HomeMy WebLinkAbout010-941-23-3422-LUP-1998-389 -'S,_
Application for Land Use Permit r �
County of Sawyer ° �
PO Box 668 -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 � - 1
and the laws and regulations of the State of Wisconsin.
PRINT—USE BLACK INK OR PENCIL t_ �
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Owner Builder H �
!C'�S�v I Y l�Anl�/�r/C—o/tJ li��.C /.?3�8 TF��v'�/j,y�r Poi �� °
Mailing Address Mailing Address �
��i��c���/�'-D Lt'i l SU-�'�3 /�ff!''�/c�f l�� u'i �`��-�,�� �
City, tate,Zip City,S ate,Zip -
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Daytime Phone Daytime Phone �-i
Building Land Use
( )New ( )Filling Zone District �'-/ �
�Addition ( )Dredging
( )Alteration ( )Grading Lot Size
( )Moving On ( ) �
( ) ( ) Acres �� '% ?
0
c
Primary Struchue Accessory Building Addition ;�
( )Dwelling ( )Garage-attached/detached �Deck n �
0
O Yeaz round O#of car stalls �Porch � o
( )Seasonal ( )Storage Building ( )Enclosed �
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( )Frame built on site �Screenhouse ( )Living room
( )Modular/manufactured ( )Greenhouse ( )Kitchen `
( )Mobile/manufactured ( )Other ( )Bedroom �� �
( )Other primary structure ( ) ( )Relocate/enlazge �� �'`�
( ) ( ) ( )#of new �„ >
� �
Type of Construction �,, �
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete a
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( )Other "
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Construction Cost$ �,y. ; _
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Vol Cc _�� Pg ��%L of Deed Certified Soil Test# � �'
CSM Vol�Pg I'� >�` Sanitary Permit# �
Plat Envelope Or: z
Condo Vol Pg Year Installed ;� �
Aff of ex septic V P Owner When Installed: ,
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Application for Land Use Permit — Page 2
Describe Construction: List dimensions of each structure, story, addition, or alteration.
#1. (�c•:t�h' #2. /�"`'� #3. #4.
Size� ft. wide _� fr. wide ft. wide fr. wide
��ft. long � fr. long fr. long ft. long
Floor area �� d sq. ft. 5�C sq. fr. sq. ft. sq. fr.
Hgt.from gade ,k to peak fr. hgt. ft. hgt. ft. hgt.
Stories I stories stories stories
# of bedrooms �
rear 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. L� ;
_ _ i „� ,_
Indicate distance to:
Waterline �
Road �
Lot lines ��
Septic system
Distance between structures. � C� v�2 �n� '
7�0 /j�3 c. k L o T
Indicate North. �G L '�- /_
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FireNumber: / � �ous� , 5.-p7,�
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Signature Owner /C
The above certifies that the listed j�
information and intentions are[rue and — — — ._ ---
correct. The above person/s/hereby �-'-�T � � ti i=
give permission for access to the
property for onsite inspection. ------- centerline of road-------
Issue Date July 24 , 1998 Expire Date July 24 , 1999
Office Comments: ( �l/Q���� '����li'�"`��
Signature of Zoning Administrator
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� TERMINATION OF DECEDENT'S
PROPERTYINTEREST �
DecedenYs Name
FLOYD N.MERCER
Address of Decedent at Date of Death 2 6 818 3
Route 10,Box 272,Hayward WI 54843
Date of Death Social Security Number Reqb�ar's Otnce}�
A ril 27,1998 053-18-2303 Sa�M'd��unry ,�^� da o1
P Ne aived for record this_,ff Y
A p�g�yi�o'clatk
PRESENTATION OF DEATH CERTIFICATE M and recomed as vo�..l[[�S
I certify that I have viewed a certified copy of the decedenYs death o�p�rds on p�4e ���� /LI�__'
�e(tifi�te,. H pi.ier
` H — 6"3-9$ � wm
�•R gi er of�eed 'Signature Date
Re To:
• � I e��st . roperty is terminated under(please check appropriate WARD WM. WINTOPI,ATTY
;�' s�tute): P.O. BoX 796
' ' ' Hayward, Wi 5qgq3 ob
�f ' �867.045 which pertains to property in which the decedent was a a 7
� �
�74int tenant,"`had a vendor's or mortgagee's interest,or had a life parcel Identiftcation Number 010-94L23-3415
estate. *(You must provide a copy of the document establishing joint oto-9a1-z3-3az2
tenancy or life estate.)
3,�§867.046 which pertains to(1)property of a decedenl;specified in a marital property agreement,and
also to (2) survivorship marital property. (You must provide a copy of the document establishing
survivorship marital property.)
Presentation of recorded document establishing joint tenancy, life estate, survivorship marital
property,vendor interest,or mortgagee interest in real estate.
This document number is 246998,Volume 550,page 88 of Records X Deeds_
This document number is 259916,Volume 599,page 405 of Records�Deeds_.
Description of the real estate.
Include on�v the extent of ownersh�or vendor or morteaeee's interestl in]and at the time of the decedenYs
death. If the extent oFland is exactly the same as on the document,a copy of that document may be attached
to describe the real estate. T'he legal description of the property and the persons receiving the property are
as Follows: (If more space is needed,attach pages.)
� See Attached
Description of personal property(if any)being transferred.
You may list savings accounts,checking accounts and securities on attached pages. Indicate person(s)
receiving property.
DECLARATION: I(we)declare that this document is,to the best of my(our)lmowledge and belief,true,
correct and complete and is in conformity with the provisions and limitations of the Wisconsin Statutes.
Name and Address of Person Relationship Signature(Notarized) Date
Receiving Property to Decedent
Dorothy A.Mercer Spouse � �' �
Route 10,Box 272
Ha ward WI 54843 �������"��i�
y �,��(�OWN.hj;y'T,�� ST.ATEOFWISCONSIN)
°��',�NOTAf?.. oy� )Ss.
r%= y SAWYERCOLJNTY )
• s�}i
This document was draftgd b¢: t� � ��a Signed and sworn to before me on this day oY
� v, , "U B L i C;;�� May,19 ,by the above named rson.
Ward Wm.Winton �,�� , .. .;•,�J,
Attomey at Law ,�TF'���' '�'S��o` ��
..,,�F WIS ��..
P.O.Box 796 �«un����+` K g ��yinton,Notary Public
Hayward WI 54843
(715)634-4450 y commission expires: April 18,1999.
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