HomeMy WebLinkAbout002-130-00-1001-LUP-1997-359 Application for Land Use Permit r y ��
County of Sawyer y � �
PO Box 668 -Haywazd WI 54843 p �
715/634-8288 a
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. 2��., �
PRINT—USE BLACK INK OR PENCIL '�
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Owner L t> `,�' '�_ � Builder S
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Mailing Address Mailing Address -f- :;
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City,State, ip City,State,Zip �
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Daytime Phone Daytime Phone �. �� �
Building Land Use ,�I
(�'New O Filling Zone District F+- � 3j
( )Addition ( )Dredging 1�
( )Alteration ( )Grading Lot Size �
( )Moving On ( ) � `7
( ) (� ) Acres � ro �
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Prim Structure Accessory Building Addition " ��
(�Iling ( )Gazage-attached/detached ( )Deck ;.� �
(�az 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 `c'
( )Other primary structure ( ) ( )Relocate/enlazge � . `��
( � ( ) ( )#of new �
Type f Construction ��
(�ame ( )Log ( )Pole/metal ( )Block ( )Concrete :
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( )Other
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Construction Cost$�.Z-.Si , ,�
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Vol �'-'U-: Pg of Deed Certified Soil Test# " ;,
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CSM Vol� �Pg Sanitary Pertnit# �1�" ��� '_� c
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Plat Envelope Or: ✓ ° z
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Condo Vol Pg Yeaz Installed �.�i �
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Aff of ex septic V P Owner When Installed:
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Application for Land Use Permit—Page 2
Describe Construction:List dimensions of each structure,story,addition,or alteration.
#1. r #2. .,J 1_' '' ; , #3. #4.
Size 3�- ft.wide 3 Z ft.wide ft.wide fr.wide
5 �' ft.long i L ft.long ft.long ft.long
Floor azea 17 d� sq.ft. '�� sq.ft. sq.ft. sq.fr.
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Hgk from giade]�to peak �' fr.hgt. ft.hgt. ft.hgt.
Stories � stories stories stories
#of bedrooms ,�
reaz lot line or waterline of lake/river
In the box sketch in:
Location and size of all ���
existing and proposed structures.
Location of septic system. W����"�°``
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Indicate distance to: �
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Waterline ;
Road
Lot lines r��(�'�
Septic system
Distance between structures. 1
Indicate North. e' DUs�'�'q�
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Fire Number: �4 ,, �y� ��r,��`
�`7�)�L/o� �(.� Cliut��v ��f.
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Signature of Owner
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-------centerline of � '' road-------
IssueDate 14 August, 1997 ExpireDate 14 August, 1998
O�ce Comments: C ,v� .� (,X,'��YlS_�-��
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SEC. 34 TWP. 40 N . F
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