HomeMy WebLinkAbout002-940-05-4404-LUP-2001-525 �75�
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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
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 ,` _
BEGIN UNTIL THE PERMIT IS ISSUED. �' �
PRINT-USE BLACK INK OR PENCIL `oa'.
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�A V�1�D �- C�4('L�n;� �v tc.;��ru r•3 /��l�a7�-i,��'o, �;i�D,rl�-s y �'1
Owner Builder ' � �
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Mailing Address Mailing Address �
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City,State,Zi City,State,Zip
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Daytime Phone Daytime Phone �
Building Land Use —
(�New ( )Filling Zone District ��-�
( )Addition ( )Dred�ing �2
O Alteration O Grading Lot Size � _ �
( )Moving On ( ) ,� � ��
( ) ( ) Acres y,�'}9 � �
� � �
Primary Structure Accessory Building Addition � °
( )Dwellin� ( )Gara�e-attached/detached ( )Deck � �
O Year round O#of caz stalls O Porch
( )Seasonal �Storage Building ( )Enclosed
( )Frame buiit on site ( )Screenhouse ( )Living room
( 1 Modular/manufactured ( )Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other ( )Bedroom � �
( )Other primary structure ( ) ( )Relocate/enlarge �
( ) ( ) ( )#of new ' (n
` � �
Type of Construction e o >
( )Frame ( )Log �Pole/metal ( )Block ( )Concrete � �
( )Other '' �
�
Construction Cost� �������� � `�
-`0 9 7 �5 �
Vol 84= Pg y�-7 ofDeed Certified Soil Test# 95 �5 ay � �
CSM Vol Pg Sanitary Permit# `�.5 vS�/ -� z
Plat Envelope Or: ��P 95 �.59�i � �
Condo Vol Pg Year Installed � �
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Aff of ex septic V P Owner When Installed: � �j�ai��a i
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Application for Land Use Pernut—Page 2
Describe Construction:Lis dimensions of each structure, tory,addition,or alteratio .
#1. #2. #3. #4.
Size z� ft.wide ft.wide ft.wide R.wide
�� ft.long ft.long ft.long ft.long
Floor area �.3� sq.ft. sq.ft. sq.ft. sq.ft.
Hgt.from gade��to peak ft.hgt. ft.hgt. ft.hgt.
Stories C�hf� ories s ries ries
#of bedrooms /`�A
reaz lot line or waterline of ��r�`'����"'"" �'i1e� lake/river
In the box sketch in:
I,ocation and size of all I,����T L%�N�>
existing and proposed structures.
Location of septic system.
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Indicate distance to: �1�
Waterline/Wetlands \
Road y
Lot lines �� c,"='`�
; ��+>,e!F
Septic system/privy - ,,�
Well _�_
Distance between structures. � �qZ / � p.� ,j
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Indicate North. c, ) e��°1��y �,.si 2'�V�
Fire Number: � �; ��
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SigoatureotOwner �v�� ap�
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The above certifies that the listed �-c�U�!
information and intentions are true and
correct The above person/s/hereby �„v`���at
give pernussion for access to the
property for onsite inspection. -------Centerline Of /� f m � �_.���_road-------
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Issue Date September 26, 2001 Expire Date September 26 2002
Office Comments: ���/i2%C����LiI/GGtis��/i`P`"�!
Si�nature of Zonin�Administrator
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SPRING
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SGALE: I INCH=4O0 FEET FOR ASSESSMENT USE ONLY NOT
DRAWN BY: DATE : INTFNffFn T� SNAW C[�NCLUSIVE