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012-740-24-3104-LUP-1997-628
Application for Land Use Permit r y �- County of Sawyer H � � 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 , �V � �_;c�.i�1 t�,c ��"�SC;.� ��C:.KS l.�C�h!•��l1 g Owner Builder ' 7. � I�� `7 L7Lx `)3�fS � (:�o S I/I�ta�,�o.1 ��� . � Mailing Address Mailing Address � l-�r��I w � i� �� C�,��5�/k�f3 ��c ;�r�-i z_:�- , (.� ; . S S��'�3 City,State,Zip ' City,State,Zip 71�- y[, � - .� i.'71 ��s - '�/(�� - a3 �7 � Daytime Phone Daytime Phone � Building Land Use ° ( )New ( )Filling Zone District ���- � ( )Addition ( )Dredging f . ( )Alteration ( )GradinQl Lot Size ( )Moving On (�-�CJC�T �µ�,c�,ti� h n ry ( ) (�� lZ.e,�.— Acres e /u �'3 S�L� C�;,.�. ° Primary Structure Accessory Building Addition � � ( )Dwelling ( )Gazage-attached/detached ( )Deck � � ( )Yeaz round ( )#of caz stalls ( )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 � : Type of Construction � � ( )Frame ( )Log ( )Pole/metal ( )Block �Concrete > � )Other �,�.ca�c�t �;,:�.�, l�a� . ���� �� :, t��, o � �� � � b � � Construction Cost$ �2a.�..-..(� a�5 fjU d� R ,� 'ti 6(� �5 C��`° = a y Vol �r jj r Pg - %� of Deed Certified Soil Test# � CSM Vol Pg Sazutary Permit# � Plat Envelope Or: -� z Condo Vol Pg Yeaz Installed � � � Aff of ex septic V P Owner When Installed: � ��.%';: Application for Land Use Permit- Page 2 Describe Construction: List dimensions of each structure, story, addition, or alteration. #L P,� , , • �<r��, i . #2. ���_-C�lif #3. #4. Size�ft. wide `Z ft. wide ft. wide ft. wide 3 S ft. long 7 v ft. long ft. long ft. long Floor area `I,'�C sq. ft. ��� ( sq. ft. sq. ft. sq. ft. Hgt from g�ade to peak ft. 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 �� S� z ����.,���� �'N w� existing and proposed structures. E;,� �,«t i�,.�,..�+�, :.� Location of septic system. `�� �� N�'I � S� ��'"� "� , �v � � Indicate distance to: � Waterline � Road Lot lines �k: Septic system t�, Distance between structures. o -* — Qr�P`s"'� �' y' �Q� ¢� Indicate North. i `n—�S,,c f? �' C Fire Number: X �36v N �r �;r������ �C . �, C` — � c � ; i,�, �� I��-�,..,,,.-_--- Signature of Owner �_ Ic � L ���� p�Ir�µ,,,l') ------- centerline of road------- of� � ct IssueDate 31 October, 1997 ExpireDate 31 October, 1998 � Office Comments: � � �C,. 5r -i� L �-�fsc��� APPLICATION/PERMIT FOR BOAT RAMPS • ,,:��f Neturnl Raources Pursuant co uccion 3012(3)(a)5,�Y�s.Stan.Fortn 3500-95 � nis form is required under Section 30.12(3),Wis.Slats.Refusal to prwide this information may result in the dismissal of your appliation. � ersonalty identi6able information on this form will be used for no other purpose. i�ndamefs Name Peoject Lnralion �,/4 F(� CJ-f�PP E�A A Nj PG�QU/.��/ O/[ /�l.S nddress �1 1 Strcct or Rou�e � o�e 93'� ft y/y3 "� � � 1/4. 1/4,S<ction�_,T�D N,R�_ (g) Ciry S atc,Zip Codc � �c�ry pqr� O v�i�,ge or � /U��Q i�-r i{ome TNephone No. Work Tde hone No. Fre Number Tax Parcel No. � Counly Na e of Wa�envay i / ( / (, - (� O �100 �.0 ,q (z R t� uJa bE hercby ani(y that the in[ormation contained hercin is trve and accunta I am ihe owna of[Ae riparian pmperty or am the duly authonzed repraenutive and :ay sign iAis application on bchal(o[the owner(s)o(uid property. 1 have«ad and undersund all of the conditions o[ihis permit liseed on�he rcverse sidc and ,II coiuwct thc above mrntioned pfoject in compliance with ail such mnditions. I undenund that failurc io mmply wi�h any or aIl of the provisions o[ihc ermit«nde[s tAe authorvation conuined hettin null and void and maV ecsul[in a 6ne and/or impriwnmrnt under the provisioos oC s.30.12(5),Wis.Stais.or �rieiture under s.30.d5,Wis.Staia. PriNcd or Typed Full Name oC Applican[ 'nalure of Applicant Da[e signed �o,�a�� � �a„�so,� -(�?�-�.----- 9/�7 ATTENTION!! YOU MUST COb1PLY WI'TH TI�E CONDITIONS ON THE BACK OF TFIIS PERMIT v�DINGS OF FACT Thc applicint has complicd with aIl proccdural and Icgal ttquircmcn�s oC Wisconsin Law. The proposed project will not r�sul[in a matenal obswetion io navigalion,will not adversety a([cct water quality.wili not incre�se waler pollution in sudace watees and will nol�ause environmenul pollmion az deGned in s.144A1(3),Wis.Stats.,i(the project is constru<ted in accordance wiih this ��it. The Department has dacrmined that the granting oC this permit woWd nol be a major state action signifcantly a[Cecting the quality o[thc human en�ironmenL � 'It�e Depanmmt and the appliant have completed ali procedural requittmrnis and ihe projeci as permi«cd will comply with all applirable requircments of Wisconsin Administrative Code and Wisconsin Sla�utes. 'Ihe pcojtt[will not impact wctlandt. 'ONCLUSIONS OF IAW 'itw Department has authonty under s.3012(3),Wis.$la[s.,and applicable Wiuonsin Administraiivc Codrs to issue a permit for this projet[. 'ILe Department has complied with s.].il,W'is.StaLc.and NR 103,Wis.Adm.Code OTICE OF APPEAL RIGATS ��ou be(ieve that you ha�c a right to challenge Ihis decision,you should know Ihat k'iswnsin Adminis�rdti�e Cod6 and Wxonsin Slatutet establish time penods ;hin which requau to review Depanment decisiom must be Gled. �requcct a contated case hcaring pursuanl to s.227.42,k'is.Slats.,you have 30 days after the decision is maikd,or othecwix se�ved by ehe Departmrn[.to :ve a peti�ion Cor hnring on the Secre[ary o(�he D<panment ot Natural Resourtes. 'R�is notite is provided puesuant to s.227.48(2),Wis.Stau. LEAVE BL4NK-DEPARTMENT OF NA'IURAL RESOURCE USE ONLY STAIE OF WISCONSIN-DEPARTMENT OF NAIURAL.RESOURCES For Ihe Secrclary fssued By. ���AI�+� Datc Signed (�—� /� /��� iiile: /���� Fee Received S �O'�d � � .. . .,...� eM�.5.:.:iiT: � ' � . . r � i • wM �'� . l Sf10W I'OU[C t0 pfO�a[ �p��' �jlJd�fl� tltaiLft Qli�(1 t�p�Q �Q Q'Oq�d. �B � DRAWINGS OF PROPOSED ' ACTTVITY SHOULp BE PREPARED � �� ���o���E �� S�� N p�AWIIVG SHEET • _ ...._ . � ,_ _, ��......�.. .. ........ .. . _ I � � _ - � . � � � i �. � � '� t� �P�'`� : :�' a{ _. : ��° 9 . ��; I ; . �', t � �,.Y f � ;,. • 't _ . . � . I ' �-' ` �� -, ; � '� , r � - ..t .t , .� �� ' . �� ;f • � "..� — — � �� � � y� '� �� � � ��� 1' a �M' „ � 1 '� ���+' j � . �� ; ... .. { � r T ' �..' .. : � . 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" 7�y 9i3 �- ' . 7� � 1 ' � � ; .�. � t � �� � � I. �-�{,:� � ,+:E'-,. }S �t`°� �,t F i �„ ^ � � . 3 �};.. � �r` {.� �. � . ,.. , , r . �. � t � / . �` s "t � .� �i. 3 '� .t `/_ !1/ '; ... _ J f �,;Y` , �'' ....�.. ._ _ � �,/+' � � � � ,.-,r "r� •bP � --- -.. .__ � '_' � � . �',,,..�.r'P" v -�-..�'"J � „ �- .— --'�- -- _� . r--'`�_,�r- '�•.-. ,�� .. . ;'; ' . �� , ,�'..r+•A`��� ♦�. . � � � � • Y�r,i��� ~��"�.�^^"� •t' � .. � i ( � 1 � ♦� ." � � � ! i ' :f { � � j � , `'�' ,'c—�;-� 1 � �t�T� � ;e include a top view and typical cross secrion with yottr plan. Clearly identify dimensions or indicate scale and indicate �orth direction. (LJse additional sheets if necessary.) 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