HomeMy WebLinkAbout010-941-28-4237-LUP-2002-228 Application for Land Use Permit o o —
County of Sawyer N � O
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. �
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. >
= �� . �RINT—USE BLACK INK OR PENCIL
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Owner Builder N �
10 I 6 `al- I 61 Kq�l 4���,Z P�l �:
Mailing Address Mailing Address
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C�,�State p� � City,St te,Zip �
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Daytime Phone Daytime Phone p
Additional Information: Zone District�P��i��v.Tlc�� � Q�'1
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Lot Size ,�
Acres �-D ���`"�
Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river,
creek or stream) If yes,how far from the shoreline&water name: h C� �
Is there wetiand neaz the proposed structure?If yes,how far �
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Building Land Use °
(�New�"�#ov"��- ( )Filling Floodplain:( )Yes ( )No # :;
Dredging � �
(�Addition#� �`�( ) �
(�)Alteration O Grading Chippewa Flowage: O Yes O No U �
C� t"
( )Moving On ( ) • °
� � � � Driveway:( )State ( )County ( )Town Rd. �
Primary Structure Accessory Building Addition �
( )Dwelling (�Garage-attached/detached ( )Deck �
( )Yeaz round y�( )#of car stalls ( )Porch � F
( )Seasonal ( )Storage Building ( )Enclosed \
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom R�-`
O Other primary structure O O Relocate/enlarge A
� � � � ( )#ofnew �
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Additional Information: „y
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Type of Construction �
�Q Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other
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Construction Cost:Primary Structure$ -�
Accessory Building:$ ���O �01�tc� Addition: � � �'� Q, z
S� 77
Vol��Pg J�� of Deed Certified Soil Test# �1���1�!� �
CSM Vol Pg Lot# Sanitary Permit# R��I S�' N
Plat Envelope �r� � �
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Condo Vol Pg Year Installed
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Aff of ex septic Vol Pg Owner When Installed:
Gazd Gazebo Vol Pg
Previous Variance: LUP: InspectionDate: ��U`�(
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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.
#i. �-,;;. �,(� t� #2. �-a�- o► "`�f���oy' #4.
Size ft. wide ft. wide
� ft. wid�' �G'j ft. ide
�,. ft. long , a. ft. long ft. long ft. long
Floor area �1 �A sq. ft. �Q sq. ft. sq. ft. sq. ft.
H from e to eak c� ft. hgt. ft. hgt. ft. hgt.
�• � � P �--
Stories �� �, _ stories stories stories
# of bedrooms �_
Lot Line or Lake/River name: 1 `
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Fire Number and Name of Road � �1 S � � ��-+ n`Z- ���
�! Fill in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
��, Indicate location and size of existing and new structures.
3. Indicate location of well, septic tank, drainfield.
4. Indicate distance to existing structures, lot lines, septic system. ('��Q�`�,�:��;._. �/�����;�1
�'S. Indicate distance to the ordinaxy high-water mark of any lake,
pond, river, stream, creek, and name the body of water. PrintName: I F.�C,e-`J� ��t(7�
The above certifies that the listed information and intentions are
true and crorrect The above personsls hereby giv� permission for
6. Indicate any grading or clearing in excess of the construction site. a�cess to tne pro�erty tor o�s�te�ns�ect�o�.
7. Indicate distance to any wetland.
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Permit Fee: 7.� ` �-' f .�
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June 7 . 2002
Issue Date Signature of sui gent
June 7 , 2003
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Expiration Date
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Office Comments:
Inspection Date: 50% Rule Applies: Avg. Setback: ! i
Restrictions and other information: I q
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�st. ADD.
JOHNSON
ADDITIOIV
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SCALE : I INCH = 400 FEET FOR ASSESSMENT USE ONLY dT
DRAWN BY : S.R.o. DATE : 2/3/84 INTENDED TO SHOW CONCLUSIVE
COLON (:) INDICATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
BOUNDARY LOGATIONS
295903 �
SiATE 8AR OF WISCONSIN FORM 3- 1999
DOCUMENT NO. QUIT CLAIM DEED
This Deed, made between HERMAN C. HEIIv'Z and THELMA J. R�ister's Ottice
HEINZ, Husband and Wife, Grentors, and TERESA L. SHELTON, an adult, gawyer Covory � SS
Grantee. peceived tor record this o11 s r tlay M
hl bV_A D 20_QJ,_at,�: ao o'GDck
Grantors quit-claim to Grantee the following described real estate in �_M antl iecorded as voL —77 b
Sawyer Counry, State of Wisconsin: of Records on page SD O
Ra�ieler
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Retum To: �
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Pazce] Identification No. 010-941-28 42]1
This is wt homestead property.
The South 432 feet of the East 252 feet of the Northwest Quartet of the Southeast Quarter (NW'/.SE'/.)� Section
Twenty�ight(28), Township Forty-one (41)Nocth, Range Nine (9)West, and that part of the Southwest Quarter of the
Southeast Quarter (SWY.SE'/.),'Section Twenty-eigltt (28), Township Forty-one (41) North, Range Nine (9) West,
described as follows: Beginning at the Northeast wmer of said SW'/.SE'/. [hence running variation South 1°45' East,
along the Eas[liue of said SW'/SE'/. , 3882 feet ffience running variation South 88°15' Wes[, 239 feet to a stake; thence
running variation N3°30' West to a stake on the North line of said SW Y.SEY.; thence running variation North 87°00'
East, along said North line 2509 to the point of beginning. Subject ro a 2 rod road right of way along the South line
of said parcel and also subjec[to a 1 rod road nght of way along the East line of said parcel.
FEE
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EXEMPT
Together with all appurtenant rights, title and intecesls.
Da[ed this 21 st day of November, 2001.
(�-- � o�, �.�. �. o .,; a
Herman C. Heinz Thelma�
AUTHENTICATION ACKNOWLEDGMENT
SignaNre(s) State of Wisconsin )
) ss.
authenticatcd this day of , 2001. Sawyer Counry )
Pecsonally came before me this 21st day of �
Ward Wm. Wintoq Attomey at Law November, 2001, the above nazned Herroan C. Heinz
State Bar of Wisconsin and Thelma J. Heinz, to me known to be the persons
who executed the focegoing instrucnent and
T1-iIS INSTRUMENT WAS DRAF7'ED BY: acknowledged the same.
Ward Wm. Winton, Attorney at Law �`��'�-4..L��
State Bar of Wisconsin Member No. 1013645
P.O. Box 796, 15842 WestSecond Street Ward Wm. Winton
Hayward WI 54843 Notary Public, Sawyer Counry, Wisconsin.
(715) 634-4450 My commission is permanent QO �(�1ti1• j.����
` Names of persons signing in any capacity must be QUIT CLAIM DEED S ���j,��i', �'f.
typed or prin2ed below their signatute. State Baz of Wisconsin, Form No. 3 - 99 _ ,
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YOL 776 PG 500