HomeMy WebLinkAbout026-170-00-0400-LUP-2001-571 U�%
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Application for Land Use Permit o 0
County of Sawyer v �
PO Box 676 -Hayward WI 54843 ' �
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 �
and the laws and regulations of the State of Wisconsin.CO�iSTRUCTION NIAY NOT '
BEGIN UNTIL THE PERIVIIT IS ISSUED.
PRINT—USE BLACK INK OR PENCIL � �
a
� �! �-l�� l�A�i'fJ 17 EL✓J �U,�s f,.E'�<�,'n,,� `��'
Owner Builder � � �
-5��o ��'�lrn n b f��>� ��66 zc /�,� �'�� ;
Mailing Address Mailing Address �
S� . I�'1��,� vL�l Il� —`�S�D 3 S fo,"t L,.vit'r �ti/ J /��C
City,State,Zip City,State,Zip C
7/f �df-z>c/,�7if �iia os,�
Day�time Phone Daytime Phone
Building Land Use
O New O Fillin� Zone District �Q�Q�
(�Addition ( )Dred�in� �
( )Alteration ( )Grading Lot Size o
( )Movin�On ( ) _
( ) ( ) Acres I , �j0(o �
�
Frimary Structure Accessory Building Addition , �
( )Dwellin� ( )Gara�e-attached/detached (o�Deck � o
( )Year round ( )#of car stalls ( )Porch
( )Seasonal ( )Storase Building ( )Enclosed �
( )Frame built on site ( )Screenhouse (�Living room Q
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom o _
( )Other primary structure ( ) ( )Relocate/enlarge �
� ) ( ) ( )#ofnew � •
�
�
Type of Construction O :
(,�J Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other u �
n �
Construction Cost$ Z_S Grx:� �` � —?
(a65 � f
� .�a =
Vol�Pg �`1� of Deed Certified Soil Test# � C�
�
CSM Vol Pg Sanitary Peanit# z
Plat Envelope Or: /.�(� 98-yb8 �'
Condo Vol Pg Year Installed �
Aff of ex septic V P Owner When Installed: �
/p�(�D l
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Application for Land Use Pernut — Page 2
Describe Construction: List dimensions of each structure, story, addition, or altera[ion.
#l. ���(���..�� #2. #3. #4.
Size� ft. wide �� ft. wide ft. wide ft. wide
2`� ft. long /2 ft. long ft. long ft. long
Floor area�sq. ft. / `/ �/ sq. ft. sq. ft. sq. ft.
Hgt. frvm gcade l � to peak - ft. hgt. ft. hgt. ft. hgt.
Stories � storiesi�f<;< stories stories
# of bedrooms
reaz lot line or waterline of i„ ,l„r f , ,� �< ake/srver
In the box sketch in:
Location and size of all �g,s ,7� '
existing and proposed structures.
�>�-3
Location of septic system. � G,zz �
�e� �,;s- ,, � �
, �� �o :6,
Indicate distance to: -��/p - `` ��rU� a � �r,,,� �
Waterline/�Vetlands �.�,fti�,� �` f,,,, . G � -�. r. (�( �
Road a•,s,, �r� -�z.��.�� '�
c
Lot lines ��� � �
�� _z/
Septic system/privy � � q ��=M
Well �a � �
Distance betw een structures. ,�
s ,
z�r,�
Indicate North. °
�'
Fire Number. �
lo s ac� N c�/-Ce �J.��, � �
� �� i
�f2
Siguature of Owner
'I he above certifies that the listed '
information and intentions are�ue and
coaect The above person/s/hereby i
give permission for access to the
property for onsice inspeccio❑. ------- centerline of 1 A/(� ,�f, „� road-------
IssueDate October 12 , 2001 ExpireDate October 12 , 2002
Office Comments: ��G������Z�iy��
Signature of Zoning Administrator
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ON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
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BOUNDARY LOGATIONS