014-942-28-3111-LUP-2004-411 Application for Land Use Permit(*Shoreland*) o o��
County of Sawyer �
PO Box 676 -Hayward WI 54843
715/634-8288 �
*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 a
the property's boundaries. � � �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. O
PRTNT—USE BLACK INK OR PENCIL „�. �
� / � ( � r
�- �'(`—l.��� � ,�U�r�h ��C�..S��'� c/�Q.LQ/!.� �-',t-'17Ci'� � �
Owne� Builder a
7 �
���! ��ll,� �rr� �'�IOC'� �ii�('�� �.
Mailing Address Mailing Address � O �
/-�� �ru-1,1rCa �.L����C �r'����� �-{C.l�/cc�nrc� �[�,�;�� � ��!►
City,5 te,Zip � City,Sta e,Zip
i
1.�3�/� �� 5�-,� !n3� —� ��.5
Daytime Phone Daytime Phone �
Additional Information: Zone District: (�,�/
Lot Dimensions:
Date lot was created: Acres: .'l$
Is there wetland near the proposed structure?If yes,how faz o
Building Land Use Floodplain:( )Yes (�'JNo �
(�'New O Fi(ling Chippewa Flowage:O Yes O No c�
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading ( )Private Rd ( )Town Rd � -
( )Moving On ( ) ( )Counry Hwy ( )State Hwy �°
G�
� ) � ) � �
x in r
Primary Structure Accessory Building , ...._ Addition o 0
O Dwelling (�Garage-attache etache O Deck N �
�o
O Yeaz round (�#of caz stalls O Porch W
( )Seasonal ( )Storage Building ( )Enclosed �,
O Frame built on site O Screenhouse O Living room cc
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ° �
( )Mobile/manufactured ( )Other ( )Bedroom p �
( )Other primary structure ( ) ( )Relocate/enlazge L `�
� � ( ) ( )#of new z
z �
AdditionalInformation: � >
�
�
00 "
Typ f Construction: ' �
( Frame ( )Log ( )Pole/metal ( )Block ( )Concrete W
_ �
( )Other ' .�
Construction Cost:Primary Structure$ ,.� �
Accessory Building:$ � ��� C'c C Addition:$ � ^�
� �
Deed:Vol 70'] Pg 0 b Certified Soil Test# pp,2 7S � z
� �
CSM:Vol Pg — Lot# Sanitary Permit# oo- y�9 �
Plat Envelope Or: ? ,�
Condo Vol Pg Year Installed: n>
� �
"Loads and Flows": Vol Pg Owner When Installed: �
ci
Previous office approvals/actions: -�
Variance:# LUP:# SP:# CUP:# —
Inspection Report:# Change of Zone District: ���10,,1
�V�
I���q
Describe the construction using these columns. List the dimensions of each structure in a separate
column. List each story, each addition, e�ch alteration in a sepa�-ate column. l��"�
#1. � � � 5 '_ #2. ` � � � #3. c ��' �v #4. � �-�' �
Size . wide ft. wide ft. wide o2 � ft. wide
, ft. long / ft. long � fr. long ��ft. long
Floor azea � � b sq. ft. �% q. ft. �o � ft. �sq. ft.
Hgt from e to fr. hgt. fr. hgt. ft. hgt.
Stories _� stories stories stories
# of b drooms�
Lake/Pond/Flowa e/River/Stream Name
� �
��� ��1���� eS=
Fire Number and Name of Road �v�����y �(. � ��� �[�C /'� � ,��'�' �t' ` ��>c:-�<�7{
1. Enter lot dimensions and indicate north by arrow. S nature of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction
ignaNre
activiries. /
Prin�Name: —r� .F' l �1 /CS/�%'�
3. Also, 1nd1C2te Ylle loCatlon 2Tld dlstanCe to the well, The above certiTes that the li d inform tion and intentiens are
true and corred., ihat all work shall be pedormetl in compliance
septic tank and drainfield, wetland areas, lot lines, w�m me req���meo�s or u,e sawyer co��ry zo�m9 oroma�ce
and ihe laws and regulations of the State of Wisconsin, and if
CCnteTIlnC of tlle rOad anC�watelbOdles. acting es owneV(s)agent,has the permission ot the owner(s)to
perfortn the work requested on ihis application. The above
personsls hereby give pertnission for access to the property for
onsite inspectian.
o�
Permit fee: $ ��
Total land area within 300' of the waterbody: (A) 3C�, C'���'
Total impervious surface area [including this project] (B)_�� r7�7
(B) / (A) x 100 =%Used /L�� �e�7e (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Axea: Mitigation Required? O Yes O No
August 6 2004 "
Issue Date Signature of Iss ng ent
August 6, 2005 50%Rule: AverageRoadSetback:
Expiration Date
Office Comments:
Z --� �- l_ _ �-_-� _2 C_ � t
-
,
�_ � � � � -�- � �_ �� � �__=�Z_,_-�_.
� /Cro,��� - �-_;
, 3� � � � � • '.
� i �� ,�__ 1 ,.
� `
.� � " �o'
� � E--�
\ ��
�
�1( .�'� �Xi
1��c,l� � �- �,t o
� � �-� �a u�.
o _ ��
�
� � I c
���� �,� ii7,�r-+ 'i �� �
��,�-- i� d �� Ft ,�
1"o-ti� /� P� -r+ � �
`�
�L�o /�� ��` r t 1
��� ��
�
_i,�„e,� �0
(�a ° ^ ��rY� �#
`' 8�i� p�' r-f- I r,�
� �
`1` � � � �
� I_ � �
.� _���
, �, a
� n�
� � � �
2 s ��
� I 3 �
��
+ � ��
�
� �
� `-���
�__.___ -�-_
-�____
�
/ '7 8 •�
,k ',o
�" � '. �r� �� �
� � , .7•7
z � , .73 � •8-7 .8.6
.y ��
.7. (O h /
� •7�� •�� G I �8
,7.� .75 z' �.
� .i. .� � � C2 . �: ��
� a
� .�, •8.3 .8.4
y
' 1 ,-�j`=."�`✓f<'£}f� k:....- r.. � �.. �� a
•y �Q
•1 •�7� �
z.:3 .g.3
.IO.I .�.�
.�.5 . i
.3. 6 .9.19
. . .9.7 �
.�.8 .�.g I°�
.9.l0 .9. 11
9.12 � �. 13
. 10.2 .9. 1 .�.t4
s.is
.9�.17 .g.18
� � �o i �
.I 1.5 .12.14 .12.15
.I 1.6 . -
�
,� �2 _
7
. 11.4 - . 12.16 .r5.Z
.1�..1 ` ,J5.
��
6 4 `
.l
. I I.3 �R'�`�'`''�
Tr�,� _
5 .1 I.! � �
.12.13 .12.12 .I� i . � ,
. I1. 2
� -
RE►�ERENCES : SAWYER CO. DEED I�EGORDS SCALE : I INCH - 400 FEE
U. S. G. S . - HAYWARD AN D pRAWN 8 Y : KNI D
STANBERRY EAST COLON ( : ) INDICATES GO
AERIAL PHOTO B3
� SHORELAND PRI;SERVATION AGR�F,MENT
(Non-Intact Shoreline Veeetation Protection Area)
Land Use Permit No. y — � � (To be entered by the Zoning Office) Index No. U'C - y1/
WHEREAS, (list all owners) ��� v /�-- -u �p J f�r�—
Tc-�d��-1,' -7- . �lc�s ft�
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.
NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Permit, that
the SHORELINE VEGETATION PROTECTION t1REA on said real estate shall be restored in accordance
� with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Departrnent.
"� The owner(s) hereby agrees that at all times in the future, the real estate subject to this Agreement shall comply
� with all shoreland ve etative buffer re uirements of the Sa
f-i S q � wyer County Zoning Ordinance in effect on the date
� that the Land Use Pemut is issued by the Zoning Office. The owner(s) further agrees to allow authorized
T representatives of the Govemmental Unit to enter onto the owner's property at the following description to
� inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE
�' VEGETATION PROT'ECTION AREA e�cists and that it is being preserved. Violation of this Agreement will
h authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance,
ginjunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all
� 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 tlus Agreement shall be filed with the Sawyer County
� Zoning Office.
, ti LegalDescriptionofProperty: _ part of the NE SW Section 28 , T 42 N, R9 W
�' Town of Lenroot , Sawyer County, WI
7
�
Dated this 30 day of Julv 2004
( ier) (Owner)
�
(O er) (Owner)
(Owner) (Owner)
This inswment was drafted by:
Sawyer County Zoning Office