HomeMy WebLinkAbout010-841-29-3207-LUP-2001-617 �75 s'
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Application for Land Use Permit r ,� -:
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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 cegulations of the State of Wisconsin.CONSTRUCTIOiV MAY NOT ��
BEGIN UNTIL THE PERMIT IS ISSUED.
+ i` �-t PRINT—USE BLACK INK OR PENCIL � �
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Owner Builder � o +
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Mailing Address Mailing Address �
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City,State,Zip City,State,Zip �
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Daytime Phone Daytime Phone �
Building Land Use ?
( )New ( )Filling Zone District �� ' �
��f� ,
(�.j Addition ( )Dredging
O Alteration O Grading Lot Size n �
( )Movin�On ( ) �
( ) ( ) Acres 7.�'� _
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Primary Structure Accessory B Addition n °
( )Dwellin� ( }Gara, -att etached ( )Deck � o
( �)Year round (��)#of car stalls O Porch �
( )Seasonal ( )Stora�e Building ( )Enclosed �
O Frame built on site O Screenhouse O Livin�room �
' ,.�lodularimanufactured '4 ��
� )' ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom ;,� �`
( )Other primary structure ( ) ( )Relocate/enlarge � �
� ) ( ) ( ) ofnew
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Typ Construction o
Frame ( )Lo� ( )Pole/metal ( )Block ( )Concrete �'
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( )Other ^� y�
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Construction Cost$ � �
Vol y�/9 Pg y��� of Deed CeRified Soil Test# Q�-�,(; ^
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CSM Vol_�Pg _�(t(� Sanitary Permit# ���/yl � z
Plat Envelope Or. �'
Condo Vol Pg Year Installed �
Aff of ex septic V P Owner When Installed: E ��I�pI6i
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Application for Land Use Permit — Page 2 -
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. #2. #3. #4.
Size 3s ft. wide ft. wide ft. wide ft. wide
SC ft. long ft. long ft. long ft. long
Floor area / 75o sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade_ /�,,, to peak ft. hgt. R. hgt. ft. hgt.
Stories stories stories stories
# ofbedrooms
reaz lot line or waterline of lake/river
In the box sketch in:
Location and size of all
existing and proposed structures.
Location of septic system.
Indicate distance to:
�Vaterline/Wetlands
Road
Lot lines
Septic system/privy
Wetl y i
Distance between structures.
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Indicate North. ��� � /� ���� ', PRPi`;
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Fire Number: ' ;/�� - �
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Signature of Owner �; I I
The above certifies that the listed �
information and intentions are true and y
correct. The above person/s/hereby ,
give permission for access to the
property for onsite inspeccion. ------- centerline of road-------
IssueDate November 2 , 2001 ExpireDate November 2 , 2002
Office Comments: � - �
Signature ofZ nin� Administr or
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