HomeMy WebLinkAbout002-142-01-1100-LUP-1997-305 � L..
Application for Land Use Permit �, o
County of Sawyer y � �
PO Box 668 -Haywazd WI 54843 1 v
715/634-8288 Y �
The 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 �
� ������n V�� V'Yl �, � �;' ��}�� �, i��. ���i✓' � , �
Owner Builder �`'� �
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Mailing Address Mailing Address :;
City,State,Zip City,State,Zip
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Daytime Phone Daytime Phone
Building Land Use -
( )New ( )Filling Zone District +--
(�Addition ( )Dredging �
( )Alterarion ( )Grading Lot Size 1��;� �' :7 ��'
( )Moving On ( ) r1 � •
� ) �� ) Acres J _'��n � �; - � ✓ 3
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Primary Structute Accessory Building Addition �
( )Dwelling ( )Gazage-attached/detached ( )Deck S
( )Yeaz round ( )#of caz stalls ( )Porch o
( )Seasonal ( )Storage Building (�Enclosed "
O Frame built on site O Screenhouse O Living room �J-,
( )Modulaz/manufachued ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlatge �
( ) ( ) ( )#of new
�i
Type of Construction �
�Q Frame ( )Log ( )Pole/metal ( )Block ( )Concrete p
( )Other �"
/�'o c 5 7 o15qN � i
Construction Cost$ a�" ` G�'1 C'i I ti - g �
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Vol .� P � of Deed ✓ Certified Soil Test# -� �
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CSM Vol Pg Sanitary Permit#
Plat Envelope Or: ' x
Condo Vol Pg Yeaz Installed s- �
Aff of ex septic V P Owner When Installed: � �
ys� �57 � ,, La -IG �—�
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Application for Land Use Permit—Page 2
Describe Consttuction:List dimensions of each structure,story;addition,or alteration.
#1. #2. #3. #4.
Size . ft.wide ft.wide ft.wide ft.wide
I' ' R.long ft.long ft.long ft.long
Floor azea sq.ft. sq.ft. sq.ft. sq.ft.
HgG from grade to peak ft.hgt. ft.hgt. ft.hgt.
Stories� stories stories stories
#of bedrooms_� ,
reaz lotline or waterline of lake/river
In the box sketch in:
Location and size of all
existing and proposed structures.
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Location of septic system. ��„ �
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Indicatedistanceto: „,,,-� /' �t �c�,f qS 1�5
Waterline z � �
Road � ' = is'�K ,����(�5��
Lot lines ��' 11'�� �''•
Septic system yg' ,;'t� ' ,Lo' 1�� L'
Distance between structures. �Z'
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Indicate North. sv�<- ,s i yy 'i
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Fire Number: _ �: L--_
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�.�N � IL. /�f�K 1.��L��I
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Signature of OwneN����-�<+-�v�^ � ° �L-:
U`1"�I,�s,ir��A�-s� ,;,..<s �_+
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-------centerline of road-------
Issue Date 24 July, 1997 Expire Date 24 July, 1998
Office Comments: \�JV�I���l.l.�'J�j1�,�c�-�'�-�(.�cJ
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G R I N D S T O N E 1-I E I G H T S
GOV'T. LOT 5 . SEC .20 TWP 40 N• R.8 W.
GOV'T. LO T I. S EG. 29. T W R 40 N• R 8 W•
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