024-641-25-1208-LUP-2004-387 Application for Land Use Permit(*Shoreland*) o 0
, :
County of Sawyer v � ;
PO Box 676 -Haywazd 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
the property's boundaries. � f�
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. A '
PRINT-USE BLACK INK OR PENCIL �
1 �
Ti�av�aS��o���� lS�2 e�
Owner Builder a°�.w� �
8�3�"l3�aisae��1 A�de S . � �
y
Mailing Addr�e)ss� '/ Mailing Address °� p
��oor�w��Y(;>I y�r� S`�.`�v � �
City,State,Zip City,State,Zip "
Y�a �� c,%,�a �
Daytime Phone Daytime Phone �
�
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Additional Information: Zone District: ��-/
r
�
Lot Dimensions: �
Date lot was created: !b Ja5'�a3 Acres: /,�LP
Is there wefland near the proposed shvchue?If yes,how faz ��ec . �oos e L�fi e �S� o
Building Land Use Floodplain:( )Yes (k)No G
( )New ( )Filling Chippewa Flowage:( )Yes (�f No �
( )Addition ( )Dredging Driveway access off of a(Check one): �
(X�Alteration (X)Cttading ( )Private Rd (Iv Town Rd. c�
( )Moving On ( ) ( )County Hwy ( )State Hwy °O
� ) � ) � �
Primary Structure Accessory Building Addition o �
();1 Dwelling ( )Garage-attached/detached (X}Deck �
( )Year round ( )#of caz stalls ( )Porch �;,
(xj Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room � �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other ( )Bedroom c�
( )Other primary structure ( ) ( )Relocate/enlazge � A~
( ) ( ) ( )#of new �_
� r�
AdditionalInformation: k,' �
L+
�
Type of Construction: � �
( )Frame (�Log ( )Pole/metal ( )Block ( )Concrete � �
( )Other
H
Construction Cost:Primary Shucture$ �$,o�o �
ro �
Accessory Building:$ Addition:$ '7 S� �
� 3i8�'7 � �
Deed:Vol Pg Certified Soil Test# � z
CSM:Vol a5 Pg��Lot# a Sanitary Permit# °Q �
Plat Enve(ope ��0� Or: c, �
Condo Vol Pg Yeaz Installed: �;,
"Loads and Flows": Vol Pg_ Owner When Installed: � �
0
Previous office approvals/actions: N
�
Vaziance:# LUP:# SP:# CUP:#
Inspection Report:# Chenge of Zone District: ��2,Z�(�''
�-�'�
aNS(o3
Describe the constraction using these columns.List the dimensions of each structare in a separate
column.List each story,each addition,each alteration in a separate colmm�.
#1. �e n�e�-YJl4�r� #2.�se Y�l�e.u+-�mo c� #3.�e e��- '�an�. #4.�-e c.� R cn,✓L
Size � ft.wide _�_ft.wide �d ft.wide �ft.wide
3�R long �ft.long �ft.long � ft.long
Floor area Ce�D sq.ft. /�b'' sq.ft. Ja0 sq.ft. l�y sq.ft.
�-�S��_�P� I o� ft.hgt. _�ft•hgt. �!ft•hgt.
Stories�_ � stories — stories � stories
#of bedrooms_�
e1Pon w er/S sme
�
/Ipx l(v
�a�CR��e
�� . ��
� I�C�un�n� .
LZ��dli� 17� 5'Gv_pG�I
watK-��� -- - - ao P„��. .
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�otitc.Re � �.� ib F
\ �Q �_� �Rc�t
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y g � �� � __;
(� Y'�4�1�T, I'T �7,
U.�� . ���� vz`
�dd i n� c� 3c�,s e�c�,� ah�.c-��
5,�� �fi�
Vtitoose C°'�e
Fire Number and Name of Road Na�e e nwrx}�e� - 5 ��t C�e+�Jt� �J�� I o S�S ril�rn°rs ��E
�.
1. Enter lot dimeasions and indicabe north by arrow.-See c��'�c.�, ����,,,,s,�1'1Zed Ape1t�
2. Indicate the locati�n anc�size of the{T-gr77 constiuctio (/1rnt�t��L-u�
�mPJ� uN 2°L Vi�Q,tj✓t�iV� SCIeC �, �
activities.�,l�e,e ex�-•f�rc.QC� ' �+�t��e�ko�,��k. �.�,,aPo�ja�l.
e t�a� ,,i� ��:u P�►� Z-hwHes
3. Also,in�&cate tnhe I�cahon and distance to the well, rne�o�e.�me�ed ti��mn ana t�se
mre�d m�cr,ew m��ne�romba n oamirnoe
septic tank and drainfield,wetland areas,lot lines, ���a d"�'�'�°�
era u�e�a.s a�a�apw�,e a t�s�d vurmnen.�a r
ce�erline of the road and waterbodies. ec�v m o.ner�a)e�ent im ne�or e�e o.,�.�s�b
pe�iam ue ra�c reProe�d m nb�plizMon.The aDaie
De�and3 MiebY 9Me Px�lon for eaceea b tlie papMly far
`I 5 00 ��.
r�t f�:$
Total land area within 300'of the waterbody:(A) ����� S� �°
Total impervious surface area[incladinB�P�J�I�)��-3 S�. /!yy
(B)/(A)x 100=%Used � 3�o (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area:Mitigation Required?( )Yes (�,No
�I111Y 99 9004 .Lw- �ti �L�:c.l_-�C.l l,u ��-
Issue Date Signature of Iss g ent ��—�—
July 29, 2005 50%Rule: Average Road Setback:
F.acpiration Date
nffice Comments:
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30
36
"� SAWYER COUNTY, WI
. . REGISTER OF DEEDS T(�{yL
' 316792
10/29/2003 1 : ;5 PM
RECORDING cEE 13. 00
Pages 2
SA n'YER CU UIti'T�- CER TIFIED
SUR V�' Y ��IAp
A PARCEL OF LAND LOCATED IN THE NW 1/4 - NE 1/4 OF
SECTION 25, T. 41 N. , R. 6 W. , IN THE TOwN OF ROUND
LAKE, SAWYER COUNTY, WISCONSIN.
V.4RGWCE 03—Z01 �l�PROVEC 7/18/03
� � LOT 3 CSM �4qgg
I N 1/II G10RNBR M.C.
j 3" AL j MONUMI:NT P' /RON PlPE
� S0L17oN 2s S 88'08'S1" W +s': � �
� Qa SEC770N 25 493.14 RECORDED AS 493.05' � �
I ol� �T1 � �
� m ��� 54,500 SQ. FT.t � ^: �
� � � 1.2u ACt �vvnoc vunu� cu� � v _I
S 88'S5'47` E L�J �I�' I �
i � � � 222.13 5 �
�� �; a I A T 2 ��4�98, uac � I i
i° o�- 83r4U0 �3 65 E i � }q � Z
� SQ. F"P.t .
Q� `o i 1.46 ACt m� �J� llf�L ,6'1y �, I{ i �
��i o �SsrW�� C/L 20' ACCESS N ���i'�oa�Ew"v o o I I r"�"i ao"�v� ��\
. z ' � �' EASEMEN�,�,.�� Z79.00� scvnc vcNr scrrc r.uxLc�, �ii�m \
o� ; M ^ � ,� S 86'00'47" E � 1
iy � i '� �� 486.65� � S83'?8'14'E
i i �4��, wEu "ousc � _ \
i � �01.91���ar IAT 3 1
� i S 80'q3�14. � �' 77,100 SQ. F"f.t W
� I � � e 1.77 ACt ^In"�, �
� ' � � 1
� r�Nc cs� -- o »
j JNI WRTIN - pN7rER � S �s SE�iC vELi ��'v
1�� / Sg� Sp), o �
66' R/W �� \ o ssf � Z
4 c � j �_ Qo F/ � 12�.��� Y l
T `� � a
j �a � � �.�� N 85'33'S6' E
i � /y i �
/ - ' ./•�/� I � O
� � i ° � � % �
� � o c
, �
�,�,, �,� TOTAL• \
195,000 SQ. FT.t � /
4.48 ACt \
suvar�ca� ►un►,ueqe�c ���������tWISCpq���4� \ � /
``� Hs� ���� UNE BEARINC DSiANCE //
` � y � Li S 89'18'SS' E 60.57
�1qqy � 5 8630'Op' E 2�,pp �
� �TlgN� t} � w N 1 f'JO'0p' E 17.57
$URVEY�1' -� � `
` LARRY i� _
� �� 76 SCAL : i IN 'H = 10 F E7
DAiED THIS�� pqy �6yi��R�1���1003.
too o too 200
LECEND CUfNr• REEL ANO TR/GGfR RESOR7
• �"' � ^��. � HEART OF THE NOR7H
O 1' (0.0.) r !8' IRON PIP(. WE/(�p� ✓� HJ09/99 t MW!/03 ppAF7E0 gy,. qCZ
�.�J �es/rr �:' �" - iAo' oisK• aaa� SYIRVEY/NC OFHAYWARLt IMC
nr.edw� n...... _.. -�- --
SHORELAND PRESERVATION AGRE�MENT
(Shoreline Ve�etafion Protection Area)
Land Use Permit No. C'y-38 rI (To be entered by the Zoning Office) Index No. O S� -c38�
WHEREAS,(list all owners) ����a S �i�p'n��h
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 AREA on said real estate is intact to a minimum depth of
35'landwazd from the ordinary high-water mazk of the waterbody.
�
� The owner(s)hereby agrees to comply with the shoreland vegetative protection azea requirements of Section
f-- 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)fiirtlier agrees to allow authorized
� representatives of the Governmental Unit to enter onto the owner's property at the following description
� between the hours of 8:00 A.M.and 6:00 P.M.[Section 9.13(1)POWERS,Sawyer County Zoning Ordinance)
� 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.This authorization shall terminate
on the date of expuation 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,
� injunctive relief,restoration of said real estate,the revocation of said Land Use Pemut 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
Q issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
Legal Description of Property: (_nT � ��Yl� ���'�, �p(Q�y Secton 25,
T 41 N, R 6 W, Town of Round Lake. Sawyer CountX, WI _
024-641-25-1208
tedthis �� dayof aUo�
l
(Owner) (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
�