HomeMy WebLinkAbout002-939-02-5106-LUP-1997-229 Application for Land Use Permit r y `
County of Sawyer R � -
PO Box 668 -Haywazd WI 54843
715/634-8288
T'he 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. �
PRINT-USE BLACK INK OR PENCIL
�ISZ�L'�,L SA�L'�JDE/v; � I
Owner Builder y �
�/6�5 ,S, !ou'�: �'R:�n' i�,�, � � [� �
Mailing Address Mailing Address � i�/
k�,v C�,�A�Rr f�f�� 5'�170/ • A
City,State,Zip �>+? : City,State,Zip ���
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(�%`� �?:" �`�-J�/r f�
Daytime Phone Daytime Phone
Building Land Use /
O New O Filling Zone District ' f _
�Addition ( )Dredging
( )Alteration ( )Grading Lot Size '
( )Moving On ( ) � -
( ) (�) Acres r�� °g
�
c
Primary Structure Accessory Building Ad ition ;� �
( )Dwelling ( )Gazage-attached/detached �Deck �
O Yeaz round O#of caz stalls O Porch � o
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room � �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge
( ) ( ) ( )#of new �
�Ty e of Construction �
Frame ( )Log ( )Pole/metal ( )Block ( )Concrete :
�
( )Other �
ro�
�
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Construction Cost$_f,,�,���� �
�
Vol � Pg of Deed Certified Soil Test# - �
CSM Vol�Pg Sanitary Permit# •
��;P�} i��--`-'�. . . .. ;— z
Plat Envelope Or: �
�
Condo Vol Pg Yeaz Installed
Aff of ex septic V P Owner When Installed:
p � �
Application for Land Use Permit-Page 2
Describe Construction:List dimensions of each structure,sto addition, r alteration.
#1. , #2. #3. #4.
Size ; ft.wide ft.wide ft.wide ft.wide
j;;', ft.long ft.long ft.long ft.long
Floor azea a 8B' sq.ft. sq.ft. sq.fr. sq.ft.
HgG from grade « to pealc ft.hgt. fr.hgt. ft.hgt.
Stories r', � stories stories stories
#of bedrooms ��:i
reaz lot line or waterline of 'f%�' lake/river
In the box sketch in: � i�� �
Location and size of all I
existing and proposed structures. I f ��'�k�nF ��C r
,C � ��
� �'�S� , � ��;
Location of septic system. � �
i,�x � b ���� �
Indicate distance to: l
�� , ';
Waterline ' � I ./ �
Road ���
Lot lines i � i
Septic system i ��� _
Distance between structures. � � ���� �X�5?�N� ��-��
Indicate North.
I Fii' r �ausc �
Fire Numbet: ,� �"
�D! I No«�us
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Signature of Owner
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=------centerline of road-------
Issue Date Expire Date
Office Comments: � "� ��"``� ���'- r°-J`-'��
TOW N aF BA��
SEC. 2 TWP. 39 N.
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� 2 ND ADDITION T
COURT OREILLES f
TRACT VOL.5 PG. 19'
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LAC
COURT
OREILLES
PART OF
TOWN OF SAND LAKE
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