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024-741-30-1306-LUP-2004-400 Application for Land Use Permit o o '� County of Sawyer y � PO Box 676 -Haywazd WI 54843 715/634-8288 The undersigned hereUy makes application for a Land Use Permit and agrees tihat all work � � shali be done in compliance wifli the requirements of the Sawyer Couuty Zoving Ordinance and Uie laws and regulations of the State of Wisconsin. � NO CONSTRUCTION MAY B�GIN UNTIL ALL PERMITS HAV�BE�N ISSU�D. .� � PRINT-US�BLACIC INIC OR PENCIL �( 'J v1 � �� //£/T!, /�7ii r£1 � �- �FFAX i - S% p. Owner � Builder �' ,�1 �y� �f�� ).7 S o' o 7 l f S� �T S4� � p Mailing Address P✓Iailing Address � �;Ta r r�r S C b0�D3 S7c�.U� C.A,e� LV s S�%8 7� :° City,State,Zip City,State,Zip ��y- ��- 7RQ� 7is- F�6S�-3�32 z. Daytime Phone Daytime Phone eR9p K4z'��09 y�z- 9>z � , p � Additional Information: Zone District /��'� ' C.��'�` f'02" LotSize �f)`�, X gs / ��C.K,�J Y° � '1 Date lot was created Co-/y-7 9 Acres �l�— Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a nver, � creek or stream) If yes,how far from the shoreline&water name: Lc��y�� n � Is there wetland near the proposed structure?If yes,how far � b Building Land Use ° ( )New ( )Filling ' Floodplain:(�1'es ( )No # :; Dred in � � �Addition ( ) 8 � ° O Alteration O Grading Chippewa Flowage: O Yes (�Q No � r ( )Moving On ( ) ° � � � � _ DrivewaV:( )State ( )County �Q Town Rd. Primary Structure Accessory Building Addition I ( )Dwelling ( )Garage-attached/detached ( )Deck � ( )Year round ( )#of caz stalis Porch , ( )Seasonal ( )Storage Building )Enclosed ( )Frame built on site ( )Screenhouse ( )Living room A� ( )Modular/manufactured ( )Greenhouse ( )Kitchen ( )MoUile/manufactured ( )Other { )Bedroom ^ ( )Other primazy structure ( ) ( )Relocate/enlarge � � � � ( )#ofnew � � 0 Additional�formation: b � � Type of Co�struction � y �Frsne { )Log ( )Pole/metal ( )Block ( )Concrete � � ( )Other � Construction Cost:Primary Structure$ � Accessory Building:$ _ Addition:$ �/!JD`� Z 3�a �' Vol Pg�_of De d Certified Soil Test# ?9'39� -� � CSM Vol Pg /.�y Lot �_ Sanitary Perniit# 8O"l8z ` P1atEnvelope �'Z�Z_ Or: ��P �~� � Condo Vol Pg Year Installed ��Z � Aff of ex septic Vol Pg Owner When Installed: Gard Gazebo Voi Pg �,,, Previous Variance: LUP: Inspection Date: � Z1��!o-N as933 Describe the coustructiou using these columns. List tUe dimensious of each structure in a separate � column. List each story, each addition, each alteration in a separate colunm. #1. #2. "I #3. �• Size�_ft. wide �1 ft. wide ft. wide ft. wide _�_ft. long 3 ft. long ft. long ft. long Floor azea i� 2 sq. ft• �sq. ft• S4• �• Sq' �' Hgt.from gcade�_to peak_�ft. hgt. ft. hgt. ft. hgt. Stories � stories stories stories # ofbedrooms Lot Line or Lake/River name: L171) � 1 �� ' O I �� eC �, j =--�"� �,�� _ riz r�yo ll08 � �� f '��j � � �, , �. � a�,, �.�8 � _� � r ' � =� ��s-f '---- �,��, - , � �� 5j�r J� $�' Fire Number and Name of Road�Ti�5 � 1� ��'1 4S�-VT j-fi� i 1. Fili in lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent: 2. Indicate location and size of existing and new structures. 3. Indicate location of well, septic tank, drainfield. i �j1 � � J �� v«a�- 4. Indicate distance to existing structures, lot lines, septic system. 5. Indicate distance to the ordinary high-water mazk of any lake, � ,/�`w1 Print Name: � n �`v t � � �� ' pond, river, stream, creek, and name the bOdy of water. The above certi�es ihat ihe listed �ntormation and intentions are 6. Indicate any grading or clearing in excess of the construction site. �ssio me v ce�r roo�eii rsos�cuon by Bi�e Pe�,�ssion ior 7. Indicate distance to aey wetland. Pemut Fee: August 4 2004 Issue Date Signature ofIss ' g gent August 4, 2005 Expiration Dat`e Office Comments: Inspection Date: 50% Rule Applies: Avg. Setback: Within Reservation boundaries: Restrictions and other information: JF ROUND LAKE TW P. 41 N. R . 7 W. / 9 /� :i. i 2' � ' � .2.5 2. 1 .I.I I5 3 3 4 w 1.6 2 5 .7 / ��.�_��^� .I.8 1.7 3 6 � i � 2 2.3 � � s.sz , .1.4� :1.8 l i �\ I 1.3 �1.9 � 1 2.2 � � J.2 �_ .2¢ �3 � i �.��, F y , °` �5 :2.i4 �4 � \�° i .� � .a.T � '� .4.i .2.9 �8 -y ( � 1 2 2.f8 .3.3 `` Y l , .4.2 :2.13 .3.8 2 \ Q 1 3 .4.3 � :2.i2 �3�6 \ _""� '� � _ .3.5 �l � r� 4.4 :z.i .3.y � � W )� 3 � W 4.7 � � .3. 1 •a.w Z 0 � 4.g ' , :2.4 � •;Z�s 3.q , / 7 v � .4.9 �.,, : .0 � i .av ' �•2 ) I j � .4.5 i.ry .t.io „ • , � ( ( �.b :z.i� ,a.i� � 1 29 t .�. _ - - '` i3.8 � :2. � 13.1 ' � s \ 13.7 ` 13.6 4 � s � 13•3 ♦ 13.4 ) �3.5 � �� .13.10 �" --,- r �� ly i 13.2 �11L. � i � ]X! - - � � � � ia.4 . � wy � y 2.83 � � � � � � � � � i . � � � �`` - '. , � . F � i �� t�` 1 � �- � � � � � � \ \ � �.�_ __ ��: � �� - � - =r � � �` '1 �q;��,� � w�e.��„b,. -;�.E-i.,�.ow.a ma�af d _ �u�..n.. '"A D 107 d 3 dd�d _p . �.mww r.�t c. w�.�.3..._�m vwo e2 7/ � . --�r..._, �='-f�,..4...' 1��Z x�a+x� SAWYEFt COUNTY CF�.7'IFIED SUR9EY MAP NO n CTR. OF 6E�� -- i SECT�ON 30 T41uRZW Fo.Vi'\.P. BEP.R\NGb HPSEO ON MpG13ET�C NORTH `i5�"' xo�.s9 m ti� ��' �e o`'• ZI � ti pS `oe,'°'�� O P N �� P `" l� � a �I� ��P '�•O D � `O p O I 0 m h♦ � 3 m t� C O D 0 � m 0" I � ` D p yo W. p D �0 �A i �,''N °, D O �.o r} i P>. r°� m p c N�"'� a�zn 100.0�_ � °. C � oo�i N W � � �_ Q p J �+ M' 0 5� O C \00,% e D � m � � � � �'� o ° 6� � i o/g `�� ir o ,00 zoo � D o oj��/ . � �� ;y '/-�.j o ia o � � SCLaLE 1`=\00� . > �� ^ � C � �,� �-r LEGENO : P.L ' �"'�' N � 'SET 3/s" ia 24�� \.P. _' �Q��/Da WT 1.\3 LB6 /FT. �J Q SET \" x 30' \.P. y "� WT. 1.48LBS/FT. �� O / �� O � 0 SURVEYOR�S CERTIFICATE i+ I� LYLE L. ELLIOTT� registered land surveyor hereby certify that by the direction oT DAVID STP.EATER� I have surveyed and mapped the land parcel which is represented by this Certified Survey N.ap: That the e�cterior boundary o£ the land parcel surveyed and mapped is described as follows; p part of Government Lot 2��Section 3�� Tormship 41 North� Range 7 1Jest, Town of Round Lake, County of Saveyer� State of Wisconsin znd more particularly described as follows: Cormnencing at the Center of said Section 30; thenCe N 84° 49� � 4�•68 feet; thence N 5� 11' W 700.00 £eet to an iron pipe beir� the point of begiruung� thence tJ k6° 27� 3o" W 133•06 Seet to an iron pipe; thence N 28° 20� 40" W 108.76 feet to an iron pipe; thence N 12� 20' 25" W 7A1.56 £eet to an iron pipe� thence N 81,° k9' E �•� feet to an iron pipe on the shore of Love3oy Lake; thence along said shore on a meander line S 12° 20� 25" E 201.56 Seet to an iron pipe; thence continuing on said meander line S 27° 30� ti0" E 108.10 £eet to an iron pioe; thence continuing on said meander line 5 52� 56� 30° E 11iB.76 Seet to an iron pipe; thence S Bq° 49' H 220.bk feet to the point o£ beginningp said parcel contains 1.86 acres, more or less, including all lands between said meander line and the waters edge of Love�oy Iake� and subject to any easement of record. That I have fu11y complied +,ri.th the provisions of Chapter 236-3k of the Ylisconsi� revised Statutes in surveying and mapping sarne. `, �� . ,o.:rj1SCONSIn'' �- �n �p � (�� II � � L � . , � OTT� 1 d surveyor �� U,{�t,3,p,c-'� U`��-�J � � '�on� 'n Regi stration 5-13� � � ""` tg: Juna 7, 1ry�9 � ,�, ��y. :� ��, ,, �Q�' _ ..�a> rt�5 6_ i4—'15 � �p�HfN. : /� 12ca ,,� WI6. � � 4_ � �(/ \S� � ��a��s w�: w w.�,�_ --.eND Su�iv"�;;;QO``v �'^t-�-w� c• ""� a 71 -..,,w�,�,,,,, �o.,.vR�t-1 SHORELAND PRESERVATION AGREEMFNT (Shoreline VeQetation Protection Area) Land Use Permit No. (�y-y(,1� (To be entered by the Zoning Office) Index No. �-�� WH�REAS, (list all owners) �p� �a c1 �Q,y1�2 � CrYt�S f- — � owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and LWIIEREAS, in order to secure a Land Use Permit. NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said I,and 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 shoceland vegetative protection azea requirements of Section � 4.410 SHORELAND VEGETATION PROTECTION AREA, Sawyer County Zoning Ordinance, in effect on �j the date that the land use permit is issued by the zoning office. The owner(s) fiutlier agrees to allow authorized � , representatives of the Govemmental 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. [SecUon 9.13(1) POWERS, Sawyer County Zoning Ordinance] O 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 expiration of the land use permit. However,the owner's obligation to maintain the SHOREI.INE � VEGETATION PROT'ECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION 3-- PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. Violation of this Agreement will � authorize, in addition to other penal6es and relief required under the Sawyer County Zoning Ordin.lnce, T injunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all (J structures approved by the issue of said Land Use Peanit 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. LegalDescriptionofProperty: Part of the SW4 NE � Section 30, T 41 N, R 7 W, lot 3 of CSM vol 6 paQe 271 in -the Town of Round Lake Sawyer County, WI Datedthis �R dayof _hil� 2004 � (Owner) (Owner) (Owner) (Owner) (Owner) (Owner) This instrumen[was drafted by: Sawyer County Zoning Office .