HomeMy WebLinkAbout010-941-22-1401-LUP-2000-440 ,�
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Application for Land Use Permit `����� ' '
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County of Sa�vyer � c �
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PO Box 668 - Hay�vard �VI 54843 � -
715/634-8288
Tile undersi�ned hereby makes application for a Land Use Permit and agrees that all work
shall be done in compliance �vith the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin.CONSTRUCTION NIAY NOT
BEGI�i UNTIL THE PER�`IIT IS ISSUED.
PRINT — USE BLACh I�iK OR PEi�iCIL �!' ��
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b«� � �
��n ;$ � ��. : m����, b����;n� ���� �rs �.� N :�
� .�Owner Builder o
15 S? � /1� (o'S l�w ,� '3 5~ 1% 3 �'Fi�c ��ti 0��,� �� — � �
Mailing Address �lailin� Address
c�c� � GvGZ S�{ �fY ���Q,�,��: � 5 y 7SI -��G� �
City, ate, Zip City, State, Zip �
�7�5= G 3Y � S���s�� e3y- -Lz�c� � � 7�s-a�5'� � 6 �z -�. -
Daytime Pllone Dayrtime Phone �
Building Land Use ,,
(�,N'e��� Q�Filling Zone District /�— �., ' � �
( ) Addition ( ) Dredgin� �, �
O Alteration O Gradin� Lot Size n ;
( ) Movina On ( ) � %
� � O Acres j 7� O � � ,
= �
Primary Structure Accessory Building Addition ��G, <
( ) Dwellin� ( ) Gara�e-attached,'detached ( ) Deck ja �
of car stalls ( ) Porch � �
( ) Year round ( ) ,' � '�
( ) Seasonal ( ) StoraQe Buildin� ( ) Ei�closed ��
O Frame built on site O Screenl�ouse O LivinQ room � ��
( ) i�lodular/manufactured ( ) Greenholise ( ) Kitchen �'�,y,� � �
� �
! ; �.1cbi1�.'�,:ai�uiaet��red ( ) Ot'tler ( ) Bedroom ; � ' , _
� Otller prinlary structtire ( ) ( ) Relocate;'enlarge � �� ,>
' ( ) ��ti�tYt�; e��� �I�t�� �� � ) ( ) � of ne��� Q � I�
�� � � � �' �,�
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Type of Constnlction � `
( ) Frame ( ) Lo� �Pole/metal ( ) Blocl: ( ) Concrete � I �
( ) Other � � I�
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Construction Cost S � � (?U �L� _ � <'
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Vol �/'tJy Pg�of Deed CertiFied Soil Test # �—e��/� a �'� �
CSM Vol Pg Sanitary Perinit# �j� — ,,3� �� � �z
Plat Envelope Or: �u(� 9D'�� g5 ,35(c ^ Ir_
N � �)
Condo Vol P� Year Installed �' I
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Aff of e� septic �' P O��i�er ��'hen Installed: �. I �
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• Application for Land Use Permit — Page 2 .
Describe Construction: List dimensions of each structure, story, addition, or alteration. ' _
# 1 . �2. �3. #4.
Size�� ft. wide ft. ���ide ft. wide ft. wide
� � ft. lon� ft. long ft. long ft. long
Floor area '3� b� sq. ft. sq. ft. sq. ft. sq. ft,
H�. fi-om g�-ade �2C to peak ft. hgt. ft. h�t. ft. hgt.
Stories � stories stories stories
n of bedrooms �
rear lot line or �� aterline of lake/river
In the box sketch in:
Location and size of all
existing and proposed strtictures.
Location of septic system.
Inclicate distance to:
1��'aterline!�Vetlands + r
Road `� �. ��
Lot lines
Septic systeiiiiprivy
�`"e 11
Distailce bet�� een str�ictures.
Indicate \orth.
Fire \umber:
% ; 5� 75��
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'bnature of O�r�nec•
Tl�e abo� e certifies that the listed
itlforcnatiocl and intentions are tnie and
correct. The abo� e persoit's' hereby�
��i� e permission for access to the
propercy for onsice inspeccion. ------- centerline of road-------
Issue Date August 16 , 2000 Expire Date At,g„ Gt 1 h , � 001
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�ftiCl, CO111t11tIl�S: �����
Sl"Il:llllf�C Of ZOf1lIl�� ;�CIIl111115[1':;tOI"
TOWN OF HAYWARD
PART SENE SEC. 22 TWP. 41 N. R. q W.
y.2
1.17
i
NO
J � Z
./2
/ .4. 3
SEE CITY
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V6
REF.: U.S. HWY. Io3 R. O. W. PLAT
SCALE: I INCH= 100 FEET
DRAWN BY: Pe,02)z DATE: 3-7-73
COLON (:) INDICATES GOVT. LOT
1
FOR ASSESSMENT USE ONLY NOT
INTENDED TO SHOW CONCLUSIVE
EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS
TOWN OF HAYWARD
PART SENE SEC. 22 TWP. CFI N. R. 9 W.
0000A
L00
cto6
> /01/
P"
l , �
_j
(E)
RE U. S. HWY. 63 R. O. V PLAT
70' - ti1w
SCALE: I INCH= 100 FEET
DRAWN BY: DATE: 3-7-78
COLON (:) INDICATES GOVT. LOT
FOR ASSESSMENT USE ONLY NOT
INTENDED TO SHOW CONCLUSIVE
EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS