HomeMy WebLinkAbout010-941-26-1306-LUP-2001-651 Application for Land Use Permit r ,�
County of Sawyer � � O
PO Box 676 -Hayward WI 54843S�E �.-/} "`"'`-'�'�''v
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 J�
and the laws and regulations of the State of Wisconsin.CONSTRUCTION NIAY NOT �
BEGIN UNTIL THE PERI�IIT IS ISSUED.
PRI�IT-USE BLACK INK OR�ENCIL � �: �
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.�e n�/S ,�c�,s Dr�r n i`r� ✓�c ��� �. �
Owner Builder ' � ��
/�;��T iV �,��,� y�� �c-�;x e �
Ivlailing Address Mailing Address ^ �
��v 6.�,a�c� ��,` Sq s�.�-p
City,State,Zip City,State,Zip
>�s' ('��� ��s'o �-<��h,
Day�time Phone Daytime Phone � S
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Building Land Use ` �
O New O Fillin� Zone District I'\�'� �
( )Addition ( )Dredging _ �
'4C�'Alteration ( )Grading Lot Size n �
( )Nlovin�On ( ) �
( ) ( ) Acres , ?� C
�
., G�
Primary Structure Accessory Building Addition � °
O Dweilin� O Gara�e-attached/detached O Deck � o
( )Year round ( )#of car stalls ( )Porch �
( )Seasonal ( )Stora�e Buildin� ( )Enclosed -�
( )Frame built on site ( )Screenhouse ( )Living room ``- �
( )Modular/manufactured ( )Greenhouse ( )Kitchen ��
ti.
( )Mobile,'manufactured ( )Other ( )Bedroom �: I
( )Other primary structure ( ) ( )Relocate/enlarge � �
( ) ( ) ( )#ofnew Q, � (�-
-L " a �j
Type of Construction t,-� " =
'�)Frame ( )Log ( )Pole/metal ( )Block ( )Co�crete u `�
�
( )Other � Q,
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Construction Cost$�i��`�OC� �
Vol 5 ��' Pg � t"L� of Deed Certified Soil Test# Q(� � ,3�lD W �
CSM Vol c� Pg � �o� Sanitary Permit# 9(z33� a' Iz
Plat Envelope Or: I�'
Condo Vol Pg Year Installed 1'f C �''� `-���''� � ��6�
Aff of ex septic V P Owner�Vhen Installed: � 1�1�
Application for Land Use Permit—Page 2
Describe Construction:List dimensions of each structure,story,addition,or alteration.
#l. � #2. #3. #4.
Size ft.wide ft.wide ft.wide ft.wide
�ft.long ft.long ft.long ft.long
Floor area 12$l Sq,g. sq.ft. sq.g. sq.ft.
Hgt.from grade ro peak 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.
Location of septic system.
Indicate distance to:
Waterline/Wetlands /,�
Road ��� � �'���U�
Lot lines
Septic system/privy
Well
Distance beri�een structures. � � � �
Indicate North. ��� ( � � D�-�� u �
Fire Number.
�_��
Signature of Owner
The above certifies[hat[he listed
information and intentions are hue and
correcC The above person's/hereby
give permission for access to[he
propecry for onsice inspec[ion. -------centerline of IOad-------
o���trn1U PLi 3'. �.c t = /�,(,(}U, Cu(JS�KirCZ1Uv ��S7s�/5 (,ib.5�7�LlSE
o C�,,,(� !'l1 USi�r i2t-Tzl,�ttii r�� 7v Grtc�xrv�C Or�7'J�Stc%M.S- 1 3S.Stiio 2t�l���ur/��
,zr�1J � -CL 2N1�
Issue Date December 3, 2001 Expire Date ��cem er 3 2002
Of£ceComments: ��i�2����2'�=�1J�C�+�iG��='%'�
Signature of Zoning Administrator
. _
PROPOSAL
PROPOSALNO.
SHEET NO.
DATE
PROPOS SUBMITTED TO: WORK TO BE PERFORMED AT:
NAME � ^.G ���• ADDRESS 3 97 � D �-F� � /Zp
\,
ADDRESS � �A^ 1
� a
DATE OF PLANS � � r r D /
PHONE N0. ARCHITECT
We hereby propose to furnish the materials and perform the labor necessary for the completion of
fy D e �nen
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and :>pecifi-
cations submitted for above work and completed in a substantial workmanlike manner for the sum of /�
Dollars ($ ��(/ • �Q )
with payments to be made as tollows. —�- �o.� EC0.� , S
1
Respectlullysubmitted �����V� � ���
Any aAeration or deviation from above specificalions involving extra cos�s � 1 i> \
will be executed only upon wriVen order, and will become an extra charge Per � e� n.q �_. G}J J } � �� � � d �
over and above the estimate. All agreements contingent upon strikes, ac-
citlenis,or tlelays beyond our control.
Note—This proposai may be withdrawn
by us if not accepted within_.days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications ar.d conditions are satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payments will be made as outlined above.
Signature
Date Signature
CAdams NC 3818-50 P RO POSA L
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