HomeMy WebLinkAbout002-840-20-5210-LUP-2001-509 / ��,
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Application for Land Use Permit o 0
County of Sawyer � �
PO Box 676 -Hayward WI 54843 O
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 NIAY NOT
BEGIN UNTIL THE PERMIT IS ISSUED. I� 1
NRS THt�ACKET PRINT—USE BLACK INK OR PENCIL �
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Owner Builder ' �
�� "cL}�C'.n i t L�/. �,�., �'��:�� �c.� CDu iit'� 12�r�rl, (i �
Mailing Address Mailing Address O
�.� - ,.�--:z��a.. ,��jh. Ss�37/ f�� '-'_r a h_% ,
City,State,Zip �ity,State,Zip • �
.,�-_- �
Daytime Phone Daytime Phone
Building Land Use p
( )New ( )Filling Zone District ' I��-�
�)Addition ( )Dredging
O Alteration O Grading Lot Size o
( )Movin�On ( ) �
( ) ( ) Acres �,�]�/ �
n
Primary Structure Accessory Building Addition °
O Dwelling (-'J Gara�e-attached%detached O Deck 9a �
( )Year round ( )�of car stalls ( )Porch �
( )Seasonal ( )Stora�e Building ( )Enclosed �
( )Frame built on site ( )Screenhouse ( )Living room � � \
( )Modular/manufactured ( )Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other (�Be�nm� � I _
( )Other primary structure ( ) � (7r eloca enlarge � �
O O O#ofnew
Type of Construction � =
(X�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other ^ � :
=
x
Construction Cost$ =-�� � �
Vol L� Pg c��C�, of Deed CeRified Soil Test# �y'��OSo
CSMVoI I�. Pg I�����1 SanitaryPermit# �j8 G.SS �z
Plat Envelope Or: ��+° �'OS9 89-//R �
CondoVol Pg YearInstalled /=%;; �
Aff of ex septic V P Owner When Installed: � 9��„/1�
t�/
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story, addition, or altera[ion.
#1. #2. �� �'�' �� L EU�L #3. #4.
Size ,? �i ft. wide �_ ft. wide ft. wide ft. wide
ft. long a� 8. long ft. long ft. longy
Floor area sq. ft. _�sq. ft. sq. R. sq. ft.
Hgt. from gade "to peak 8. hgt. ft. hgt. R. hgt.
Stories stories stories stories
a. ,,
# of bedrooms .
rear lot line or waterline of lake/river
In the box sketch in: �
Location and size of all
existing and proposed structures. �' C- �
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Location of septic system. "
_ - � i , c _ .
�''' � �� , =: / ;� ' -�� - �
Indicate distance to: � �� �
Watedine/Wetlands �
Road r �
Lotlines ��`I �,� � :� ' ' �
Septic system/privy ' ` �i� r/,�o�s�, � �/ � �
Well � �___ / , � � �. _— _ �R
Distance beriveen structures. ,;_ <- �
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Indicate North. `"
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Fire Number:
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Siguature o ner l7
The above certifies that the lisred �
information and inrentions are hue and
correct.The above person/s/hereby
give permission for access to the
properry for onsi[e inspeccion. ------- centerline of � '' ^ � � i :, i0ad-------
a� R �v, �X ��� II bF rw_lo���etl -k� uPp�er le�� I n � �re� c�dd�� ,
IssueDate September 26, 2001 ExpireDate September 26, 2002
Office Comments: �,�.��,�,,, � !%�
Signature ofZoning Administrator
O F B A S S L A K E fOR ASSCSSMENi USE ONLY
�W P. �t O N . R . H W• SH�P ' OR VSiO ND RY WNER- .
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