawyer � PO Box 676 -Haywazd WI 54843 � 715/634-8288 ` � The undersigned hereby makes application for a Land Use Permit and agrees that all work 3 shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance � � and the laws and regulations of the State of Wisconsin. NO CONSTRUCTION MAY BEGIN UNTIL ALL PEI2MITS HAVE BEEN ISSUED. � PRINT-USE BLACK INK OR PENCIL 1 7- /y'� � � . ll! �/�y.,.+,- ��5;1�.Sdn //!<,�tis�Hf�.� -�c>i . � Owner � Builder °' � /l�s��,,�3 L</� ltil,�.� f�/ /�'t y.l s �: Mailing Address Mailing Address � l,,�tik.. i.:.��1 S �rj6 iJ,hr4� l-%��' S Yr�� � City,State, ip City,State,Zip �if�-- ��"� - ���s�,� ��is'�.��1! ��s=� � Daytime Phone Daytime Phone � Additional Information: Zone District �/ � Lot Size l 1,�L' f'C l�J,�U � �.�T � Date lot was created Acres 7 a & Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a m•er G creek or stream) If yes,how far from the shoreline&water name: gc.�v� ,�r���.,�f ��:.- � Is there wetland near the proposed structure?If yes,how faz /v o n 0 � Building Land Use �° c ( )New ( )Filling Floodplain:( )Yes ( )No # � ( )Addition ( )Dredging � � ( )Alteration ( )Grading Chippewa Flowage: ( )Yes ( )No (� ,°<_, ( )Moving On ( ) � o ( � ( ) Driveway:( )State ( )County ( )Town Rd. i Primary Structure Accessory Building Addition � O Dwelling �Q Gazage-attached/detached O Deck �D ( )Year round (�#of caz stalls ( )Porch � �. ( )Seasonal ( )Storage Building ( )Enclosed � �� O Frame built on site O Screenhouse O Living room i p" ( )Modular/manufactured ( )Greenhouse ( )Kitchen ( )Mobile/manufactured ( )Other ( )Bedroom � �• ( )Other primary structure ( ) ( )Relocate/enlarge � h � � ( ) ( )#of new p � � Additional Information: � ,ti � i m n � � i m T e of Co�struction � �Frame � ( )Log ( )Pole/metal ( )Block ( )Concrete � ( )Other � W Conshuction Cost:Primary Structure$ � Accessory Building:$��ODO, Addition:$ Z Vol_� 585 � Pg�8 of Deed Certified Soil Test# J� CSM Vol Pg Lot# Sanitary Permit# \ Plat Envelope Or: � Condo Vol Pg Yeaz Installed P,fum, I»19�8 Aff of ex septic Vok Pg Owner When Installed: Gard Gazebo Vol Pg Previous Variance: LUP:O�-� Inspection Date: i ` 35418 Describe the construction using these colamns. List the dimensions of each structure in a separate column. List each stary, each addition, each alteration in a separate column. #1. #2. #3. #4. Size �� ft. wide ft. wide ft. wide ft. wide ��7 ft. long ft. long ft. long ft. long Floor azea,�U J sq. ft. sq. ft. sq. ft. sq� �� Hgt.from grade�_to peak ft. hgt. ft. hgt ft. hgt. Stories � stories stories stories #ofbedrooms �� Lot Line or Lake/River name: � ^ -� �� �'/. > � , , - � � � , a', � . , � / � �t . �iu���Set� (Ji,. '� =, < : ` —� 1�„) ) --� `� �� • : � �� r. t,6 �. 7 �. � ..__._._.__. �a' I����'s.i ��uL,f C � .. '`.;i ��'C /� ?Jd ) �p �i^, D . /"� .1C� �" �w{�,' I..r-�r�.. r� ?. f'��'q ..� � Fire Number and Name ofRoad � v 5 �.� 3 `-��`� l' �h�� 1. Fill in lot dimensions and indicate north by arrow. Signature o Owner or Authorized Agent: 2. Indicate location and size of existing and new structures. 3. Indicate location of well, septic tank, drainfield. L� ` - 4. Indicate distance to existing structures, lot lines, septic system. 5. Indicate distance to the ordinary high-water mazk of any lake, n pond, river, stream, creek, and name the body of water. P���t Name: //<"`lf ��'�%i"S�-` The above certifies that the listed info ation and intentions are 6. Indicate any grading ar clearing in excess of the consriuction site. tNe ana coRe�t.rne abo�e Perso�s�s ne�eby 9��e Perm�ss�o�ro� access to the properry for onsite inspection. 7. Indicate distance to any wetland. Permit Fee: � December 21, 2004 - Issue Date Signature of Is ing ent December 21, 2005 Expiration Date Office Comments Inspection Date: 50% Rule Applies: Avg. Setback: Within Reservation boundaries: Restrictions and other information: _ � � _ .��li � -'� � l �rf// �1I�L � � �_L --� �� �� .I.I �1[lL - 1-.1��L � � _�L 2.I 1� - _�1c _ �il.L� .1.2 1ll �!!L �il/L � � -�'I�i. � .�(/i ,y.8 . � � � � � � � � � � �L�.li ��f/i � .�.a � a JLL 11�LL �� 1UlL �l[[ �� �� .4.5 y.7 .4.4 �L ` �111 .4.3�. - .3.1 ��G U1 �\(// � .3.4 m - - �ll/1 �L il�/i .3.5 � .4.2 �1�L� -� 'I p .4.6 �.� .�.� - 1 �f.� - N��av���P��- � 4.1 .e.t - S.�p,'��`�(p,'(� .a.2 ���`� 8.3 �11L .3.3 �1L1 �5 - ' �1f(i .9.3 _ L — I , I , A1 _/i t � - - .14.1 .13.1 � (� _ � � _ � - � - _ � - � - _ � y a = � r e a ;�� � f.�s �re a-!c i�re r.r. s.t .16. ,��, � �_ �� :15.1 15.7 16,13 .I6.I .16.1 IG.f. e•,r- O � � ) � ��,� . �\ � \ �\ .153 '°" .�Z � ,16.i �6 2 � \ l . , , � \ � ^ v >. • ,�4 .16.1� .i�t2 .�6,9 ° '►G.s � � � � � ,.; z . . .I5.2 .IS.4 ..,y � / iri .16.3 / .1 .2 � LAKE WINTER % 2E 34 3� SGALE: I INCH= 40o FEET FOR ASSESSMENT USE ONLY N DRAWN BY : RMS DATE : e-7-�9 INTENDED TO SHOW CONCLU.` COLON (:) INDIGATES GOVT. LOT ) EVIDENCE OF OWNERSHIP Oi BOUNDARY LOCATIONS