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026-118-00-2700-LUP-1999-652
L.� v `� �./ / , , : �. Application for Land Use Permit _ a � . � County of Sawyer �; � PO Box 668 - Hayward WI 54843 �n � 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 Sa�vyer County Zoning Ordinance � ' and the laws and regulations of the State of Wisconsin.CONSTRUCTION MAY NOT � BEGIN UNTIL THE PERMIT IS ISSUED. �` � PRINT—USE BLACK INK OR PENCIL � �e• a � <' ,i , � G�� c /�.c�a l= C�"L�L�� �. o' O� er Builder � o � `7�7c'C� �����a.C��� ��. � � � .� Mailing Address Mailing Address ��� � 'Y1� 2 ,�5�'� �� � r 1.� 2 Ci y, State, ip City, State, Zip �' L, C�/� - �r�- �i/� � � Daytime Phone Daytiine Phone ��� Building Land Use /� � � ( )New ( ) Filling Zone Dish-ict /�lL. � � ( ) Addition ( ) Dredging � O Alteration O Grading Lot Size o � � ( ) Moving On ( ) _ _ � ( � ( ) Acres � � � ��� G�cc/z� � -, Priinary Structure Accessory Building Addition � ° O Dwellin� Q� Gara�e-attached detached O Deck � o ( ) Year round ( ) # of car stalls �� ( ) Porch O Seasonal O Storage Building O Enclosed g O Frame built on site O Screenhouse O Living room ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � ( ) Mobile/manufactured ( ) Other ( ) Bedroom i , ( ) Other primary structure ( ) ( ) Relocate/enlarge � A ( � ( ) ( ) # of new �� Type of Construction O A �Fraine ( ) Log ( ) Pole/metal ( } Block ( ) Concrete � ( ) Other ro -, � � Gc � COI1StTL1Ct1011 COSt $��i�� �— � p f � Vol fUL+ Pg � 7�of Deed Certified Soil Test # � �7�" '��l� �V'J CSM Vol Pg Sanitary Permit# --� �� — ��.� � Plat Envelope Or: �' Condo Vol Pg Year Installed �r� � � Aff of ex septic V P O�v�ler When Installed: � ����yl� v �►� q�--�5�, c�n �c���3 . Application for Land Use Permit — Page 2 , De,scribe Construction: List dimensions of each structure, story, addition, or alteration. #1. #2. � #3. #4. - Size_� ft. wide � �D ft. wide ft. wide ft. wide �_ ft. long _S'�% ft. long ft. long ft. long Floor area ��Y sq. ft. ��y sq. ft. sq. ft. sq. ft. H�. from grade o�U to peak ft. hgt. ft. hgt. ft. hgt. Stories � stories stories stories # of bedrooms � rear lot line or �vaterline of lake/river �e�a.P �> >�7(Q� In the box sketch in: �_ �.�-��� �.� Location and size of all , existing and proposed stnictures. Location of septic system. Indicate distance to: Waterline/Wetlands Road Lot lines Septic systen�/privy Well Distance between structures. Indicate North. Fire Number: � ���z�-,�- `�`�3�z 9 /L' Signature of Owner The above certifies that the listed infornlation and intentions are true and correct. The above persoi�/s/hereby give permission for access to the property for onsite inspection. ------- Centet'11ne Of r0ad------- Issue Date NnUPmhPr 1 , 1 999 Expire Date November 1 , 2000 Office Comments: - m��� m0���` ( O� �,���, Signature o oning Administrator �'o,m��r���e�.�' . C�. �o/aq/99 � � � s� � � �. � � �� 1 � �, o � � �� I �_ � � � � � �� �� � � � � � , � � Q � � . c � �� � X � � � ° -----_=�.�.,�,w,.,��. � � � . � � ,� 7 � o �I� � �, � N�� � � � � � �� N � rr �, 7ti �� � � 3 � � � �� �; m � � � � � � o �ro � S� � � � � � �,-, +k � I � ----� µo� � ?�� � s !� � � U � � v V o � �.� sQ �" � u �4 G � pr �t. J � ' o � � 2S � �l � �... � L��� In��_ � ol.� ' ' • ° • . . . •� � ' � � � � d � � � � 10�. ����y � �Z� � �_ � �� J � -3- � � S- / g� \ I/i .O,r. `c� �— ,O/� � _... in k T �0 � J �� �---n�j � Q ao IL. _ r � Q. . � J � ,� J ry Nt �_ o. 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