HomeMy WebLinkAbout002-940-32-3103-LUP-2001-490 17S
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Application for Land Use Permit a� o 0
County of Sawyer � �
PO Box 676 -Hayward WI 54843
715/634-8288
The undersigned hereby makes applica[ion for a Land Use Permit and agrees that ail 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 NIAY NOT
BEGIN UNTIL THE PER1�iIT IS ISSUED. �
PRINT—USE BLACK INK OR PENCIL c��. �� �
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Owner Builder ' o �
��.� 1 !I.�Y'U�..M.i 1J E b`i�:i, � �
Mailing Address Mailing Address
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t�r.u,._��r�� �• _� -_Ne4� �j.
C ti y State,Zip City,State,Zip J�
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L l�s�l i��`�i- ''�,'i'I� /� ;��,�, �
Daytime Phone Daytime Phone 1
Building Land Use 4 (n �
(�New ( )Filling Zone District / � �
( )Addition ( )Dredging �
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O Alteration O Grading Lot Size n
( )Movin�On ( ) +�� � �
( ) ( ) Acres °
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x �
Primary Structure Accesscry Building Addlion �
( )Dwelling ( )Garage-attached/detached (/�Deck 0 0
f�j Year round O#of car stalls O Porch �
( )Seasonal ( )Stora�e Building ( )Enclosed
�j Frame built on site ( )Screenhouse ( )Living room �
( )h4odul�r/m�niifactured ( 1 Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge � �
� ) ( ) ( )#ofnew '�
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Type of Construction � p :
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �'
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( )Other .d �
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=
Construction Cost$ ������� " � �` �
��3 I�Z �
Vol��7 Pg �� ofDeed Certified Soil Test# (��—�9� 9 �
CSM Vol Pg Sanitary Permit# � �— pG /� z
Plat Envelope Or: �
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. �Q�7 #3. �G� #4.
Size� ft. wide ft. wide ���. wide ft. wide
J�Z ft. long 3crb ft. long '�a ,2ft. long ft. long
Floor ar� sq. ft.��G� sq. ft. ��sq. ft. sq. ft.
Hgt. from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories Z ` stories stories stories
# of bedrooms�
� ��a�,�i,„�-� /� reaz lot line or waterline of lake/river
Flo�r1 �r �o FP� r1i �
i 5�-� , � �
In the box sketch in: � �;i afp
Location and size of all �
existing and proposed structures. ����( �
Location of septic system.
Indicate distance to: �
Waterline/Wetlands �^�% v � ��
Road V ` � fl�� �
Lot lines ��� � �`�"�`�
Septic system/privy � ' �� J
Well
Distance beriveen structures. �
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Indicate North.
— .t� � � �>c' 1
Fire Number: er r ��
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Signature of Owner � �� ��� � � ,�
The above certifies that the listed /[�v ' �
information and intentioas are true and �� ,J �Qi
coaec[.The above person/s/hereby ; t�
give peratission for access to the —
property for onsite inspection. ��
------- centerline of 0�/ d� � C� road-------
Issue Date September 24, 2001 Expire Date_ September 24 2002
Office Comments: ��L/ � �
Signature of Zoning Administrator
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SCALE : I I CH =400 FE
DRAWN BY :
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