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024-641-13-1406-LUP-2004-154/` Application for Land Use Permit �shoreland*) o o . . . County of Sawyer � � /� PO Box 676 - Hayward WI 54843 715/634-8288 � *Property that is not located within 300' of a creek, river or stream or within 1000' of a � flowage, lake or pond or does not have any of the above waterbodies located within � the property's boundaries. � � CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � ��,ma�ne PRINT-USE BLACK INK OR PENCIL �-• � �on� m �u�t� T��s Tc� m �� Owner Builder �. � � �7 3 :� � i� �� . �'c� 1 �..fv � � c.�) � � Mailing Address Mailing Address � �fl-� ��.�:�J'� � � i.L>L S� ��-!� ��A T� D �7" � ., City, tate, Zip City, State, Zip ��.� - 9��".3 �� - `� �� Daytime Phone Daytime Phone G � .kR- I � � Additional Information: Zone District: 3 � Lot Dimensions: ¢ � Date lot was created: � �J Acres: .� � � d,t $ � i3 o D � Is there wetland near the proposed structure? If yes, how far �� (� Building Land Use Floadplain:� j �es f�No � � �New ( ) Filling � � ( ) Addition ( ) Dredging Driveway access off of a(Check one): a, O Alteration � Grading (�j'Private Rd O Town Rd. o ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ti, � � ) � ) o � � r Primary Structure Accessory Building Addition � ° ( ) Dwelling ( ) ( ) Deck W ( ) Year round ( ) # of car stalls ( ) Porch � O Seasonal O Storage Building O Enclosed � G^ ( ) Frame built on site ( ) Screenhouse ( ) Living room � ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � � Bedroom �' ( ) Mobile/manufactured ( ) Other ( ) L � ( ) Other primary structure ( ) �-T�R A �s C ( ) Relocate/enlarge � � � � O O # ofnew � � � AdditionalInformation: � A i.,� � � � � � Type of Construction: n '� �f Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � �hi ,, ( ) Other ,� �d Construction Cost: Primary Structure $ � � Accesso Buildin $ I� ULC Addition: $ � � rY g� �� * ^ .-, � Deed: Vol '7G0 Pg 3�c b Certified Soil Test# �" z a'a ~ � CSM: Vol .� P .g,��3 Lot# Sanitary Permit# o� Plat Envelope �r� N � Condo Vol Pg Year Installed: � Aff of ex septic Vol Pg Owner When Installed: `-' � 0 Previous office approvals/actions: � Variance: # LUP: # SP: # CUP: # � Inspection Report: # Change of Zone District: f� I0�� Describe the construction using these columns. List the dimensions of each structure in a separate wlumn. List each story, each addition, each alteration in a separate column. #L CT(r��c�r� #2. #3. #4. Size� ��i fr. wide ft. wide ft. wide fr. wide �_ft. long ft. long ft. long ft. long Floor area '7 c�C sq. ft. sq. fr. sq. fr. sq. ft• Hgt.from gade�to peak ft. hgt. fr. hgt. ft. hgt. Stories � stories stories stories # of bedrooms Rear Lot Line T c.N 1 W • �-� Q � � < R T �J �� r �� -#-ea� : � �k• �l� x 5 ti- l�`I dd ��Y g�� xsv 5�a wc��k•�;< H�U v9 � �� R��n c F �.• P=� i'�L�- � � )��I� �o • la � �m �� Fire Number and Name of Road � J� `, � l�l �f L� 'c r' K/� L� 1. Enter lot dimensions and indicate north by arrow. Signature of Owne,J or Authorized Agent: 2. Indicate the location and size of the requested construction � , �. l�/ 7.";;, ��;�, Signature —� activities. ) rY� PnntName: �r�. R) � �a I' 1A '-tC� 3. Also, 1ndlCate tlle ]OCation and dlStanCe to the well, The above ceN9es that me listed intormation and intentions are We and correct., that all work shall be pedormed in compliance septic tank and drainfield, wetland azeas, lot lines and to the with ihe requirements of the Sawyer Counry Zoning Ordinance and the laws and regulations of the Stale of Wisconsin, and if Centerllne of tlle ioad. acfing as ownel�s)agent,has the permission o(the owner(s)to pedorm the work requested on this application. The ahove „$ personsls hereby give pertnission for axess to the property for aAo ` O� onsite inspection. Permit fee: $ ��b s ��, o �?� 7`7� � � .� - �� May 10 , 2004 Issue Date Signature ofIss ent May 10 , 2005 50%Rule: AverageRoadSetback: _ Expiration Date Office Comments: ��,z,,c. .��"'� �'�� 31 y� � �am.� o-� �' I 3 ,a5� cp 3/�i� � r13,�s� _ � 07°?0 � � � �� y y , { O .. . ll . 1 ti N V �1 .► a ^ � \\�� V � I� 1 0 i �� 0 � °� , �� _ � ;. 0 � -� �� o m l � � � � .s. � � I�� 0 u .$.i2 � ,� �--.-� - w � 1 �� .13• O /� � � v '$'� � � � = V.8.15 8•3. � � '_ N f � -� � � 1 .� m 1� .S. � O � �rf � N � � _,� �� r� . � M � V � C 1� � T � � � o I ' < �� z C � � �� ;� - o z \\ r � � u I < /V 1� � � r- ' � v0 ' � � D w _ I � � � � � � f � �' � IV � � �� GD � O � /�✓ A J ` �� 0 �� /r � � �� 1�' � I � � ��J �� 0 O � � ` I � �?� � �_ _ _� 0 � '� . i' i � A!,E. coR s.E�-n'.fy -�. � /� .' .. 6 'd..dNO•Fb .Line, .S.E y/Y.t�y��.I3, T'//N,R6YY. -J ./ _' r ! . 599. �V�o'.naa. . / •' � � ' ,, ^ ' '- .foS�' - - . ' . 1 �� '� O � N YY COR. � y15 � ��S 69'S�3%O"YY,356.36� � c�i� +�'� , �,. > �„ >: , s.�y i✓,Fy ��p ` `�.�. , �. ,� � � � � �, ag . . �. ' � � �^� ' ` ' ' l _� ` � � �. / 5 � � � ' ` . ' ' : I� ZT '�S -�i i ,';,;'"� 2 , .�a. =': � � , , � . . ` ! :<;:.9��9�Z �h � � ; S 5 '�.° , n ! I , ' '/� .�e �• . � J'CAL,E I r- /DD r � � . ', . � . FDUIyD Dr�yeryo,y � •' � Z MONUM�NT'S � ,Encroachme.�t � � � S,ET . * � � � `�,.(i aCfCJ ± `l � ` \ \ � �1 • � � B�'R.9/NGS BASE.O ON ./YORTf1 � � � �� j ,t in�E sE y N�E:y,ASS uMEO o � � � TD B.EAR E.9ST'� W.EST � � � � � ` c�.,� JAIY. /9, /9 78. , W � \ / � ° �,�� ,�, v � ,� v ; b � \ ; . � i :� � �y � ,r �� ' /35"/3 " / J: . , , - T�'� , ` ; �; - - / � � ` .� �� -� /�- :� l� � � /� , r^I � � � , �/ Q V`\ � �/ � / \ 1 // � —�i �5�� o , , � , • 3, , � , � � � � -ro-�' �`�.\ , , \ ' � � � ' � �`P��\� ��a � 'JY/y'�VS"90 jY`� . { � , gy• �v ` � ` o `1� , ° •ti � � \. � �9/ �d � . . � - \\`�/�1/� , , j � �; � �1''CONsj� � �� RONALD L. ,�, I � � PE'I'ERSON , 3-809 � tiAYYY1lRD � WlS. Q, 1� �� SUR`��O :�.� ` I Cslitiod b�uvey Na..__.� 'S� P.�o� S •� 2 P.�9e� SHOI2ELAND PRESERVATION AGI2EEMENT (Non-Intact Shoreline Ve�etation Protcetion Area) Land Use Permit No. (��/ �J'r�/(To be entered by the Zoning Office) Index No. d�-/_.5�_ WHEREAS,(list all owners) f��11�� %��/�o cC C� �! C'i-/Y�f 6�1/i/tiC� � � owns real estate w�thm 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 Department. The owner(s)hereby agrees that at all times in the future,the real estate subject to this Agreement shall comply �� with all shoreland vegetative buf�er requirements of the Sawyer County Zoning Ordinance in effect on the date that the Land Use Permit is issued by the Zoning Office. The owner(s) further agrees to allow authorized representatives of the Governmental 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 PROTECTION AREA exists and that it is being preserved.Violation of ttus Agreement will � authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance, � injunctive relief,restoration of said real estate,the revocation of said Land Use Permit and the removal of all � struchues approved by the issue of said Land Use Permit and the revocation of any other uses approved by the issue of said Land Use Pernut. All parties agree that this Agreement shall be filed with the Sawyer County Zoning Office. Legal Description of Property: S C �� /J C %,�. j�G ►3 �L.�� R(� �,j Dated this _S day of ��C[ � , �� (Owner) , (Owner) f!<�-'�-��/�i�Gz-��f.� — (Owner) (Owner) (Owner) (Owner) — C�.Meu�S:��a� �� C�c�•�w�,�+,�,�,�r�� Ace,�ell�� -y_a�Y (�� UMQ� CQvtCuYWlcl wi`l�, �j��dkP Ae��re� I.I�C_ This instrument was drafted by: Sawyer County Zoning Office