HomeMy WebLinkAbout002-840-18-5114-LUP-1997-259 Application for Land Use Permit r y .
County of Sawyer w � _
PO Box 668 -Haywazd WI 54843 �
715/634-8288 �
The undersigned hereby makes application for a Land Use Pemut 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 \ �
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Owner ' Builder y ��j
�v�y Cr�//A-h�N /2�+�L �o .�x /3�3� ° � r _
Mailing Address ���6 Mailing Address :; V 1
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City,State,Zip City,State,Zip �
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Daytime Phone Daytime Phone �F.
Building Land Use u'
FJ3)New O Filling Zone District /1/L-i �/
(k)Addition ( )Dredging
( )Alteration ( )Grading Lot Size /oZ`� � I U��'�
( )Moving On ( ) n �
� ) ��) Acres �_� � �� /-'��-�' - � �
Primary Structure Accessory Building Addition � �
( )Dwelling ( )Gazage-attached/detached (f�Deck S
O Yeaz round O#of caz stalls O Porch o
( )Seasonal ( )Storage Building ( )Enclosed
( )Frame built on site ( )Screenhouse ( )Living room � �-
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen '�' �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge
( ) ( ) ( )#of new �� :
Type of Construction
(}�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete :
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( )Other I�
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Constnxction Cost$ �1 _t i� v �
i iy � �
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Vol .S/� Pg !8� of Deed � � Certified Soil Test# y 7-�1S' � � o �
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CSM Vol�Pg /�i _,-� Sanitary Permit# �/� /�// � � � �
Plat Envelope � Or: , � z
Condo Vol Pg Yeaz Installed � � �
Aff of ex septic V P Owner When Installed: �' °� �
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Appiication for Land Use Permit—Page 2 ,
Describe Construc6on:List dimensions of each structure,story,addition,or alteration. OP� ���1L
#1. #2. #3. #4.
Size�ft.wide R.wide 8.wide ft.wide
�ft.long ft.long ft.long ft.long
Floor area �s y sq.ft. sq.ft. sq.ft. sq.fr.
H from �7yt;; cPc'G:.:.-,.,,�
gt grade� te�gee{� ft.hgt. ft.hgt. ft.hgt.
Stories stories stories stories
#of bedrooms �-� -
�L�/D�zK reaz lot line or waterline of C�-!Li�/�Si'a�'� lake/river
In the box sketch in: � '~ "` � r
Location and size of all 10'�`�•`�S`
existing and proposed structures. r
Location of septic system. �� ' S-i '
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z-^
Indicate distance ta ,��p N 3 � -
Waterline 'YS' �L T ;c� � �
Road a ��� � ,�
Lot lines � ----��'
Septic system , a � - - - n
Distance between structures. �a� � . � tY
s � y,tica^' r�kp �
Indicate North. C�W �. � � p �kT� m
�J I r O
Fire Number: � •�
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Signature of Owner ���-�'
R.� e
C c u--,�w/ 't
!35•?
-------centerline of �'r'i��f{ �o�+h road-------
Issue Date 008 J�ly 1997 Expire Date 08 July 1998
O�ce Comments: C A��K )���5 1 '�P(�t i �,U
FG;, �;.....`>1;. :i � . . •
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V A L A CLUSfSlE EVlDEf�GE OF OWf�fER-
SHIP OR BOUNDAR� �p�;qn
TIONS.� . ____. .
TWP. 40 N . R . 8 W.
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