030-737-02-5306-LUP-2004-007 _ _
_ _c, _ _ _ __ _
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Application for Land Use Permit o 0
County of Sawyer �, � �
PO Box 676 -Haywazd WI 54843 �
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agees that all work �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance O
and the laws and regulations of the State of Wisconsin.
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. i
PRINT-USE BLACK INK OR PENCIL O
��� � (2�s '� � � �
����_< <� � �
Owner 2 s �T�L. Builder �
Qf(7�� �
�'
L2i�z�Lz sf �o�.
Mailing Address Mailing Address �
� -�c�_ L F�-f�!`= L�r 5'Y�'6,� �
City,State,Zip City,State,Zip �
=�r
ti�_
f�k- -7 i 5- z ,3 y- �fY z� '`'���cA"
Daytime Phone Daytime Phone o
Ta �
Additional Information: Zone District ��`� � -
-� c `
Lot Size ��. p
;� e
Date lot was created '�/-%/'9/ Acres c��/�� `�' p � ,
Is the property in a Shoreland Dishict?(within 1000'of a lake or pond,within 300'of a river, �y �
creek or stream) If yes,how faz from the shoreline&water name: ,'o T
z � �
Is there wetland near the proposed structure?If yes,ho�v far � _ ,�
Building Land Use �"
�
( )New ( )Filling Floodplain:( )Yes ( )No # �
( )Addition ( )Dredging '� �
( )Alteration ( )Grading Chippewa Flowage: ( )Yes ( )No �
( )Moving On ( ) C o
� � ( ) Driveway:( )State ( )County ( )Town Rd. � "
Primary Structure Accessory Building Addition -� �
( )Dwelling ( )Gazage-attached/detached ( )Deck ''�
( )Year round ( )#of car stalls ( )Porch �
O Seasonal O Storage Building O Enclosed y�
( )Frame built on site ( )Screenhouse ( )Living room , p"
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured �;Other ( )Bedroom �
( )Other primary structure (��711 rr� rYqy�ehhD ( )Relocate/enlarge C \
� � �� � ( )#of new >�
�
m
0
Additional Information:
b
� �
�
Type of Co�struction �
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other � �
Construction Cost:Primary Structure$ � --�
Accessory Building:$ Addition:$ 6 z
'�
Vol '/.� Pg �r7F of Deed Certified Soil Test# I �
CSM Vol�_Pg 3�Lot#�'i�-: Sanitary Permit# ���(��y� i �
P1atEnvelope /� 3yCrl Or: �
Condo Vol Pg Yeaz Installed
Aff of ex septic Vol Pg Owner When Installed:
Gard Gazebo�"ol `3���gg
.�
'�'7�
Previous Variance: LUP: Inspection Date: -�,�\�
;1555
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. �.
Size �` ft. wide ft. wide ft. wide ft. wide
�� ft. long ft. long ft. long ft. long
Floor azea �` sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from gade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
#of bedrooms ,
Lot Line or Lake/River name:
�--�----,
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Fire Number and Name of Road /0�5�'�.I � d" ��' � /��'
1. Fill 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. n
4. Indicate distance to existing sh�uctures, lot lines, septic system.
f ��`"� ������
5. Indicate distance to the ordinary high-water mazk of any lake,
ond, river, stream, creek, and name the body of water. Pn°�Na'"e:
p The above certifes lhat the listed infortna6on and inten6ons are
We and crorrect.Tha above persons/s hereby give permission for
6. Indicate any grading or clearing in excess of the construction site. a�ss�o me P�o�e�ry roro�s�ie m5��eoo.
7. Indicate distance to any wetland. � , � �,��:_ c<<,
Permit Fee: � �`-�� S C-,
<
� ,. ,,. 6�,.zoo'� -
Issue Date Signature of Iss g t
� ,nr•� 63 . Zoo�
Expiration Date
Office Comments:
Inspection Date: 50%Rule Applies: Avg. Setback: Within Reservation boundaries:
Restrictions and other information:
SyIORi�:[.Alv!) lt�:STORATrON/PRI?tiF;RVATYON
AGREEMENT
Naomi Ligocki ,
W1I�IZI�AS, Paul Rus t , Joyce Hes s , Anthonv
and Jean Rust ,' _James and Sherri Neube,r�er
<nvns re�il csl:itc witl�it� Sawycr Cou��ty tltat is subject to the
S�twycr Cout�ty Sli�reland Ke�ulations, �nd WEILRk;AS, in ordcr
io scc�u�c ;i I�and C.1se Permit for a structure witll a .
nonccmformin� sliorcland sctback ur Land Use Pcrn�it issucd for
structures uncicr s,59.G92(Iv), Wisconsin Statutes.
NOW, THEREFn2E, tlic owncr hel•eby a�rees t� prescrve or
providc all S1�orclinc but'1`cr restoration as ru�uircd by thc Szwyer
c���nty L��ricl anil Watcr Goi�secva�ion Dcpartmcnt in order to
rc�torc ucitUo�• m�i�ltzin the real eslate; by _ N/A
'1'he o�vner hercby a�recs that at all tiznes An the future ihc rcai �S_
esta�c suUji:ct to this /lbreerticnt s}�all comply with all shoreland 2eturn to: Sawycr Guunty %on�n,; (�ftice
P. O. 13ox GGS
vc�ct�tivc bufl-cx rcquire�t�e�nts of thc Sawycr Co�inty 'Loning iiayward Wi 5454 i
Urdin�ince in effecl a� the time of sibnin3 of tl�.is document. Thc
c�wner l�urthc:r �►grccs to allow autl�orized represcntativcs o!' thc Tax P:�rc�� �v un►t�er: 0 3 0 - 7 3 7 - 0 2 - 5 3 0 6
G�vcnunent��l Unit to ente�• onto the owncr's property at tl�e
f'ollowin�� dcscriptioz� to inspect the structi�rc(s) �uthorized by L:�n�l t7sc Pcmlit to deterniine if thc shc�rciaiul
vcJctative bl�fter ;is approved by thc Sawycr Cou�aty Irand a»d Water Consetv:�tion 17epartmcn( has bcc��
estat�lish�d, restored, enhanced �1�1c1/�C �li•eserveci. "('his Agrecmcnt shall be considered a R�strictive Covcnant
ul�on thc r�al cs�ctic und il sl�zll ru11 witla the land :.uzd shall bc binditl� upon all fu�urc owncr, hcirs or assi;;ns.
ViolatiOtl O1� (11iS C.OVCi13[1t �vx�� altt(�Prire, in ilc�CI1t10f1 t0 OC�'1et �eriSllleS and relicC TCquiiCd 1111dCK t11C S:iwyer
Coi�nty 'Lo�li��;; Ocdxtaance, i�,junctivc rclicf 1nd restoration of saici rcal cstatc.
Le,<<1Dcscriptionot'Property: Lot 6 , Certified Survey Map vol _ 13 pa�e 394 . ma�
number 3407 , Part of Govt� Lot 3 , Section 2 , Township . 37N , Range 7W
Town of Weirgor , Sawyer County , Wisconsin __ _ __ __
Datcd this. . .. __1-� �t-r d�y of � � �r l.� S_T.__ � vc� "3 -
. ��,Li-/l,G, c: � ' _...... _.... _.
(p��ner) Sherri Dawn Rust-Neuberger �(pwner)
�� l
. . . _ __ __._... _.. _..
(O� ncr) James B . Neube���' (Uwner)
�•f��` :o
o=�-- _.... .._ .
- .
(Uwuer) , ,,.o��'� �• .;;:���' (Owxaer) ,
AC�1NUWl.�D�Ev y� t 1'• S' � . OF ��G,_�ivr?�a¢� COUNTY OF �'�?!`-`� � ss:
�'-'� `��� / � ��+- dzy ol' �-i� G-� ST ^o by
'�'he fore�o�.t�,�'o��e as acknowlcdgcd betore ixae this ..r � ,
. " N'� _ .. _.. _
__.._� ---.._...... , �t��_
' .�C'� '=- --
1'l�is in.r• fi cnr was dr�ftcd by:
5awyci C'c�u��ty %onin� nfficc Notzty 1'ublic
My C'ommission Lxpires; / � 3� - U� _ ,._.___.._....--.--
Z • d BZT6 4EZ STL 1Sft?J �f1FJd di0 � Z0 EO 4T �nd
SIIORF I.ANU 1t�.STORATI��RES� V O
AGREEME1V�Naomi Ligocki,
WLLfiRliNS, Paul R.ust Jovice He�G A�n�
nrl Ta^n R ,�r � �� �ie _
awns nal cstatc wdhin Sawyer ���j��As,in ordcy'
Sawyct C:ouMY Sho�land Kegulatio�s, �� a
to sccur� 1 La� U� p�°'i� f� a �`�"-'t issucd for
nonconComvnB sliocdand s�tba�k or Land Us��'�''�"
sttuMu[cs uakt s.59.692(lv).�N►�a Stnhttes.
NO�✓,THEREFO� Ihc owncr hereby agreGS�o P�rvc or
pmvidc ali sl�orclinc bul7cc r�storation as n�quiral by thc SawY�'
Cuunry I.uad
and Watcr Consecvation L�'�in ocdoc w
r�storc:uullur maintuin the ce�esuue by_. _ N/A _-
that at aII times in the fiu�c,�� Retum m:Sawycr Gwnty 2Af1°5�ce
'ilic o�vnu heceby a�S ent stw���mp�Y with all sho[eland p_O_Dox fiGs
estatc wbjeCt to Uus A� �ing iiaywacd Wi 54843
vcyc�ativc buffiz requirements of the Sawya C�tY .
Urdinance in effect at the timc o�S��°g°f�5 d�°G��of� Tu ruom r� 0 3 0-7 3 7-0�ab-
owner Cunhcr a�m allow autY�riud T�P�"'
Gov�xomcutal Unit w entc onto the owncr's�b����t to deteimine if the shorcland
Collo�ving dcscription to inspect U1e�'cturc(s)auth r��W�����o��partmcnt has bcen
vr.b+ctative Ix�ffa as aPP*o"ed by ihc Sawy�r C�tY t sha11 be coasideied a Restrictivc Covqtsutt
���yo�p�red,'Ch�s A� o all fuwro owncr,hcirs or assi�os.
cshbiish�d>*��• w the land and sh�ll bc bindin�uP°�
upon thc r�l cslatc and it s11all nu► ith �����o�p�u�y��licf rcquirod unda the Sawycr
Violation oC tbis Covcaant�I�'�' on ofsaid real c�tG
C:ounty'LomR4�►'dm��'�n�uncuvc rdicCand t�ad
That part of Govt lot 3 Section 2L .T^^�^�
hin '�7 N.
Lc�a1 Dcscription of Pmp�Y�------'
Ranv� i W T^ ti ^f ('artif__ie�._ ' '
------�_
Weir or Saw 1� - ��o�
�dayof ''
Dat�d Utis
� < �f G',��/ _.._._._-
Naomi�.�ocki ����
�Q�vnCr� _. . ._...
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(Q�VRCf� ' '
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S'���F�'U=„..CO[JN'fY OF /
ACKNO��. _��= - �yofc�vlLu,. ,�1�=-� ,��hY
The fon�4��!'N'%',;"m`�Owlcdgcd before me tl�is 1�
�—t---�,�. � 7'� u. .�( / k-c�'��z�
Thitin�q�+�S�dr.i�pY " No1�rYPublic -.---
tia���0tl�'��,O"`°-'n[r�e - My��issian lacpires 6 J'-�?�_O �
.:4'_.
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.�` �-.�_ ��J`��,�
w��i��r.��"'����
ORATIOIV/PRFSF. V
Sl101il:�•nlvu �GREEMEIVT
A---- Naomi Ligocki ,
Paul Rust , Joyce Hess , A�o�
WLItR1iAS. — S—�:�
s�n�yyet CO ty ���° u�e
owns rral ca-�ats�w�'�K��i��WtIERtiAs,in ordtx
S:twycr County U� p�it for a sw�Te `"`�� �
lo ��� ' �orcLwd sctback or Land Us�Pc.T""t �ss�cd for
nonconCurming ' nSiatutes-
stzuctutcs anJer s.59.692(Lv�\Nisoo�
NnW, TFIEREFO�. ihc owncr hereby ��-S �o Pr'�rvc or
pmvidc all sl�orciioc bulTce r��on as n�quit�l bY thc SawYe�
Cuunty L.and and Watcx Conta'�'�°n �t
in o[de� w
nstore:uuVor maintain the tsal estn�bY-- - N��--'-'
'll�c o�vna herehy a+,�� � at all limes u►the Cut�c,
thc rcal R�m:Sawycc�'°1ty ZomnS 01F'ce
esta�c wbjcct to this A�ment shal� comP1Y with a1l stwreland P.O_Dox�3
v�ccativc Uuffix rocN���a of �hc Sawycx C°u°n' L°"'ng Iiaywacd
of this document-T� �,u p�h�p�: 0 3 0-7 3 7-0 2-5 3 0 6
Urd�nancc in effeci at�e��ofau�� �i��li�a of the
owner (unhc� a� �to the owmx'S ProP�Y at the ne if the shocclanS
GovcauncNal Uait W �ta t the sttucturc(s) au�orized bY L����t to ddecmi cnt Uas b��:n
Collowing dcscrip6on to in�by � Sawy� C�ri � snd Watcr Cunsecvu�on Departm
t �be ���� a Restrictivc Covqrmtt
vcgctative bi�ffa as � �� p�,� �is p�'
cshblishod, *��• with the land and sha11 bc tiutdio��all fuwro owncr,hcirs or assi��ns•
m addihon to Whec P�'�aes atxl rcUcf m9uirod unda thc Sa�vycr
u�on thc[�I cstatc and il sLall nui
Violatiou oC This Covcnan��� ���on ofsud real�G
�.OUR�}//ADItI��aIICC��T��� m c
That part of .Govt lot 3 Section 2 ,. T�� h' D �� N"
Legal Dcscription of Prop�RY=__--�-- y �
Lot 6 of CSM vol 13, a e 394 Town of Weir
Ran e 7 W, __�--
Wisconsin -- a va3
_ a�,of, � .
Datc.d tl�is_ C'______�_— _._..._ -
(pwner) � � � (�n�) � ���/bL� J �`� .__.
� � C�rn� � �� w�� thon � us
{ � ` �
Paul Rust (��� ^�-, �'S ,� ��
(O�Vncr),� '_ ,�� .
�9-
�p�yna) Jean�Rust
(Owner) " J� e M. He s s � _COUNPY�F- � �� � � �����' ss:
ACKNO�V�. _��:SJra1�6 OF-� ��� :L _
.��ny
befoee me this 2��h day of Y�ec c ,r� ��
; n,;knowlcd� -
' --..
The fon�R��"�°""' ,
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