026-939-09-5305-LUP-2004-459 � Application for Land Use Permit(*Shoreland*) o � � �
County of Sawyer � ,
PO Box 676 -Hayward WI 54��:: ,'�,�',-.,,�_i.i.;:`F."i'�`�+-'���� �
715/634-8288 �� I
*Property that is located within 300'of a creek,river ar stream or within 1000'of a �
flowage,lake or pond or has any of the above waterbodies located within
the property's boundazies. �`a
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. T ��y
PRINT—USE BLACK INK OR PENCIL � r
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Owner Buil�c er a
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Mailing Address Mailing Address _ '� �
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City,State,Zip City,�j te,Zip
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Daytime Phone Daytime Phone �
Additional Information: Zone District: ���
Lot Dimensions: I I � X �� �2� � �
k
Date lot was created: Acres: Z�45 a
n �Is there wetland near the proposed structure?If yes,how faz o
Building Land Use Floodplain:( )Yes (.�To � '�
�eW O Filling Chippewa Flowage:O Yes O No c�
)Addition O Dredging Driveway access off of a(Check one): �
( )Alteration �}Grading ( )Private Rd ( )Town Rd. �
O Moving On O O County Hwy O State Hwy o 0
� ) � ) N �
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Primary Structure Accessory Building Addition o 0
( )Dwelling ( )Garage-attached/detached ( )Deck � w
( )Yeaz round ( )#of car stalls ( )Porch �
( )Seasonal (�'Storage Building ( )Enclosed �,
O Frame built on site O Screenhouse O Living room c�
( )Modular/manufactured ( )Greenhouse ( )Kitchen ,•`_',
( )Mobile/manufactured ( )Other ( )Bedroom C �
O Other primary shvcture O O Relocate/enlazge N
� � � � ( )#of new �,
AdditionalInformation: � a
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Type of Construction: �', -�
( )Frame ( )Log �'Pole/metal ( )Block ( )Concrete '
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( )Other �"' �
Construction Cost:Primary Structure$ .ty� �
Accessory Building:$ 3 �a o-o'� Addition:$ � `"�
�4� 8Z5 P9 t4'1 � �
Deed:Vol a 3.� Pg��____ Certified Soil Test# �, z
vo ,�
CSM:Vol Pg Lot# Sanitary Permit# �
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Plat Envelope Or: °`
Condo Vol Pg Year Installed: /�-n� '_� N �
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"Loads and Flows": Vol Pg Owner When Installed: �
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Previous office approvals/actions: ;;1
Vaziance:# LUP:# qg-.�L�� SP�# CUP:# ./
Inspection Report:# Change of Zone District: (��1�bV�'
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�81�IS
' 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. #2. #3. #4. '
Size �o ft. wide ft. wide fr. wide ft. wide
_� ' ft. long ft. long ft. long ft. long
Floor azea �S� v sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade�2�to peak fr. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
#of bedrooms��
s � Lake/Pond/Flowa e/River/Stream Name
` � � 3 � �
,}� �� 77�-
��€y uv � _� �„�,� �,L �y,�. t� �„n��,e�l
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Fire Number and Name of Road (o[.� 7v N ( l-Iv � - �., r� /� 7ow N I��,ad
1. Enter lot dimensions and indicate north by azrow. Sign re 0f Owner �i r¢ed Agent:
2. Indicate the location and size of the requested construction � � l��c : �-- -
Signature
activities.
PnntName: � � •`'< < '�-'Y�""��
3. Also, 1ndlcate the locatlon and dlstance to the well, The above ceNfes that Ne listed information and intentions are
true and correct.,ihat all work shall be performed in compliance
SeptiC t&RIC and dralnf eld, Wetland aze3S, lot llnes, with the requirements ot ihe Sawyer County Zoning ONinance
and Ne laws and reguWtlons of the State of Wisconsin, and if
centerline of the road and waterbodies. ac��s as ow�er�s>ayem,nas me���ssio�or cne ow�ed5)ro
peAortn the work requested on ihis application. The above
personsls he2by gNe permission for aaess to the property for
onsite inspection.
Permit fee: $ .�C�'� ��'`z�-�� �"``���
,�,.,� ��v���`� ��-
Total land azea within 300 of the waterbody: (A)�
Total impervious surface azea [including this project] (B)
(B) /(A) x 100 =%Used (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required?'� Yes O No
September 1, 2004 '
Issue Date Signature ofIssui A e t
September 1, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments: �`bv� ��� �'Q O� �Q� Q�� Y�1,�S �-OCGt�-i on
4�- �e -�x..u� c'oc�.d2 l.oC�x�t o� ��
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f ��oN i � Private Road
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6356N County Highway
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L�'—•n--��� ' Bndge
`T� i. �`� 6544 --_
662IN I �
' ;/ — Railroad
> > ,b�.o� --r— Water less than 15'+-in width
� Y -:. ,; Water greater than 15'+-in width
_ � I ' I, � Island or Marsh features
6S06N
�OYLAN RD � ---- Inset Boundary
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16,,,,, ,6„S 6+��N PLSS Section Line
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__------ Political Township Boundary
6�29N '� 6�4� — • — — County Boundary
6139N
� .--- City and Yllage bounday
b.nN o __---- Lac Courte Oreilles Reserve Boundary
6392N � ti
6383N ���I I
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6317N 6334N �
6317N �!
�� 531pN �� B45G Ma Created• B : SCo. Gov. & PNM
� / e3oeH � i 6320N Dote of Creation: 3 19 2001
Drafter: Todd Goold
I Z ses9N i � Compony: Point North Inc.
I61�OV 16120V $n� e J m� �
-g g a � :� z �� 1 C p r o w i n File Nome: MB 39-9
i6«� ^�"' � Disk: CD 911
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tszzev e �;�,� � '°� ^ � � � � Date of Fieldwork Revisions: 2002
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� � � Page 40
SHORELAND PRESERVATION AGREEMENT '
(Non-Intact Shoreline VeQrtation Protection Area)
Land Use Permit No. — S J (To be entered by the Zoning Office) Index No. O y - S�S9
WHEREAS, (list all owners) William Schraffi
owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
WHEREAS, in order to secure a I,and Use Permit.
�
t� NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Pernut, that
r the SHORELINE VEGETATTON PROT'ECTION AREA on said real estate shall be restored in accordance
3 with the Mitigarion 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 tlus Agreement shall comply
£ with all shoreland vegetative buffer requirements of the Sawyer County Zoning Ordinance in effect on the date
� that the Land Use Pemut is issued by the Zoning Office. The owner(s) fuither agrees to allow authorized
� representatives of the Governmental Unit to enter onto the owner's proper[y at the following description to
inspect the structure(s) or uses authorized by said Land Use Pernut and to determine if the SHORELINE
VEGETATION PROTECTION AREA exists and that it is being preserved. Violation of this Agreement will
� authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance,
injunctive relief, restoradon of said real estate, the revocation of said Land Use Pemut and the removal of al(
� structures approved by the issue of said Land Use Pemut and the revocation of any other uses approved by the
� issue of said Land Use Pemut. All parties agree that 11us Agreement shall be filed with the Sawyer County
�" Zoning Office.
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� I.egal Description of Property: �,2�c- /�'�9 -09- 5 ���
O Part of Gov' t Lot 3 Section 9 , T 39 N, R 9 W
Dated ' 7 August 2004
,
. �
(Owner) (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instiument was drafted by:
Sawyer County Zoning Oftice
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