HomeMy WebLinkAbout012-740-36-1405-LUP-1997-161 Application for Land Use Permit �, o , �
County of Sawyer � �
PO Box 668 -Haywazd WI 54843 �
715/634-8288
The undersigned hereby makes application for a Land Use Pernvt and agrees that all work S
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance s�
and the laws and regulations of the State of Wisconsin. � �
i PRINT-USE BLACK INK OR PENCIL
MarY s. £ �
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��ouG��i1C. l:io6/1 t�u�ner ��
Owner Builder y �
/77 9 +3ux 9.?(0??,4 � �
Mailing Address Mailing Address s � ���
NLl%tt/�j IZ� , W/ '`�'�v i �-
City,State,Zip' City,State,Zip °
�1� a-�5�,;7 � z
Daytime Phone Daytime Phone d
Building Land Use �
( )New ( )Filling Zone District ]�(�-�
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(X)Addition ( )Dredging N
( )Alteration ( )Grading Lot Size O
( )Moving On ( ) �
( ) ( ) Acres ���(o �
c
Primary Structure Accessory Building Addition ;� �
( )Dwelling ( )Gazage-attached/detached ( )Deck s
O Yeaz round O#of car stalls O Porch � o
( )Seasonal ( )Storage Building ( )Enclosed -
O Frame built on site O Screenhouse O Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured (,�)Other ( )Bedroom -c �/
O Other primary structure (v)�i G� ���o O Relocate/enlazge � m
( ) ( ) ' ( )#of new v,1 �
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Type of Construction 1 �
Q�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete ,c >
O �n
( )Other "'� �
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Construction Cost$ /f}-o�u o v � �
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Vol 5 3 S Pg �2.� of Deed Certified Soil Test# Q 3-300 �
CSM Vol -- Pg — Sanitary Permit# �f 3- �g� � o
Plat Envelope Or: �'� z
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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 Construc6on:List dimensions of each structure,story,addition,or alteration.
#1. #2. #3. #4.
Size�ft.wide ft.wide fr.wide fr.wide
��ft.long ft.long ft.long fr.long
Floor area��sq.fr. sq.ft. sq.ft. sq.fr.
Hgt.from grade /� to peak ft.hgt. fr.hgt. ft.hgt.
Stories stories stories stories
#of bedrooms
rear lot line or waterline of � ,=� �•'- ,v �o w,y�c-: lake/river
In the box sketch in: �
Location and size of all
existing and proposed structures.
Location of septic system. �$� 4 y���� 1=L�1n/sj G.L
Indicate distance to:
Waterline
Road
Lotlines Cd�fU����
Septic system G'Q�$0
AeG K
Distance between structures. ��J� �r. i V�
Indicate North. �1
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Fire Number: �
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Acces� o�'F (.aw�oe 12d•
Issue Date 28 MaY 1997 Expire Date
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