HomeMy WebLinkAbout002-148-00-2200-LUP-2001-505 L—
Application for Land Use Permit o 0
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 j� `r _
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 bfAY NOT
BEGIN UNTIL THE PERIVIIT IS ISSUED. �
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I��p.tti(� �,v� PRINT—USE BLACK INK OR PENCIL �
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CN2� s N���l-c� o����� y
Owner � Builder ' � O
/vs?� �r (���ir�i7�'���N � � �
Mailing Address Mailing Address � ~
/,�cyww�� L✓lsc Sy6v3 Z y.
City,State,Zip City,State,Zip � `^
/,�y' 36'i� c
Daytime Phone Daytime Phone `1
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Building Land Use /�// � �
(�'New ( )Filling Zone District,/�1`
( )Addition ( )Dred�ing �
O Alteration O Grading Lot Size � �J o
( )Moving On ( ) ,a
( ) ( ) Acres ,�<G� `
x n
Primary Structure Accessory Building Addition �
O Dwelling (:�Garage-attached/detached O Deck O r
( )Year round ( )#of car stalls ( )Porch �� �
( )Seasonal ( )Stora�e Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room �
O Modular/manufactured O Greenhouse O Kitchen 4' o
( )Mobile/manufactured ( )Other ( )Bedroom g �
( )Other primary structure ( ) ( )Relocate/enlarge ` ;�
O O O#ofnew , � �
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Type of Construction `
(�J Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
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( )Other � G ,�
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Construction Cost$� � ��" � � �
�- Co39 % !v5 —� ��
�Vol j�D Pg/D�" of Deed Certified Soil Test# '�'� � � �'"� ` v v
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CSM Vol )� Pg�� Sanitary Permit# � � � � :p N z
PlatEnvelo e /D� �r� ��`��� ����� � � �� � �
P " �,vP 9& -3�7 � O
Condo Vol Pg Year Installed I�'
Aff of ex septic V P Owner When Installed: �
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Application for Land Use Pemut — Page 2 �
Describe Construction: List dimensions of each structure, story, addition, or altera[ion.
#1. #2. #3. #4.
Size �G ft. wide ft. wide ft. wide ft. wide
� ft. long ft. long ft. long ft. long
Floor area /`f yv sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from giade��ro peak ft. hgt. ft. hgt. ft. hgt.
Stories_�_ stories stories stories �
# of bedrooms � ��p Q� c,7
reaz lot line or waterline of lake/river
,
In the box sketch in: �
Location and size of all
existing and proposed structures. �3' � '
Location of septic system. I �
Indicate distance to: � � �
Waterline/Wetlands �
Road �
Lot lines '�
Septic system/pri�y (�Gl�, , 'd*�
Well � � �f� � //J( E
Distance betwee structures:�%`"- __ �---�
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� , �.: , : ,,�� a� ?
Indic e North. � ,— — ,-
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Fire Number: �
!/ S?D (-�/
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N0� t �
�//�iCr ��-�19 � I
Signature of Owner I
The above ceRifies that the listed ` f � „ �_
information and intentions are true and � �� �
correcC The above person/s/hereby ,��
give permission for access to the
property for onsice inspeccion. ------- centerline of road-------
Issue Date September 26, 2001 Expire Date September 26 2002
Office Comments: �P Y' L�� �'� �/i/��s.-���-I�7./1'����
qg - 3 u 7 Signature of Zoning Administrator
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IAN TRAILS SUBD. PLAT SCALE: I INCH=�tO�Q FEET
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DRAWN BY: .�'� DATE : 2 -9-79 I
COLON (:) INDIGATES GOVT. LOT i
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