026-939-26-5406-LUP-2004-236 �
Application for Land Use Permit (*Shoreland*) � '
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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 Cl•,� �
flowage, lake or pond or has any of the above waterbodies located within �,
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
�,/;' ` � PRINT-USE BLACK INK OR PENCIL '
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Owner Builder � �
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Mailing Address Mailing Address � O
t��� �.e�� G��� 5 Y��� ��-,,u� �,,�e � L-v � �Y �1,6 �
City, State, Zip City, State, Zip �
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Da ime Phone Daytime Phone M,
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Additional Information: Zone District: /�-�-1 `x'^
Lot Dimensions: j� r �� � �
��v �
Date lot was created: }" j Acres: _��.3
Is there wetland near the proposed structure? If yes, how far � o � 1
Building Land Use Floodplain: O Yes ( �No � �
�New ( ) Filling Chippewa Flowage: ( ) Yes .Q��) No � �
O Addition O Dredging Driveway access off of a(Check one): �
( ) Alteration ( ) Grading Q�) Private Rd ( ) Town Rd. �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy `�'
� ) � ) � �
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Primary Structure Accessory Building Addition o 0
� Dwelling ( ) Garage-attached/detached (�� Deck �
(jQ Year round ( ) # of car stalls �) Porch W �
� Seasonal ( ) Storage Building (X) Enclosed �
( ) Frame built on site ( ) Screenhouse ( ) Living room �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom p
( ) Other primary structure ( ) ( ) Relocate/enlarge � �
� � ( � O # ofnew �
�
�
AdditionalInformation: � �
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Type of Construction: �� �
( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � �
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( ) Other y
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Construction Cost: Primary Structure $ �p} d� � ,.d
Accessory Building: $ Addition: $ � �
�
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Deed: Vol 7�� Pg 3� Certified Soil Test# N , ( . � z
CSM: Vol � =-- Pg � � `' Lot# Sanitary Permit# c' a � a �` � � �
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Plat Envelope Or: � �
Condo Vol Pg Year Installed: N
� �
"Loads and Flows": Vol Pg Owner When Installed: �
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Previous office approvals/actions: �,
Variance: # LUP:# SP: # CUP: #
Inspection Report: # Change of Zone District: ; i �j
(� 1 �
a�or �
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. ,(�4x� #z. oP��1 :�€��� #3. C^�ci. sznro,-�\ c'�';�.I #4. �Fr
Size 1.� ft. wide E ft. wide 1(, ft. wide � � �8 ft. wide
`-�4 ft. long �a ft. long �`� ft. long ��� �L� ft. long
Floor area I �3'a sq. ft. 3�6 sq. ft. ���1 sq. ft. �OQ ��`� ' sq. ft.
Hgt.from grade �`F to peak � ft. hgt. �a ft. hgt. g � g ` fr. hgt.
Stories � � �Y � stories I stories � � stories
# of bedrooms�_ '
hJ�,� I.-�I«
a e/Pond/Flowa eBiver/Stream ame
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Fire Number and Name of Road �!'�J r�i�¢ �o a � tn /�61 e� c1�+-l e �-a
1. Enter lot dimensions and indicate north by arrow. Signature of Owner or At�thorized Agent:
2. Indicate the location and size of the requested construction e/�",�,t,c�c., �t.�-6Zz�
SignaWre
activities.
Print Name: S�ZS L�L ��1�,ti� �S t���l'4,
3. f�ISO, 1rid1C8Y0 Y.110 IOCBYlOri 1I1C1 d1S1HriC8 t0 t110 W011, The above cedifes that the listed infortnation and intentions are
true and wvect,ihal all work shall be pertortned in compliance
septic tank and drainfield, wetland azeas, lot lines, w�m tne reqo��eme�� or me sawye� co�nry zo�m9 om��a�ce
and the laws and regulations of lhe State of Wisconsin, and if
CenteT'llne Of T.Ile Toad and wate7bodles. acting as ownef�s) agent,has the permission ot the owner(s)to
pedortn Ne work requested on this application. The above
personsls hereby give permission (or access to the properry for
onsite inspection.
Permit fee: $ d 7� �
Totalland area within 300' of the waterbody: (A)
Total impervious surface area [including this project] (B) i 5 �Co
(B)/(A) x 100 = % Used _S ,5�Je (Shall not exceed 15%[ar 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes �No
N/ �� �
June 4, 2004 —
Issue Date Signature ofIssuing Agent
June 4, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments: �N�-�i ��ti'u'�-4� �''�'" a�� ��������
� S- 21- 2Co`i, '�-�R-,�w¢` ..�%, ��� u"�
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Certified Surve No.
SHOREL,AND PRESERVATION AGREEMENT
(Shoreline Veeetation Protection Areal
Land Use Permit No. _��/Z�(o I To be entered by the Zoning Office) Index No. ��-�3�
� WHEREAS, (list all owners) Steve Friendshuh and Mark Friendshuh
�
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d owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
y, WHEREAS, in order to secure a Land Use Permit.
7
+ NOW, THEREFORE, the owner(s) hen�by certifies that, as a condition of issue of said Land Use Permit, that
N the SHORELINE VEGETATION PROTECTION t�REA on said real estate is intact to a minimum depth of
r 3S landwazd from the ordinary high-water mazk of the waterbody.
�
� The owner(s) hereby agrees to comply with the shoreland vegetative protection area requirements of Section
C 4.410 SHORELAND VEGETATION F'ROTECTION AREA, Sawyer County Zoning Ordinance, in effect on
d 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 auttnorized by said Land Use Permit and to determine if the SHORELINE
� VEGETATION PROT'ECTION 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 SHORELINE
� VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION
a PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. Violation of this Agreement will
Oauthorize, 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 remova] of all
structures approved by the issue of said Land Use Pertnit and the revocation of any other uses approved b}� the
issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
LegalDescriptionofProperty: Lot 5 CSM vol 22 pg 227 part of Govt lot 4, _
section 26, t39 N, R9W, Town of Sand Lake, Sawyer County, Wi.
Dated this 2 day of June 2004
►//T'i_..�i�. > �lnw_.t�l4�C=�� —
��� --- -
(Owner) (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sa�ryer County Zoning Ottice