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026-173-00-0601-LUP-2001-323
-r � `n �,. Application for Land Use Permit o o O County of Sawyer � � PO Box 676 -Hayward WI 54843 ^� 715/634-8288 1 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 MAY NOT ` BEGIPi UNTIL THE PERMIT IS ISSUED. �v PRINT—USE BLACK INK OR PENCIL � � a � y ��.. r�. jr)I;p;. `l l�1,+.5� / ��. � � .� � . . a. Owner -- Builder � o ��]�.�. '.�I���' � � Mailing AddressJ Mailing Address _._ � � ._ City,State,Zip City,State,Zip � - � ��. Daytime Phone Daytime Phone Building Land Use (r)New O Filling Zone District ��°� ( )Addition ( )Dredging O Alteration (�)Grading Lot Size o ( )Moving On ( ) .� ( ) ( ) Acres a �� ` � � Primary Structure Accessory Building Addition � � O Dwelling O Garage-attached/detached O Deck 5� o ( )Year round ( )#of caz stalls ( )Porch 'e � ( )Seasonal ( )Storage Building ( )Enclosed "q O Frame built on site O Screenhouse O Living room -�t'3 ( )Modular/manufactured ( )Greenhouse ( )Kitchen � � ( )Mobile/manufactured ( )Other ( )Bedroom � 9� ( )Other primary structure �i')�!=,, , i°: ( )Relocate/enlarge U � � ( � ( ) ( )#of new o � 9� O Type of Construction ' Q�Frame O Log O Pole/metal O Block O Concrete � ( )Other � �� � �' � Construction Cost$�l�% � � � Vol�Pg l�% of Deed Certified Soil Test# �F1' -O5`� ' � �C�-�D CSM Vol_�_Pg_�a _ Sanitary Permit# (�9'—�+�/� �.� iz �� ��d Or: `J � Plat Envelope � � � Condo Vol Pg Year Installed ���( J Aff of ex septic V P Owner When Installed: � M � ������ �-C'Y�-l���o-r� 2(�`t L¢ i � �� , Application for Land Use Permit - Page 2 Describe Construction: List dimensions of each structure, story, addition, or alteration. #1. #2. #3. #4. Size ;�i � ft. wide ft. wide ft. wide ft. wide ft. long ft. long ft. long ft. long Floor area "` sq. ft. sq. ft. sq. ft. sq. ft. Hgt. from grade to 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. � �_; ) _ . j � _� Indicate distance to: , � �' ��� Waterline/Wetlands � � Road �=? ' � _ . _..��� fi�� ��� I,ot lines '/��� ,: � �o' Septic system/privy � � ' Weil r'�'� � � Distance beriveen structures. � ' < — � �,�xa � Indicate North. � '� �aX ' ��� �Jorch i ' � _ ; �-� �a t � i-��SP �'` � FiteNumber: �� � �� p�rx4o��0�� i ir' � '� 5e.�'�'c � / i � � „3, �� ' � � _ ;l ; srE� , ��!i� � � _ _ __ � �� I- -- � � � ��r��a—� rn��� .1 Signatur� of Owner ��a ��� The above cer[ifies that the listed information and intentions are true and r'�'i conect.The above person/s/hereby � � � l � I give permission for access to[he �� properry for onsite inspectioa ------- centCilinC Of road------- IssueDate July 26, 2001 ExpireDate July 26, 2002 Office Comments: ��i!r''�l, �id'�`!'��%i�� Signature ofZonin� Administrator OF SAND LAKE TWP 39 N. R . 9 W. , �"� 2.� TOWN OF BASS LAKE (SEE FOLDER 1.39.9 TOWN OF BASS LAKE) �� �� I I ES I LAKE I TOWN OF SAND LAKE I � I . 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