HomeMy WebLinkAbout008-174-02-0400-LUP-2001-298 �L"O�-�
Application for Land Use Permit o o �
County of Sawyer � �
PO Box 676 -Hayward WI 54843 IT�
715/634-8288 r �— �
The undersigned hereby makes application for a Land Use Permit and agrees that all work —K �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance aJ F �
and the laws and regulations of the State of Wisconsin.CONSTRUCTION NSAY NOT (� �
BEGIN UNTIL THE PERMIT IS ISSUED. � �
PRINT—USE BLACK INK OR PENCIL e��, N
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Owner Builder ' o
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Mailing Address Mailing Address � C/ �
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City,State,Zip City,State,Zip �
�ta� - Z3�- aor 9 � 15- 35'f- �3�i I � �
Daytime Phone Daytime Phone �
Building Land Use
C� �
(�New ( )Filling Zone District ���` �
( )Addition ( )Dredging �
( )Alteration ( )Grading Lot Size o �
( )Moving On ( ) � ,�3 �
( ) ( ) Acres .�C ^
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Primary Structure Accessory Building Addition °
(�)Dwelling (�Garage-attached/detached (�Deck o
(�Year round (Z�#of car stalls (�)Porch j
( )Seasonal ( )Storage Building ( )Enclosed --
(�Frame built on site ( )Screenhouse ( )Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom n
( )Other primary structure ( ) ( )Relocate/enlarge �' �
O O O#ofnew n
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Type of Construction � =
6C)Frame O Log O Pole/metal O Block O Concrete �
( )Other � �
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Construction Cost$ ��J� (�C� O � �
Vol rn 1 q Pg 7d of Deed Certified Soil Test# (��' � 5� � �
CSM Vol Pg Sanitary Permit# (� 1 —/ '� (� z
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Plat Envelope Or: CL �'
Condo Vol Pg Year Installed �0
Aff of ex septic V P Owner When Installed: �
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Application for Land Use Pernut — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. #2. #3. #4.
Size `� d ft. wide a`� ft. wide � 2- ft. wide � Z ft. wide
� 3 ft. long '� � ft. long Z� ft. long z 3 ft. long
Floor area 1 �l � sq. ft. ��f N sq. ft. a4 o sq. ft. a�� sq. ft.
Hgt.from grade 2� to pealc �`t � ft. hgt. `d ft. hgt. S ' ft. hgt.
Stories�_ stories � stories � stories
# ofbedrooms 3 �
reaz lot line or waterline of �..�k� e.k�-F�c � /river
In [he box sketch in:
I,ocation and size of all
existing and proposed structures. r
Location of septic system Z' `3 ��
3 � �St 4,
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Indicate distance to:
Waterline/Wetlands a�, Y;
Road �i'� ' 3 2'
L,ot lines
Septic system/privy y� �I � � ; �_
Well ���
Distance between structures. , WI W saL1cJ ti't
o��iby I �ws,�,,,.t-n
Indicate North. � N�n�-4�
Fire Number: I ��-�.�--
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ignature of Owner � s�
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The above certifies that the listed q ./a.
information and in[entions are true and Z � tiJ ��'S�
correct.The above person/s/hereby n
give permission for access to the � ,. � ,
property for onsite inspection. ----- �m�r(i Of J���'S^--`r ���c�n. ��� road-------
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IssueDate July 17 , 2001 ExpireDate Ju1y 17 , 2002
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Office Comments: - �
Signa[ure of Z ing Administrator
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DRAWN BY: DATE:7-5_84 INTENDED TO SHOW CON
COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP
BOUNDARY LOCATIONS
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