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014-942-34-4112-LUP-2001-118
�5`� � L. Application for Land Use Permit o 0 County of Sawyer � � PO Box 676 -Hayward WI 54843 � R 715/634-8288 z o � 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 bIAY NOT BEGIN UNTIL THE PERMIT IS ISSUED. � PRINT—USE BLACK INK OR PENCIL � a � �/ H ��c�- �t/C' c' C c�/l� '� ��Iv tV I S �p 1 G� o. Owner Builder ' o � �z�3� N. � �3y�� �o�,� i:���s � -rw;,� �ir. ,�v � Mailing Address Mailing Address i_� i K1rkla�d a, y�o.3y r-� w��, Gi,�: sy�y� ,� City,State,Zip ity,State,Zip � G�a— �' — S��� �'�lo�?-37/G �/1 aytime Phone Daytime Phone �, Building Land Use � ( )New ( )Filling Zone District_�,('�____�_ "� ( )Addition ( )Dredging (�Alteration O Grading Lot Size (' i��x ,3�,t� � i�%�z��c-� o ( )Moving On ( ) � � ( ) Acres � �Z /1(' ° � a � Yrimary Siructure Accessory Building Addition � o O Dwelling O Garage-attached/detached O Deck p o O Year round O#of car stalls O Porch i ( )Seasonal ( )Storage Building ( )Enclosed � i ( )Frame built on site ( )Screenhouse ( )Living room c}.� ( )Modular/manufactured ( )Greenhouse ( )Kitchen � c ( )Mobile/manufactured ( )Other ( )Bedroom rn ( )Other primary structure ( ) ( )Relocate/enlarge L > ( ) ( ) ( )#of new �.. � \ Type of Construction Q' � (�Frame O Log O Pole/metal (x)Block O Concrete r � ( )Other � � = Construction Cost$ �S o-c� � � � w Vol /q�� Pg 3�' �of Deed Certified Soil Test# �/`�— 'U�J� N r CSM Vol Pg Sanitary Permit# /� ,��(r,� ,z Plat Envelope Or: ��' Condo Vol Pg Year Installed i� � 0 Aff of ex septic V P Owner When Installed: � ��1 i��� \ Application for Land Use Permit — Page 2 � Describe Construction: List dimensions of each structure, story, addition, or alteration. #1. r��� #2. Fi'Ep/AcE Craw� #3. #4. Size ab' ft. wide � ft. wide�'"�� ft. wide ft. wide � ft. long �3�_ ft. long ft. long ft. long Floor area a v�� sq. ft. sq. ft. sq. ft. sq. ft. H�t. firom g-ade to peak ft. hgt. ft. hgt. ft. hgt. Stories ' stories stories stories p # of bedrooms IC£O�qCE EXSK'�i•�� dec� �•�,c orwaterlineof N�� Son� �Ak� lake/river /o o • In the box sketch in: '� Location and size of all � existing and proposed structures. w\ Location of septic system. �,- �� , � �`� - Indicate distance to: �� � Waterline/Wetlands t� �'� 3� A, � � — �'� Road �� � �`'� °� n , �� Lot lines Septic system/privy \ ? jS��N y � Well � � � �C,B ?� Distance betw•een structures. i ���0 � IndicateNorth. `�� � � Fire Number. I�a l� r�/ � �w�� �/✓� �1 1`{ Signature of��r�U����� The above ceRifies that the listed information and intentions are true and cocrecL The above person/s/hereby give permission for access[o[he �� property for onsite inspectioa ------- Centerline of road------- Issue Date May 10, 2001 Expire Date_1� a�, 1 Q,, 9007 Office Comments: / - � Signature of oning Administrator 1 � .i.i NELSON LAKE i . .5.8 .�.z e .i, 6 .8.7 .8 : �9 .3.1 , .3.5 .4.1 � .8.10 '2 .3 � - � �';.8.15 .3.9 B•� �• •`.8.16 •3.10 .3.14 �, I .3.11 .3.15 .8.1I .3.1 � i..i .3.12 ^ �b.3 �.. �3.17 .4.2 'r� a re d� � � � .13.1 � 13. J ,/ � 3. � �� ,� SHEE7"2 � � .3. 13. r� .14.1 ✓ �, 13. �� ^ 13.9 �' .I ✓, � .13. " .1,3.1 .13.13 •µ�Ib SNEE7 3 .I5.1 .�Ii, ,.1�, � � 35 3 2 SCALE: I INCH= 400 FT. KM 8-10-77 „ . . , .�.�:� .�.�.�:�:�:���: . . . . . . . .�.�.�.�.�. .� �'�' : . ''' � .+Yiil}15�1 N '�� . "�Y... ' .. ., . . _ . . rcL 1 I I �� . . . ._�._,.... :.:. .. . \ ; . . . 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