HomeMy WebLinkAbout008-937-30-4302-LUP-1997-237 Application for Land Use Permit y �
County of Sawyer � � �
PO Box 668 -Haywazd WI 54843 "
715/634-8288
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
'�iPodora" � n ,U2]—/� �h2odore � l'��2T/� g ` �
Owner Builder y
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Mailing Address Mailing Address p � �
�//1C�/•/Cc�ool� , (�/, �`�8�7 ,�irchu�ond: W� �S�B/� �
City,State,Zip City,State,Zip � �
(7,.�� .�ss�-.��8 7 _ l��s) .�s�-��B�
Daytime Phone Daytime�hone �
Building Land Use f.0
�New ( )Filling Zone District� � � , ,
( )Addition ( )Dredging � � .0
( )Alteration ( )Gtading Lot Size �3,�0 j( /�8 7 C,
( )Moving On ( ) � �
( ) (� ) Acres �� °g �
� �.
Primary Structure Accessory Building Addition �
( )Dwelling �Gazage-attached/detached ( )Deck � �
O Yeaz round (2)#of caz stalls O Porch r
( )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 �
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_Type of Construction AIT�
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete
( )Other �
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Construction Cost$ c�DCJU- =
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Vol �,',� Pg _`;�;/_of Deed Certified Soil Test# �� ^� �� `� �
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CSM Vol Pg Sanitary Permit# `I� '/� S �h
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Plat Envelope Or: (v z
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. #3. #4.
Size �O ft.wide ft.wide fr.wide fr.wide
�ft.long ft.long ft.long ft.long
Floor azea /2oC? sq.ft. sq.ft. sq.ft. sq.ft.
Hgt from gade /�� to peak ft.hgt. ft.hgt. ft.hgt.
Stories � stories stories stories
#of bedrooms
reaz lot line .,�::R�.:� 1�
In the box sketch in: � ,�3 a
Location and size of all
existing and proposed structures. N
Location of septic system.
Indicate distance to:
Waterline �
Road
Lot lines
Septic system
Distance between structures. ,_,
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Indicate North. \� "�'��
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Fire Number: N �
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Signature o ner .�c-
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-------centerli e of G—'edav ��c� road-------
Issue Date O1 July 1997 Expire Date O1 July 1998
Office Comments: l JL�+n�.rC.t)C`7�P S�c.,-�1�.��
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S.T.H.48