HomeMy WebLinkAbout008-190-00-0300-LUP-1997-215 Application for Land Use Permit r y
County of Sawyer y � �=
PO Box 668 -Haywazd WI 54843 �
715/634-8288 �
The undersigned hereby makes application for a Land Use Pemut and agrees that all work ��, = _ t1
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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Grv� ��e���n��!1�� D/�o=' �>���r)i�<><���;� �I�Y. � �
Owner Builder y w ,
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Mailing Address Mailing Address �` � `�
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City,State,Zip City,State,Zip - --
35�/- �/ ?/ �,-- `�
Daytime Phone Daytime Phone �
Building Land Use �
( )New ( )Filling Zone District ' �-.�.
( )Addition ( )Dredging
( )Alteration ( )Grading Lot Size ��
;�
( )Moving On ( ) �
( ) (� ) Acres i L�:�� �
Primary Structure Accessory Building Addition���''`'•" �
Dwellin Gara e attached/detached Deck f' �
� ) g � ) g - �) ,. l�i,(.t: o
O Yeaz round O#of car stalls O Porch � � 4 r
( )Seasonal ( )Storage Building �Enclosed ,, ,`{' o
O Frame built on site O Screenhouse O Living room `_ (N
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary shucture ( ) ( )Relocate/enlazge
( ) ( ) ( )#of new �
Type of Constnxction �
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete >
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( )Other �
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Construction Cost$ ��/�� /`(' C� =
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Vol '� Pg ,/?,: of Deed Certified Soil Test# �v,:., ; � �
CSM Vol Pg Sanitary Permit# 7�'" 6 7$ �� �
Plat Envelope Or: z
x
Condo Vol Pg Yeaz Installed
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. #2. I;;Y,�i<; #3. #4.
Size ft.wide /?— ft.wide ft.wide ft.wide
ft.long �9 ft.long ft.long ft.long
Floor azea sq.ft. 2,2,g sq.ft. sq.ft. sq.ft.
Hgt from gade to peak ft.hgt. ft.hgt. ft.hgt.
Stories stories stories stories
#of bedrooms
r - (�� lake/r}ver
In the box sketch in: f
Location and size of all '
existing and proposed structures. I
Location of septic system. '��% �
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Indicate distance ta
Waterline -
Road
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Lot lines i -'
Septic system
Distance between structures. � (
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Indicate North.
Fire Number: -
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�Signature of Owner � � ..d ,��
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Issue Date S���� l$ 14°��% Expire Date
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