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024-641-24-4109-LUP-2004-561 � Application for Land Use Permit(*Shoreland*) o o �,� ' County of Sawyer � � 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 proper[y's boundazies. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ' PRINT-USE BLACK INK OR PENCIL n -�-} / [� / � � �7 t�? ,�el/'�/ SCvin'1G� FCL-,DT I �UGCUC3Gd �G/Vleg � (` Owner Builder Q- S Po �3ox, G 8� l 5�3`7 C7" Rr1 P-� o: Mailing Address Mailing Address � � �'i�t��rz. �ake w-z S�/~/0 ���� r,�a rz�I ��:Z �Sy�y3 :� � City,State,Zip City,State,Zip � a�� - ��y -���9 ���� ����- Daytime Phone Daytime Phone �} � Additional Information: Zone District: ��'� �" _� Lot Dimensions: (11 Date lot was created: �� � � '� 9 Acres: � �/ � � Is there wetland near the proposed structure?If yes,how far o Building Land Use Floodplain:O Yes {�No SSd59/ o%i56 C r�-- 64 New O Filling Chippewa Flowage:O Yes O No c� � O Addition O Dredging Driveway access off of a(Check one): � r O Alteration O Grading QC�Private Rd O Town Rd. � ( )Moving On ( ) ( )County Hwy ( )State Hwy 00 � � ) � ) � S � r Primazy Structure Accessory Building Addition o ° (?�.Dwelling ( )Garage-attached/detached ( )Deck N �o (�Q Yeaz round O#of car stalls ( �Porch W ( )Seasonal ( )Storage Building ( )Enclosed �, O Frame built on site �i Screenhouse O Living room �, ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � (�c� ( )Mobile/manufactured ( )Other ( )Bedroom � � ( )Other primazy structure ( ) ( )Relocate/enlazge 'y � � ( ) ( )#of new � rn Additional Information: > . � � � Type of Construction: � � (�'rame ( )Log ( )Pole/metal ( )Block ( )Concrete � � ( )Other `x � Construction Cost:Primazy Structure$��,DO B � ,.d � � I Accessory Buildine:$ ��/ X /2. Addition:$ � 3�s yv � j� R � Deed:Vol Pg Cartified Soii Test# �"�� �i`_��� � z CSM:Vol P � Lot# � Sanit Permit# [, �-+ -��i`-� "° 7� —�� g—� azY Plat Envelope Or: o, � Condo Vol Pg Year Installed: i:, "Loads and Flows": Vol Pg Owner When Installed: � � � Previous office approvals/actions: � Variance:# LUP:# SP:# CUP:# Inspection Report:# Change of Zone District: i ���, . � � I�'�' ��;� 2N5�� 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. ,blo n1� #2. � #3. #4. Size�ft. wide ft. wide ft. wide ft. wide �/� ft. long ',`t ft. long ft. long ft. long Floor area /I 7 �. sq. ft. _��sq. ft. sq. ft. sq. ft. Hgt.from grade I y ',S` to peak ft. hgt. ft. hgt. ft. hgt. Stories � stories stories stories # of bedrooms �. Lake/Pond/Flowa e/River/Strea�n Name � , � �—T— . ��_r_ �C �'� O) � � � - . ��:� ,\ , � - �`j� / 1 � S� � � , �`^ o�!/ ',� � \ � � -, V �' � �� \v� 1 l , � �` - � � .`e' . .� � t � \� _ 4,�L,r� . r �_ ; - _ � �� `��� �, ' Ia_______�, 2�a t . � `�� � - ` _ _ � � � a, , �- , � ,_ _ ; _ ,� , � — f � � ; - � � . , �� � /�� ��� , yF� V , � ` ��`� ��, � ' . W ,�,',` c���1 � ' , � - ,._ - � -- i ' , � -•- - --�}---1_-r--,--1_--�- , sh-�l� z � ' `--� � , , � , C,' Fire Number and Name of Road 1. Enter lot dimensions and indicate north by arrow. Sig ature of Ow er or Autho ized Agent: 2. Indicate the location and size of the requested construction �_ - Signature activities. Print Name: 3. Also, indicate the location and distance to the well, The above certifies that the listed information and intentions are true and correct.,that all work shall be performed in compliance septic tank and drainfield, wetland az•eas, lot lines, with the requirements of the Sawyer County Zoning Ordinance and the lav:s and requlations n,r the State o(Wisconsin, and if centerline of the road and waterbodies. a����9 as ow�,er�s>age�r, nas tne per,r.ission 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. r , — , Permit fee: $ ��l� �i �:. � �' ,� Total Ia�nd area wiinin 3t���' ot tne waterbody: (A j C�_(o�� , j,;,=� Total impervious surface area [including this project] (B) " l.5�� (B)/(A) x 100 = % Used �,J°;�'n (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? Yes (� ,No October 7, 2004 - \ Issue Date Signature of Iss g A ent October, 7, 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: � ' � .z.� . A \ h"� \ � 2.b ,:; � 2.{ � `� .2.$ � � 1.1 2.¢ � 2.5 ) 1 �3 � �� � 2.3 �� 2.2 � .� 1 �� �/ \ O �\\ / / 2..� � // \ �� -___-_-_�/% \�\\\ �J.� \_ / 1\ I 1� ' MOO SE 1 � � _� 8.� LAKE 4�1 ► � � _ ._.,S l � � \ 13.2 �^"� �_ __ __ ___ _- --- �J =�,Z ����' j� 148 �� � 13.1 14.1 4.9 ( . 14,12 I i 4.10 \1 .13.7 = 13.5 Z ''�'8 y 14J1 \\\ .13.8 3 3A S �) � /� ia.2 1 ���,� ,�i / 14.3 13,9` ,C \ ,� � � � 14.4 > � � •� � J � �- —, 14.5 .13. ` �` � \ /( Rs 13.� � -' 14.�O << � y � 14.7 ) 13z � i., � � —, � � �5_a _ re.e � ' J '5�' - 1 k- � �5 2 �� I b.2 .16.10 16.3 -- � � 15.3 1 b.4 ` I � � 15.4 (\ �Ic•5 i I � �5.5 I 4 .16.9 � .15.9 �r'� I ` i�'� .6.1I I � /' �L3 i' '�� L�-- / l � � �. 16 1 •I �,� J ��r �.�r.z _ .15.6 �� � ,//15.7 � `" �, 16.8 15.10 ' � �` ''_ ' 16.7 ,�,. ' �^ �� = FEET FOR ASSESSMENT USE ONLY NOT :DRAWN BY: CI( DATE: INTENDED TO :SHOW CONCLUSIVE COLON (:) INDICATES GOVT. LOT EVIDENCE OF QWNERSHIP OR BOUNDARY LOCATIONS PAULA CHI55ER - SAWYER COUNTY, WI _ ' REGISTER OF DEEDS 324641 OB/31/2009 11:45 AM RECORDING FEE 13.00 APEX SIJRVEYING 15614WindroseLme,Suite330 eages 2 Haywvd,WI 54843 715�343435 Fcc 715-9342739 SAWYER COUNTY CERTIFIED SURVEY LocqTE� tN TNE ►�EY� - SEVy SEcTiorJ Zy, Tyi,J- R6u/, Tou�IJ OF (�ovi.+D �AKE , SAu�ER Cov��y , ��SCo�JS/►J. S}+EET I OF2 EYyCnR, se�. z4 1�' cs.n�. sYio 3Y8,�,� qQ'� �ka � �89��i-�sB r9�f.'�6 ��� �se9°il�-is'� � .ro �' �02.00' � N � �� i4B�Y6' J� CR4o Asi495z� �6-00' „W /E I�. � � � �,c 'o �..I17 // A�' �,m ��y If" p M V,� L � �� � � � - LflK� ;,��� NT m � g o ' e rt'�. x = � ti�`�M�.N a W LAn105 � V� N° Lo-� I �� z � /, � m � - � . ��o�,` _ / i I.y6+A� � uLi � sE coR ��I t��,vr w 63725TSF. ,� - m„ sE�zy b i %W �iY,��G o / � 3 ACJr.f.G? 5 �+b o y � ` ��.��SCON''�.. u� � , .t��'. 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I � ,._ ,, , , .. . ��`���;; :.::.:: , : �t ; � . r 6�d�9'T� � �' �� � � ' �� �� ---� _ .��.�.�., ';:,,.� . , ,... ., .... ::: `� � � / � _Rl-ATION �.:.. �,. ... . .• �..�-.-: ., ___ _ __ '� � � :.:;<:% - --- — -_ __ ___ _ ___ _____ _ _ � . _ �: �� ' f �/,.� ��: � �`, �' / 1�_ � �: �I i � t ; " . y ll ', �'�� �! � _ d i ;� � � . . � t� r� ��� � � �. ' � ' � � , �� � VENISON 11 �,� � ' � �� . R �� � . . n'��'� �_ � � - ! ,. �� � � SPRING -� � �� �� , ,. r � � i . . ' �� ' �. �. , - ' . . � � � - � . . � .. .. � .� � �C��/ . � � ���N� � �C� ; � � ' :C���S � 1 � � � ��� � � ���: �� �. . ,�::':::}:�.�:t��r—rf �� � '�� ; � ' �ONE X , .� � �2 �;: �: s.:'�: � I � o � � . ,. . �,.�. .�.�...... .� . . . . ::�. ....f i ::: � � .� �, .. ,' �}� � "- � ,� '.�'� '.. ' � vVf� EZIti✓E�'< � � , ��� . . FAbNN � �_'� ..�1 ..... . , ., fi � ::.. . _ � ..� �� LAKE , �;/�-,f ;��t � �SOC�f?''. � � �r ��� � .�``' �` ./ . ��� ' ,; i �.,Z'._�:!"'•.•}.r. .. .. ! i � _..��. � � � r �'�' . , =— _ � / . .. ........ . . . � i i .•:�;� i .. . � � .:.::.:.:.:.:.. ... � �, i ,,, ;.. _.... _ � � —r . _=' � �----- ..•. -------- - .... � � . I � �._ _ _ " � ' �� �. . _—— --- ------ _. � f .--- ---------- I` ---- -- 1- � i� '�'� ! VENISON �. � � � r , � — ..... . � � �" LAKE .... ._ . . ... .�.•:ia.�: � �� ; SHORELAND PRESERVATION AGREEMENT (Shoreline Ve¢etation Protection Area) Land Use Permit No. _5�/ (To be entered by the Zoning OFfice) Index No. Q y -S(p/ WHEREAS, (list all owners) `� 1 �' -� � - ;�< < , - - - _ _, 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 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) further 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 temunate (f� 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, � injunctive 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 Oissue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer Coimty Zoning Office. , �. r ,� �, � . . , f , , .. . � , � Legal Description of Property: ( ;� � ! �� a,� " � ��, �� t � i _ � , , , -- � � i , ._ � - E � � � :. - Dnated this day of , �YT/YYI D2. � �J�E � � � � �C' � r (70wner) (Owner) (Owner) (Owner) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office � .-r- - � i�'y �' ;`, � : , : � rrt.{ �� , �, �.,�� �u `y: . `,�,a ��. ,-� ;� � '� r 1, ��.. �.:� � , .� ,M : �e ;• r �Y'� - 4 � ', r � y�' .. + ,; ' .;e?� � �. + �i « � ` �1 ��': �a+. � Z\ M�7 * 1 `�'. • i , '.'�`�I '+� ``� ` �,` �,. ,�. �; : . 4 , :-�. , ,, . 1 ; ..s ' ��+�`;�.�, ,, , ...