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HomeMy WebLinkAbout026-118-00-1300-LUP-2001-352 , !�__ Application for Land Use Permit o a County of Sawyer y � PO Box 668 - Hay�vard WI 54843 v - 715/634-8288 � The undersi�ned hereby makes application for a Land Use Permit and agrees that all �vork 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 N1AY NOT BEGI�i UNTIL THE PERi�1IT IS ISSUED. �{" PRI�T — USE BLACK ItiK OR PEtiCIL � / � ��i z9 G ���L ,S' j�/ 7 ._. � , ' . ` < /7� �rJ i � i � [J> �d�,E'S� y Owner Buil er ° , o ��/.�3� S ;Ss��.�C < �-,�<< �'� GZ�� �� � �� ;��_ � , r /�I�, fc�.;/�� ; ; Mailin� Address �lailing Address _�i��,�� ����� , G�;s• `��L/�'��, s�n>�. �y�� L��,s� S yd'>� City, State, Zip � City, State, Zip - r 7/s'���-.s'- ���� �7i��<��s�- ��%c y Daytime Phone Daytime Phone ' Building Land Use - �Ne�v ( ) Filling Zone District ��— ( ` ( ) Addition ( ) Dred�ing ' O Alteration O Gradin� Lot Size ' �� ( ) tiloving On ( ) � � � ) ( ) Acres / D 3 � � , ' � i _ ` Primary Structure Accessory Buildin� �ddition � �� ( ) D«�elling �GaraQe- detached ( ) Deck � =`� ( ) �'ear round (.� � of car stalls ( ) Porch ( ) Seasoelal ( ) Stora�e Building ( ) Eilclosed �� I O Frame built on site O Screenhouse O Living room � ( ) Nlodular�manufactured ( ) Greenhouse ( ) Kitchen � � ( ) Mobile/manufactured ( ) Other ( ) Bedroom �� I ( ) Otller primary structure ( ) ( ) gelocate/enlarge � �� � � � ) ( ) r of new O Type of Construction Q � � Frame ( ) Lo� ( ) Pole/metal ( ) Block ( ) Concrete � ( ) Other " L �� > � Construction Cost S / � ; (�(�P) � <' Vol (s,�( Pg� '�of Deed Certified Soil Test m_ �J'Q -- �� � � CSN1 Vol Pg Sanitary Permit � 9r� —;���, " � — � z Plat Envefope Or: ,,�(� � 4'S --�id C�' x � Condo Vol Pg Year Installed � � .Aff of e.� septic `' P O���ner �Vhen Installed: � �/�''j D j � l� `� S� � � Application for Land Use Permit — Page 2 _ - Describz Construction: List dimensions of each structure, srory, addition, or alteration. #1. /� i �Z. �3. #4. Size �cF� ft. wide ft. wide R. wide fr. ��ide i �� ft. long h. lon� ft. long ft. long Floor area __�,�;� sq. h. sq. ft. sq. ft. sq. h. i H�t. Crom grade l� to peak ft. hgt. fr. h�t. ft. hgt. Stories � stories srories srories � of bedrooms _� rear ]ot fine or �caterline of��,'q „s'syd¢;qm•� lak iver In the box sketch in: Location and size oFall � ��� existing and proposed stnictures. Location of septic system. i Indicate distance to: � �b'ater(ine/�b"eflands �� Road Lot lines � Wall �^�u 5v� Septic systent;'privy �� f) � �± o i \�'zll 7f �gD � ` �� Distance beh��een stnictures. �� —� � _r � , Indicate I�or[h. � � � � � Fire A�u/mber: � �i ��`� �� 7 �,�3 �1;� i� �� ��'� � . , � �y ' ,�8 -� �ti `, � � `� � , . ��_ • � � , � � `� ' � � ; Sig atureofO��ner �jSSeds� '9m�� Lt � �' Tliz above certifizs that thz listzd �� �� information and intzntions are true and corrzct. The abo��z pzrson:'s%hzraby c�iez pzrmission £ur access to thz propzrry for onsice inspzccion. ------- cen[erline of �SS'�,��, < �'.n road------- Issue Date August 6, 2001 Expire Date August 6, 2002 Ofticc Comments: ��L�t(�.Yt,�j.���/'lZf2������ Si�naturc of Lonin, Admini;uator 1'ID 2�V 1 S Z STATF BAIt OF W ISCONSM FORM 7-1999 Reg�sler s ONica Documenl Number /� QUIT CLAIM DEED sa»ye�caumy } 55 . Feca��ya�0forrecorOmiS �C/ tlayol /(/U(J AD19 ciL_o'dacN � Mar�tlrecortleDasvoL Co9/ Elizabeth Ann Smith. Truste ot the EI'zebeth An Sm'[h F 'I Tr t � o wpa9e /08 dated Mav 17. 1999 qm[-claims[o Elizabeth A. Smi�h Wisconsin QuallTed � �ii .i/UI�,[2.�. " Personal Residence Trust, F.I'vabeth A. Smith, Trustee the following � Ragisie� described real estate in Sawyer County,Stafe of Wisconsin: "'�'— DApury RaorEin /vice Namc end RCNm Address Itomae W.DuRy P.O.Ho:]52 Hayn�rtl�W15,813 4Ib118-00.1J00 Parcclldrntlfwt�on Numbcr(PM) This b wt humuleed properry. Lot Thirtcen(13),Fairview Subdivuion F�C ' '/^G N � EXEMPT Dated this�day of �V CM l�-�,1999. . ���'� �- �-�- �-� •�nbetA nnSmith,Trustee AUTHENTICATION ACKIVOWLEDCMENT SignaNrc(s) .A Y 1��� STATE OF ) ) COUNTVJ euNenticaredthis_dayof . Pers Ily e before me Ihis 7i Cay of .�"1999 [he ebove named Elizabelh Ann Smilh m me known to be Ne person(s) who executW �hc • Coregoi ' swmrn� d ecknowl e the sam TITLC:MF.MRER STATE�AR OF WISCONSIN � Qf not, authonzcd by'706.06,Wis.SiaLs.) --- TNISINSTRUAIENTWASDRAFfEDBY NolaryPublic,S�ateo� � Thomas W.DuRy My nmmi io is pertnenrnt pf not, sule expiration daze Hayward,WI 54843 - '�—'� (Si�uwcs m�y be authmtiuled or azknowlcdgM. 9dM1 ue wt ROMLEV D.ASILE °C`ssBry.I � b 91 NotoryPublk-Mzona m.�.oro�+,�e���e���r���r�wa x�>vw«w�•a e�u�.metr:�aa��u. tiN Carxnission Em4es � Mr�M 31.4003 ^ QVITCIAIMDL[� $TATLB.UIOiWI$COYSLY � '�'•, �V POPMhaI.IfM I����ay4�eCunpnY FwqyLec Wvuroin 8'bfi55.]p21 �' i �r �h S 'S ��i �S� 2� y h o 's o q � � .q, '° 5 I � -.,o.� N° -o. - 9 11 � `n� �` -a.u.i ho �i�\�� 9 � �� a.� -.,Z., 1z o , � / � I � \\� — -9.16.1 ,� I 1� {- z58' LAKE (I� P. 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