HomeMy WebLinkAbout010-130-00-0600-LUP-1998-203 Application for Land Use Permit r y
County of Sawyer y �
PO Box 668 -Haywazd 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.
PRI1�T—USE BLACK INK OR PENCIL (
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Owner Builde� y
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Mailing Address Mailing Address z;
City,State,Zip City,State,Zip ���.
,
Daytime Phone Daytime Phone
Building Land Use ;_��
( )N w ( )Filling Zone District ��� � �
Addition ( )Dredging
( )Alteration ( )Grading Lot Size �
( )Moving On ( ) �
( � �� � ACLBS ��� �
❑
Primary Structure Accessory Building Addition � �
( )Dwelling ( )Gazage-attached/detached ( )De �
O Yeaz round O#of caz stalls orch � o
( )Seasonal ( )Storage Building ( )Enclosed o '"
O Frame built on site O Screenhouse O Living room
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen n
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary shvcture ( ) (/�Relocate/enlazge
( ) ( ) ( )#of new`-- �
Ty £Construction
Frame ( )Log ( )Pole/metal ( )Block ( )Concrete - >
�
( )Other �
� �
Construction Cost$ ' � = �
#
Vol��Pg /Q�p of Deed Certified Soil Test# — �
I
CSM Vol Pg Sanitary Permit# 70- /..� ;%; �
Plat Envelope Or: 5' z
7�
Condo Vol Pg Yeaz Installed Jq(r�i
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Aff of ex septic V P Owner When Installed:
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Application for Land Use Permit—Page 2 ,
Describe Construc6on:List dimensions of each structure,story,addition,or alteration.
#1. , A���a,+;<,� #2. #3. #4. �
Size ft.wide ft.wide fr.wide ft.wide
ft.long ft.long ft.long ft.long
Floor azea sq.ft. sq.ft. sq.ft. sq.fr.
Hgt from grade to peak ft.hgt. ft.hgt. fr.hgt.
Stories�_ stories stories stories
#of bedrooms
reaz 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.
Indicate distance to: �' ( .- �
Waterline i� �
Road ��� ��3� (��� ,;
Lot lines
Septic system Z �
Distance between structures. � �
�i%eL-- � � / �
Indicate North.
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Fire Number: /�� , _� � . '
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Si ture of Awner � � �
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-------centerline of road-------
Issue Date May 26, 1998 Expire Date �y 26, 1999
Office Comments: INiG%t%�.«��/2�
TO�VN QF HAYVUARD
HAYWARD HEIGHTS
PRT SE- NW SEC. 21 T 41 N. R. 9 W
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DEER LANE
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DOCUh7E�NT NU. �� I O�• z, � 3 f ���, O p �' �ia;rr c��ni�% ntas;n I
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�I „! y j� • � ! �� 67ATG OF WISCONSih — FORM 13 �
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. I� . li ':f11:1 6PACC pEGERVLD FOR R[CORDIN:: UA`M
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TIIIS I:\Tll�NI"UiZ�, Madc by........Judith A. Kc]..seY.._...an...-•---..... I • , ,>"� , j, i � (!
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.............••-•--•-•.................--••---............-•••-••-•---•..............._.__.......••--....._.._ grantor........, -i���x��,��Q. � -- ;.
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Saw e2' __.,_..,_.., County, Wisconsin, hrreby quit-claims to �i _ �;
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RETURN 70 I�
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Sawyer I =� ' �
�rantce........, of...........................................:.. County, Wisconsin, for the sum of � — -
One Dollar and other � ood and valuable consideration -----------
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the following tract of land in..._...Sawxer.._ _.__._....____.._,_.._. County, State of Wisconsin: !.
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Lot Six (6) , Fiayward Heights Subdivision, being a part of the Southeast ''
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Quarter of the Northwest Quarter (SE 4 NW 4) , Section Twenty-One (21) ' ,I
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Township Forty-One (41) North, Rang� Nine (9) West. ��
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Subject to reservations , exceptions and easements of record. ;!
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(IF NECESSpRY, CONTINUE D�5CRIPTION ON RE4ERSI: SID�) I I
Tn Witness�YR�ereof, the said grantor.....,ha..�.._.hereunto set..k1�X:....-...hand...... and ;eal...... this...2�.��........_. I
day of-•--•----June.................. ._.:, A. D., 19.7.�_.. .
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� State of Wisconsin, i
Sawyer ss. A.F-y, ' i
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. County. Personally came before me t�11S...�_1�4Ai-••--• CI1 of_...._..►T.1,1A�........:...........
A. D., 19..7.2..., the within named_.._._...�t�d�..�k�...�_,.---Kelsey-,�--•an__.adult---womans..................................... i I
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to me nnown ro be the person._.i;::vj�J3o.•e5.'ecut�d.,t�t�Ore zg instrument and acknowledged the same. I
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THIS INSTRUMEN'( �NAS DRAFTED�BY� � .. • • + _;y�T_Q�ILnP T � T'TQC�,]"P
��1 ��i niY`' ��otary Public, .........._Sawver....--•................... Counly, Wis. � I
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OFIl:E.'r �r�sl4• ��u Y�••� ��,.,�''rty commission (expires)?��K...,IllTle....H� --.1.��rJ.....................•—
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il�,' �i.�nr� ��( tht �. .�.,�,••. 1'�au�rr�, wrtr.�.tc� and n��l�iy ticrlinn 5y.�t1 s�i. �larl�� ic,�ui.cf th�t tLc n.:n�t,��f thc �crl n i�-h ,r�'r t:o�•crn-
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SUBJECT: Request for additional information
Sawyer County Zoning Administration
P.O. Box 668
Hayward, Wisconsin 54843-0668
715/634-8288
To enable this office to process ycur applicaticn for a Lar.d Us� Permit
or Conditional Use Pezmit, the following information is required:
(x) Complete legal property description
(�C,) Mailing address of property owner f `
( ) Name and mailing address of builder, if other than owner
( ) Volvme and page number of recorded deed or legal document showing
proof of ownership
( ) Vclume and page number of recorded Certified Survey
( ) List the size of
( ) Size of property in footage
( ) Type of structure: dwelling, garage, storage building, etc
( ) Tppe of addition: livingroom, bedroom, utility room, kitchen,
porch, deck, etc
( ) Type of construction
( ) List estimated cost of construction
N1 The rectangle on the right of the application represents your prop-
I`
erty. Sketch in the location of the
ivin all distances to ot roads,
s ore ine an ot er ui ings on t e premises.
( ) Sketch in the location of the existing septic system, giving all
distances to the dwelling, proposed addition, and accessory buildings
( ) Attach the required fee of
You may make check payable to Sawyer County Zoning
( ) Retaining your check/cash to cover the fee
( ) Signature required on bottom left line of application, use only
black ink
( ) Certified Soil Test required
O Sanitary Permit required cur sys�P�n w°s %ns�.���1
$n�ur..,c.+:o� y .
O Existiag septic system a€€�e1rit required awe�� 4{ µw��''ne
( ) PJ_ease print, use only black ink or pencil. Applications completed
in blue ink will be returned. ,-' , ✓
(� What year was the existing septic system installed y _ F- . �
� � Ii tne septic was instalied after i968; wno ownec cile proper�y
at that time
( ) If the new dwelling will have a loft or second story, list the
size of the loft or 2nd story in the spaces provided
(�) Retum the original application; photocopies or facsimilies are
not accepted
,�,.
(X) �-r�CI ud�t G t r�e. �J�m bed re o r �r.P�r.r�-� �� ;�-� �
( )