HomeMy WebLinkAbout026-939-12-5611-LUP-1999-511 � Application for Land Use Permit '
�
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 5 �
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 NIAY NOT � �
BEGIN UNTIL THE PERI�IIT IS ISSUED. F
PRINT—USE BLACK INK OR PENCIL �' � �
a �
��'1�J,G�f S l�/��/c'�S �/�P„S''�'- CfJ�S}� ✓t.�%Dit/ �� �
Owner Builder � o �
��Y St. %�S�:�� Si-�f r �/��Y �Z7�7 ��' �
7���—s._,��c�u �
Mailing Address Mailing Address �
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�G���� v �' (( e M 1U �.�� (3 S`��.JP �-�f� � ,S��i' 7�r s
City, State, Zip City, State, Zip
(05- - � - l ?�5- �l `'7Z - ��b � `✓,
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Daytime hone Daytime Phone
Building Land Use v
( ) Ne�v ( ) Filling Zone District � � �
( ) Addition ( ) Dred�ing tn
( ) Alteration ( ) Gradin� Lot Size �
( ) Moving On ( ) _
��cc..��- ( ) Acres . �� �
�
n
Primary Structure Accessory Buildin� Addition �
( ) Dwelling ( ) Garage-attached'detached �Deck �
( ) Year round ( ) # of car stalls ( ) Porch � �'
( ) Seasonal ( ) Storage Building ( ) Enclosed � �
O Frame built on site O Screenhouse O Livin� room �'
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen
( ) Mobile/manufactured ( ) Other ( ) Bedroom 1
( ) Other primary structure ( ) ( ) Relocate/enlarge �, a
O O O # ofnew � I
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Type of Construction ^ >
(�Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
( ) Other � --�
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.,
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Construction Cost $ �R � , U � -�
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Vol �� ��, Pg � l� of Deed Certified Soil Test # �� '��� ^ �'"�
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CSM Vol ° Pg �(�7� Sanitary Permit # g/ - �%`J
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Plat Envelope Or: ���F' �`i -�1 r'7 ^'
Condo Vol Pg Year Installed
Aff of ex septic V P O�vner VVhen Installed: �
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� Application for Land Use Permit — Page 2 '
Describe Construction: List dimensions oFeach structure, story, addition, or alteration.
#1. #2. #3. #4.
Size_�� ft. wide h. wide ft. wide ft. wide
�_ ft. long h. long h. long h. long
Floor area ,{� _ sq. ft. sq. ft. sq. ft. sq. ft.
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Hgt. from gcade��L to peak ft. h�t. ft. hgt. h. hgt.
Stories srories stories stories
# of bedrooms
rear lot line or waterline of lake/river
In the box sketch in: � 5i�E
Location and size of all �
existing and proposed structures. �
Location of septic system. V�A
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Indicate distance to: `� '1'
-�
Waterline/Wetlands /1—
Road �
Lot lines T
Septic systen�/privy � �� ( � �` i0U'r
�Vell �., l�
Distance between structures. `�
ry� � Qi
Indicate North. � ��' � ^ �U J
p�c:/L
Fire Number: /` O
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Signature oen� .,ar �L(.� (�`OV __ ..
___ _ _ ----
The above certifies that the listed �Ofi L/i✓C' �
infomtation and intentions are true and � S�Dt-� �
correct. The above person/s/hereby
give permission for access ro the
property for onsite inspec[ion. ------- CetttO[llrie Of road-------
[ssueDate September 7 , 1999 ExpireDate September 7 , 2000
Office Comments: / .�.�',�£lmm,( , 1
Signature of Zoning Administrator
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WHITEFISH LAKE
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RIPLEY ENGINEERING, INC. •
321 South River Street
Spooner. Wisconsin 54801
CONSULTING ENGINEER
AND LAND SURVEYOR
3909-12(6) S8123 WTM 2175CSM
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DOCUMENT No. STATE BAk OF WISCONSIN FORM 5 - 1982 THIS SPACE RESERVED FOR RECORDING D,�TA •jl
PERSONAL REPRESENTATIVE'S DEED ;�
� �� � 'r � � � .
----- ---------_ (
� ___ --- - --
I �'''r.r' °"°° ;
John Harris Iverson �b""�
- - - -------------------•-•-------------•-------------------------------•------------•-----------• eci for ,re�o�d �02
.
----••--------------------•---•--------------------- --------•-------------------------------------------------- __ A D 19 et L,�o'abc�l
_________________________________________________., aa Personal Representative of the estate of r��;,� !n vol.�_
Gene A. Harris
•------------------•--------------------------------•----•---,------------------------------•--------------------- � «, �o �!X'_
--------------------------------------------------------------�-------------------------------------------------- ,
------•----------------------••--------------------------------�---------------•-•------
_ ("Decedent"),
for a valuable consideration conveys, without warranty, to ______________________________ �
�
Dennis A. Harris
�--------•-•----------------------------------------------------------------------------------------------------- — --_ --_=- =_ -
_- _--- - - i
--•-----------------------•--•---------------•••----•-•-----•--•---------------•---•----•---------'--Grantee, R@TURN ro I
the following described real eatate in ._.__.___.__�s3ls�yeS_____________________ County, 3 J p�
State of Wisconain (hereinafter called the "Property") : � I`�' �-T,,U�
_�-- __---- ------ - -
Tas Parcel No: ..-••---•----------•..._....._
That part of Government Lot Six (6) , Section Twelve ( 12) , Township Thirty-nine
(39) North , Range Nine (9) West , described in Volume Eight (8) of Certified
Survey Maps , page 208 , Survey No . 1684 .
. T�N��.��`
� � �_
�
� � �EE
,� .
Personal Representative by thia deed does convey to Grantee all of the estate and interest in the Property which
the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the
Personal Representative has since acquired.
Datedthia ------------•-----12th...................... day of ----•----------------•----------•-MaX---------•----•----------•--. i9------4.4
' � �
-------------•-(SEAL) ��2t"�--------(SEAL)
ohn Harris Iverson
. ------------------------•-....._.._..---------------..._....------
-----------•----------•-------------------------------------------
Peraonal ReDresentative Pereonal Repreeentative
AUTHENTICATION ACKNOWLEDf� MENT
Signature(s) STATE OF WISCONSIN
------•-•-----------•---•-•-•-----•---------•-----------•--• ss.
----•---•-----------------------------------------•--••-----•--•--•-------------
Sawyer
----------------- •------------------- oun y.
suthenticated this _._.._._day of___________________________ 19_.____ Personally came before me this __ 12th___.__day oi
• ---•--------...-•----Max---------------- 19_.94__ the above named
---------------•••----•------•--------------•------------------•-----•---------- John Harris Iverson
TITLE : MEMBER STATE BAR OF WISCONSIN _�.P�p���M�r� _________________ _______________________________________________ ';
. _ _ _
(If not- ------------------------------------------------ 3��0 �C //
authorized by § 706.06, Wis. StatsJ to me _no�► to be the person ._.___.___. who executed the ,
I �� ��M�2�oi g,�i�trument and acknoyvledge the same. _� � �
_ .._ / ��
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3? _.._ _�--- � -
THIS INSTRUMENT WAS DRAFTED BY � DUFFY ..._.� - � <� �_ ,�-- 'I �
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/�� ql - -� .s--------------------------••---------------------- ---•------••-
Haywar-dz WI .--•----------•----------•-------------•------ �) � �f �+� ublic -------•-Sawyer----- ---------------County, wis.
(Signatures may be authenticated or acknowledged. 8����.�� nlmission is permanent. (�F ,
iI are not necessary.) � dat� -•--•-- •--- --- -- --•-----•-• � �
------
.._ 19__...---•
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•Nnmea of persons siSning in any capacity etiould Ue typed or nrinted below their signuturea�. 5 � � � � � 1� II
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