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 �
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Owner Buil er °
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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 "
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> �
Construction Cost S / � ; (�(�P)
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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�
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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. �� —� �
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Indicate I�or[h. � � � �
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Fire A�u/mber: � �i ��`� ��
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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
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