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008-938-34-5215-LUP-2004-587 L--_ Application for Land Use Permit(*Shoreland*) o 0 County of Sawyer � � PO Box 676 -Haywazd WI 54843 � 715/634-8288 T1� *Property that is located within 300'of a creek,river or stream or within 1000'of a ;� flowage,lake or pond or has any of the above waterbodies located within n � the property's boundaries. � CONSTRUCTTON SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �^ J�S��+� Q`d PRINT-USE BLACK INK OR PENCIL � I � � �Q��r I . Zw,�-�<:. Ih�+e�- �cr�:�Kc� ���i���ers G Owner Builder a 3�3�7 �3�,�� S# I S 7D3 ya{� St. � � Mailing Address Mailing Address � O L��� :f,� :vx, a��; L�T� `�41`7,,1� �I co✓rvzr L�-�r S�l-1 a<l � � City,S ,Zip City,State,Zip (��5� �!�,� -:���y l��s) 556 � is 3G Daytime Phone Daytime Phone n 3 Additional Information: �one District: R K � �� ��,�w�c- I�-���.� asGer�r� . a ro,�. � LotDimensi�i�is: I�Q �}(�,c1e�2053�1;er� N ? ' Date lot was created: 1 I I���I I Acres: �.�� a-^ Is there wetland near the proposed structure?If yes,how faz �� �t. o C�— Building Land Use Floodplain:O Yes (X�No�659/ 0300 8 � �,��-� ('�(New ( )Filling Chippewa Flowage:( )Yes � No rn (� �� O Addition O Dredging Driveway access off of a(Check one): x� �- O Alteration O Grading O Private Rd Q�j Town Rd. � ' ( )Moving On ( ) ( )County Hwy ( )State Hwy °O � ) � ) � � Primazy Structure Accessory Building Addition o � �Dwelling ( )Garage-attached/detached ( )Deck � � (�Year round ( )#of caz stalls ( )Porch �„ ( )Seasonal ( )Storage Building ( )Enclosed � O Frame built on site O Screenhouse O Living room � ( )Modular/manufactured ( )Greenhouse ( )Kitchen � ( )Mobile/manufactured ( )Other ( )Bedroom C � ( )Other primary structure ( � ( )Relocate/enlarge � � � ( ) ( )#of new � -O W AdditionalInformation: ���� L����'�tmt� �lag�1�<1 sr-�b�*�.Us�n 5���`* �j��D ' re „ w � � Type of Construction: �„ � �(Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � �. ( )Other I(n� � Construction Cost:Primary Structure$ ��0 OOv �o Accessory Building:$ Addition:$ ^ w 0 �o- 3�3t5�s2 � �ced:Vol g Cartific3 Soil T�st r� D`� — 33 l � z CSM:Vol /�Pg / Lot# � Sanitary Permit# �4' y�1 � � Plat Envelope �3y�� Or: o� � Condo Vol Pg Yeaz Installed: c� � "Loads and Flows": Vol Pg Owner When Installed: � � Previous office approvals/actions: Vaziance:# LUP:# SP:# CUP:# Inspection Report:# Change of Zone District: Ib� �°��o►�- at��o Describe the construction using these columns. List the dimensions of each structure in a separate column. List each story, each addition, each alteration in a separate column. � � #1.YUr t?��t„w� L,;,_„�t(�,.� #2. l���� #3. ,..- � �, ` ,-, #4. 1 ;� � ti; Size .3c:� ft. wide I�sF�. 23 ft. wide � r ft. wide �' ft. wide �_� ft. long a, � ft. long ft. long `! 2 ft. long Floor area I "�2�� sq. ft. �{ g 3 sq. ft. � t� `3 sq. ft. -` ' ' sq. ft. ' R.:..�► �ca� � �,;a. � ii.,�l z 5;d G Hgk from grade � �r to pea�c f't. hgt. ���.+�; c�:•.*) � � ft. hgt. ft. hgt. Stories �2.�'��`�K"�`� ��`�'�`""`""�' stories stories staries # of bedrooms ��'� Tv�a,l l�i Lake/Pond/Flowa e/River/Stream Name N ; i �p�xyO� Ctio.le� s�yle � ' Cc.bih /N:;,,,e w��1-�-. Lo��o.�d .iLa _A-.r_- � ..�_ � � �.�_,� �U x �i1. DecK k,,G � 1� 00.� '�,.��� ��.,.e,,�F- '=+ �� ,l,c_,u_, 1t7�� �.C� L� yC T ( _____.._.._.�_. .- - - ----�_�_ .___ � -- - ---- � �_.___ � !._. h e�c�c �-a'�� �s' � �� 7c.n k . / ti�.�. �� (GCs' � .�- ; Dro,,M / _ , c.��_. r +�L.oK � 3Q � � � � � F i i ' . -t-- �e , � � ��►c�- — � 30 <� � �" , � L .�-- --�'- --- - � ' �f i M'ti � a1Ert�--�� 4 i� r-- � �Q ,� ' �. 75 r� + �1 ��' � J ( 1 , �, w �e Na.,r;� . �(� _;-.;�. ��a . , � � � �- r� :ctbc.� i. �'�'.�p'�'� f�'J` � +, y. r , t�; ker •, * We�i � � ; i 'n l l �� „u ��� , , I >.� � — , �•,+.. �.., . j -�b, — g"u'° � !� �: _+'I�I y 8' - _ .. -` / ; . t�1� �s.. . . � �(A,x:�, _ / _ ___ ;�_ -- - 1 � 1� za� ��+ � � w.� / ` � P Sv���' . !3 `�y � _ �,� i� 2c�� , � i 55 z � � : � � � r � 7Z � � / Fire Number and Name of Road tcx5� s hc��-� D � 1. Enter lot dimensions and indicate north by arrow. Sign ture of Owner or Authori d Agent: 2. Indicate the location and size of the requested construction ,-, i' ..�- Signa re activities. PrintName: 1�fY • .- P zc.�.�c��� ��� r' 3. Also, indicate the location and distance to the well, The above ceRifies that the listed information and intentions are true and correct., that ail work shall be performed in compliance septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if centerline of the road and waterbodies. a�t��9 as ow�er�s� a9e�t, has the permission of the owner(s) to perform the work requested on this application. The above personsls hereby give permission for access to the property for onsite inspection. Permit fee: $ ' � = `�r _ � ' U� I T-� � Total land area within 300' of the waterbody: (A) L 3, �:,tal ir,�pervious sur:ac� area [in�luding tr�s p:oject; �L,� �`l ���� (B) / (A) x 100 = % Used < a�F..� (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes (��) No 1 ' October 15 , 2004 - � � Issue Date Signature of Issu gent October 15 , 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: SHORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) Land Use Permit No. Qy-S8 rJ (To be entered by the Zoning Office) Index No. Oy - 58� WHEREAS, (list all owners)�et�.h � (,:•�,,,�A To Sc� �{'� L Zc,J r C'_�F-� /�+.0 �-e�` � � � owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and � WHEREAS, in order to secure a Land Use Permit. ri � NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Permit, that � the SHORELINE VEGETATION PROTECTION AREA on said real estate is intact to a minimum depth of � 35' landward from the ordinary high-water mark of the waterbody. � The owner(s) hereby agrees to comply with the shoreland vegetative protection azea requirements of Section � 4.410 SHORELAND VEGETATION PROTECTION AREA, Sawyer County Zoning Ordinance, in effect on the date that the land use permit is issued by the zoning office. The owner(s) fiirther agrees to allow authorized ��9j, representatives of the Governmental Unit to enter onto the owner's propeRy at the following description d between the hours of 8:00 A.M. and 6:00 P.M. [Section 9.13(1) POWERS, Sawyer County Zoning Ordinance] �3 to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE N VEGETATION PR01'ECTION AREA exists and that it is being preserved. This authorization shall terminate on the date of expiration of the land use permit. However, the owner's obligation to maintain the SHORELINE � VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION � PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. Violation of this Agreement will � authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance, i mjunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all T structures approved by the issue of said Land Use Permit and the revocation of any other uses approved by the � issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County Zoning Office. I,egal Description of Property: �s{ � 'Z p+ C,-�v (� } � ��� ��, 1 � ��� /1 � G� �.. o � Cr�Qvt a .r� � ��r �'� , d08 -� 3�5 - 3�- ..�'i215 _ Dated this �z�� day of ��� , Z�� (o� r (oW ) — , ; � , (Owner) ( er) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office ��, � • ��� / y� - �i��� ( F � �D hVRV�Y MAP �rk ok l�a��Ynr�cnk Gok 2 h��kion �i�, ���n� �q �l �owh o� �d��wa�cY. h�u�ver '�o�nkv. 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