HomeMy WebLinkAbout002-940-11-3201-LUP-2001-515 �
Application for Land Use Permit r ,�
County of Sawyer � � 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 "' �
C �'�'
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 1
BEGF:1 UNTIL THE PERMIT IS ISSUED. � �
PRINT—USE BLACK INK O12 PENCIL c
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Owner Builder ' o �
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Mailing Add Mailing Address
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City,State,Zip y City,State,Zip �
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Daytime Phone Daytime Phone ''
Building Land Use
(�New O Fillin� Zone District ����� l i` �
( )Addition ( )Dred�ing r�
( )Alteration ( )Grading Lot Size � �
( )Movin�On ( ) � �~
( ) ( ) Acres �=
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x �
Primary Structure Accessory Building Addition g
( )Dwelling ( )Garage-attached/detached ( )Deck :� r
( )Year round ( )#of car stalis ( )Porch � I�
O Seasonal (?C)Stora?e Building O Enclosed r 1
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom � �-
( )Other primary structure ( ) ( )Relocate/enlarge �
� ) O O#ofnew <�
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Type of Construction :
( )Frame ( )Lo� (�Pole/metal ( )Block ( )Concrete �
( )Other � �
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Construction Cost$ �����'��r � �
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Vol G��� pg�S�ofDeed Certified Soil Test# �'���- ���� -, �
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CSM Vol_�Pg�'J � Sanitary Permit# �y — ��� �, z
Plat Envelope Or: �'
Condo Vol Pg Year Installed
Aff of ex septic V P Owner When Installed: � c�13�'
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Application for Land Use Pemut — Page 2 .
Describe Construction: List dimensions of each structure, s[ory, addition, or aiteration.
#1. #2. #3. #4.
Size � o ft. wide ft. wide ft. wide ft. wide
S� ft. long ft. long ft. long ft. long
Floor area /SG 9 sq. ft. sq. ft. sq. ft. sq. 8.
Hgt.from giade :�a to pealc ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms_�
rear lot line or waterline of lake/river
In the box sketch in: � �
Location and size of all !
existing and proposed structures.
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Location of septic sys[em.
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Indicate distance to:
Waterline/Wetlands
Road
Lot lines
Septic system/priry �q�rl'
Well �
Distance between structures.
Indicate NoRh.
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Fire Number. sz �
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9o � 8 /J i��
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Signature of Owner � 6�
The above certifies that the lisred � u� �°
information and intentions are hue and �n
correct The above person/s/hereby i �
give peraussion for access to the �f��
property for onsi[e inspec[ion. ------- centerline of � iNe �C;
, i�t-' � � road-------
IssueDate September 26, 2001 ExpireDate September 26, 2002
Office Comments: ��(/� ,^ ��-,�vZ�%/C�/
Signature ofZonin� Administrator
62
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