HomeMy WebLinkAbout002-940-01-2104-LUP-1999-137 �� �� _---__�.._.
Application for Land Use Permit �. ,� -
� o -
County of Sawyer � � �
PO Box 668 - Haywazd WI 54843 � '
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agrees that aIl 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.
PRINT-USE BLACK INK OR PENCIL �
�
���i�-��� � G�vt/ :✓�/��'y :��1�.,/ a
Ow�ner Builder y'
o' 1y
�,d G ,�/ C��� �� � ' o �
. � {�
M ling Address Mai ing Address �
r/ T`'V�/��' � w'L'"' C7'y'� Z /�`7 y�ti�''�r � ' �4 ��
City, tate, Zip City fate, Zip
� U ' / �� � �-j3.5� �
Da ime P one Da ime hone �r �
Bui ding Land Use � � --�
ew ( ) Filling Zone District ��'�_ v � �
ddition ( ) Dredging " —
( ) Alteration ( ) Grading Lot Size � � �
( ) Moving On ( ) � � �
( ) ( ) Acres �J ,�
� �
Primary Structure Accessory Building Addition � n �
( ) Dwelling �`arage-attached/detached ��eck � s-
( ) Year round (� # of car stalls ( ) Porch r �^
( ) Seasonal ( ) Storage Building ( ) Enclosed o � �
( ) Frame built on site ( ) Screenhouse ( ) Living room � `�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen N
( ) Mobile/manufactured ( ) Other ( ) Bedroom
( ) Other primary structure ( ) ( ) Relocate/enlarge � ,
( ) _ ( ) ( ) # ofnew >
�
Type of Construction
�rame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete N �
( ) Other �. �
�
:�
A 1'
Construction Cost $ � U . O c7 `� i
� � - 6Co�l� -�
�
Vol�� Pg oZ of Deed Certified Soi Test# q a-.3�� i �
CSM Vol �_ Pg � 1 Sanitary Permit # �/ -o2y� ' p
q � -�a 99 �'` 'z
Plat Envelope _ �r� �
Condo Vol Pg Year Installed '� `jcy .�' � I ,�
'�y
�ff of ex septic V P Owner When Installed: I
�:'; � � �
� r ��.
���
QI4`
" �(vtao �