HomeMy WebLinkAbout002-940-14-4201-LUP-2001-390 �s° .
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Application for Land Use Permit � o
County of Sawyer � �
PO Box 676 -Hayward WI 54843 V , j
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 r
BEGIN UNTIL THE PERMIT IS ISSUED.
PRINT—USE BLACK INIi OR PENCIL � �
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Owner Builder ° �
8�751v� G✓i L�i�m s �'C�--":���T'/c�Q � �
Mailing Address Mailing Address
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City, tate,Zip City,State,Zip
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Daytime Phone Daytime Phone ">
Building Land Use
(e�'New ( )Filling Zone District ��`( -_,
(Jf Addition ( )Dredging
O Alteration O Grading Lot Size o "
( )Movin�On � ) Acres g• .3 �
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= n
Primary Structure Accessory Building Addition �
( )Dwelling (�'Garage-aHae�ed/detached ( )Deck o
O Year round (2,1#of caz stalls O Porch ,
( )Seasonal ( )Storage Building ( )Enclosed � �
( )Frame built on site ( )Screenhouse (.�j Living room
( )Modular/manufactured ( )Greenhouse (�.j Kitchen �-�
( )Mobile/manufactured ( )Other ( )Bedroom � "
( )Other primary structure ( ) ( )Relocate/enlarge � �
O O O#ofnew
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Type of Construction `
(Jf Frame ( )Log ( )Pole/metal ( )Block ( )Concrete g
( )Other �
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Construction Cost$�_Q r�e-�� �
Vo q,�ti Pg ��� of Deed Certified Soil Test# ���/�h? ������� fi �
CSM Vol�_Pg �(o �3i 79 Sanitary Permit# �l—/9� pN V�� � z
Plat Envelope Or: <.�i' 9 5 � y63 `�/-a?? �'
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Condo Vol Pg Year Installed < �/>
Aff of ex septic V P Owner When Installed: �
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. #2. r #3. #4.
Size � � ft. wide ,� f� ft, wide ft. wide ft. wide
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'?4� ft. long ,3a ft. long ft. ]ong ft. long
Floor area ' `��Sq, ft. � sq. ft. sq. ft. sq. ft.
r�„r .?� ,
Hgt.firom gade&ct iS to peak_� P. hgt. ft. hgt. ft. hgt.
Stories�,��, 1, , , ,;_,- � 1 stories stories stories
# of bedrooms `
• reaz]ot line or waterline of 13�Rn�o lake�r�ver
In Ihe box sketch in: �:
Location and size of all � N'
existing and proposed structures.
Location of septic system. , „ _.,
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Indicate distance to: �o � �
Waterline/Wetlands �
Road ,
Lot lines '
Septic system/privy � � �j � �
Well �� �'; I, �^
Distance beriveen structures. � -� ��- � `` -'�� -- �
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Indicate North. ' �
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Fire Number. �
9�[r, 15N ��� �
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Signatur of wner `�'
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The abov�cPftifies tha[the listed "-
information and intentions are true and
coaect.The above person/s/hereby , r'�
give percnission for access to the
property for onsite inspection. ------- centerline of road-------
IssueDate AuQust 16, 2001 ExpireDate August 16, 2002
Office Comments: �tx r����,v\`� r-x-��'�-��� ` ' _-�`��
G���,�,r� ,�� ��.Sr;,;u.�p,�t�,� �lp a.p03 �. Signatureof oningAdministrator
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LE: I INCH=400 FEET FOR ASS S ENT U �� ONL ' NOT
WN 8Y: DATE : INTENDED TO S CONCL IVE
ON (:) INDICATES GOVT. LOT EVIDEN NERSHIP O
BOUN /►RY LOCATIONS