HomeMy WebLinkAbout002-940-22-5119-LUP-2001-174 Application for Land Use Permit o o �
County of Sawyer � ��
PO Box 676 -Hayward WI 54843 �
715/634-8288 �
The undersigned hereby makes application for a Land Use Permit and agrees that all work ,
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin.CONSTRUCTION MAY NOT
BEGIN UNTIL THE PERMIT IS ISSUED. �
PRINT—USE BLACK INK OR PENCIL �
'�J E[.o QF_5 Oc,HV.. TE,�F' �E�n�l<E o �
Owner Builder 7 � �
sag�n� o�a��.�a �s���aw RErNKE R�, �
Mailing Address Mailing Address
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City,State,Zip City,State,Zip
Lo3� -.�g��l �3�- 3isi
Daytime Phone Daytime Phone
Building Land Use
O New O Filling Zone District �(�f
( )Addition ( )Dredging
O Alteration O Grading Lot Size o
( )Movin�On ( ) �
( ) ( ) Acres �3nlo
� �
Primary Structure Accessory Building Addition o �
O Dwelling OO Garage-attache detache O Deck o
! )Year round (�#of car stalls O Porch +
( )Seasonal ( )Storage Building ( )Enclosed � �'
�.
O Frame built on site O Screenhouse O Living room �J
( )Modular/manufactured ( )Greenhouse ( )Kitchen c�,
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge �,.� >
( ) ( ) ( )#of new :
Type of Construction '
(�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other �O w �A
Construction Cost$��SOQ a� � �
�
Vol �� Pg ��� of Deed Certified Soil Test# ��—��� �
CSMVoI Pg SanitaryPermit# �'�� �. z
0
Plat Envelope Or� �` ��
Condo Vol Pg Year Installed �
Affofex septic V P Owner When Installed: � ��.�5���
�
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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� ft. wide R. wide ft. wide ft. wide
oZ � ft. long ft. long ft. long ft. long
Floor area (07� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from gade�to peak ft. hgt. R. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms
reaz lot line or waterline of lake/river
In the box sketch in:
Location and size of all
existing and proposed structures. a� i
Location of septic system.
Indicate distance to: — � �
Waterline/Wetlands (j
Road !Do' � �, J�
Lot lines ,�
Septic system/privy � ��� g
Well � a <
Distance between structures. 3� �
Indicate North. �'�
�
FireNumber: �.� �
F'.�gG N w�y �so
m p=,�
t.1o�sE
c�ur
' nature of Owner
The above ceRifies that[he listed �
information and intentions are true and W���� Gb �--R K�
correct.The above person/s/hereby
give permission for access to[he'
property for onsite inspection. ------- CeIItelllri0 Of road-------
Issue Date _Map 31 , 2001 Expire Date May 31 , 2002
Office Comments ��,���� �L-//���%%���
Signature of Zoning Administrator
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