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008-174-04-0602-LUP-2001-431
_ �75 Application for Land Use Permit r ,� �� . � o County of Sawyer � � ' PO Box 668 - Hay�vard WI 54843 ��%�Q f��a�e q R��ITl 71 S/634-8288 Ppties� ��, The undersigned hereby makes application for a Land Use Permit and agrees that all work � _ 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 MAY NOT � , BEGIN UNTIL THE PERMIT IS ISSUED. 5 PRINT—USE BLACK INK OR PENCIL `� � � a I�.-�- J. -�}e�r �i f z�c� �r�i s"r ( � -�--�-�-�'�� y: o �Owner B ' der � o N io7g S� �f�v� [�oad �"�' ����� s �,, � �,. Mailing Address Mailing Address S � �a C ros 5 � c..e.�l �`f�0( ���.�:�-t��zg�.��' .Z" 5�/g��' ,� T. City, State, Zip City, State, Zip 'r N G��X-7��'-�G6J r��..�/53�;'� -3 SG,y ��s- - � y - 33 �/ c� Daytime Phone Daytime Phone �0 A Building Land Use s— � O New O Filling Zone District �Z R —� � � (7j-Addition ( ) Dredging ( ) Alteration ( ) Grading Lot Size o ( ) Moving On ( ) � - ( ) Acres - 3'� G •`i � � �, Pi-imary Structure . Accessory Building Addition d � (��) D�velling�,�� �q�5`") Garage-attachedldetached O Deck o 0 ( )Year round ( ) # of car stalls ( ) Porch '4 r ( ) Seasonal ( ) Storage Building ( ) Enclosed ( ) Frame built on site ( ) Screenhouse �}-Living room ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � ( } 1Vlabiicimar.ufaciureri ( ) vii7er ( ) ��urocm ° ( ) Other primary sfizcture ( )___ _, ( ) Relocate/e%large � A � � ( )_ ( ) # of new O Type of Construction A (�Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � ( ) Other ro ` � J � I ��00�� ,�� � � Construction Cost $ ���� � C�i3 30( i Vol (O S2 Pg Y(o 1_of Deed Certified Soil Test# gg—O�,C�� °° CSM Vol Pg Sanitary Permit# :� z G� � Plat Envelope � 3 �r� �.UP g$- ���' Condo Vol Pg Year Installed � Aff of ex septic V P Owner When Installed: C 1ll?�'6! � . �--i a t 3 C�� Application for Land Use Permit — Page 2 . Describe Constnzction: List dimensions of each structure, story, addition, or alteration. #1. #2. #3. #4. � Size�_ ft. wide ft. wide ft. wide fr. wide � fr. long ft. long ft. long ft. long Floor area y/,� sq. ft. sq. ft. sq. ft. sq. ft. H;t. from grade��to peak ft. hgt. fr. hgt. ft. hgt. Stories / stories srories stories # of bedrooms__� �1 ar lot line or waterline of lake/river / In the box sketch in: �; Location and size of all � existing and proposed structures. G _.�. _� , Location of septic system. �� � Indicate distance to: F � ' Waterline/Wetlands � Road / � Lot lines ;'� '�(��p � p,�',,�,.� Septic system/privy �� �'� (3!.d�"""` �/ Well � �� — Distance between structures. ��I ' � �w.�,�c � '''.e � —' Indicate North. ���� � _���� j � �^ - � (� � �W�p , 'U �� ', Fire Number: a � T � , <� '(� , � IHs� �11 S�asef 3�ac� � _ , ��,�'� "' � � r , -; y' �_L ✓�—��bF '�'" a F� 6 r , , � _ � _ --- �.c� � , ��+�`'=t ���e��Q � � � y5 � �;� Signature of Owner - — — The above certifies [hat the listed - �� �• � � � � information and intentions are true and correct. The above person/s/hereby eive permission for access ro the property for onsire inspection. ------ centerline of road------- S �lo �� Issue Date August 29, 2001 Expire Date August 29, 2002 Office Comments: w !�?'i��✓ � y � �� Signature o:Z r.ir.g Ad.r.inist,ator U� � v v . . v r. � v �r\ v I 1 SEC. I? TWP. 37 R 9 W. PART OF G�V 10.3 �� �� � ,o.� �o.z � MAP 2 OF 2 9• i 9.2 1 e.� 9. 2 � / 7. 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