030-737-10-5603-LUP-2004-063 * � � �
Application for Land Use Permrt ( Shoreland ) r y ,
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
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 o��-
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Mailing Address Mailing Address � p
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City, State, Zip City, State, Zip
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Daytime Phone Daytime Phone
Additional Information: Zone District:
Lot Dimensions:
Date lot was created: �- 1 LJ� `r<�' Acres:
Is there wetland near the proposed structure? If yes, how far o
Building Land Use Floodplain: ( ) Yes ( )No �
( )New ( ) Filling Chippewa Flowage: ( ) Yes ( ) No �
O Addition O Dredging Driveway access off of a(Check one): �
( ) Alteration ( ) Grading ( ) Private Rd ( ) Town Rd. ?
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy UQ
l � � � N �
Primary Structure Accessory Building Addition o �
( ) Dwelling ( ) Garage-attached/detached ( ) Deck �
( ) Year round ( ) # of car stalls ( ) Porch W
( ) Seasonal ( ) Storage Building ( ) Enclosed �
( ) Frame built on site ( ) Screenhouse ( ) Living room c�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom
( ) Other primary structure ( ) ( ) Relocate/enlarge "
� � ( ) ( ) # ofnew
Additional Information: �
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Type of Construction:
( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete
( ) Other ,�
Construction Cost: Primary Structure $ ,.b �
Accessory Building: $ Addition: $ �
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Deed: Vol ��Pg �� Certified Soil Test# %y -G%`� � � z
CSM: Vol ��'� Pg ����� Lot# 1 � Sanitary Permit# i�- �y9 �'�_��/ "�Q �
� 3s 70 �
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:# `�y-CS�� SP: # CUP: #
Inspection Report: # Change of Zone District:
3�����y
31�35 C��"
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 columa
#1. #2. #3. #4. �
Size �� ? ft. wide ft. wide ft. wide ft. wide �
ft. long ft. long ft. long ft. long
Floor azea sq. fr. sq. fr. sq. fr. sq. ft. a "
Hgt from giade to peak fr. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms
Lake/Pond/Flowa e/River/Stream ame .
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4�
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✓ -i'��+�,. �' _ _ — _
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Fire Number and Name of Road
1. Enter lot dimensions and indicate north by arrow. SignatUre of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction G���i�--�_
Signalure -��
activities. �� %�. � ��'�� ,�
PnnWame ��� � �
3. Also, indlCate tlle IoCatlon and Q1StanCe to t}le well, The above ce�fes that the listed intomiation and intentions are
We and tovec[., ihat all work shall be pedormed in compliance
Sept1C t&i11C and (�731nfleld, Wetland azeas, �ot 11nes, wiM Ne requirements ot Ne Sawyer Counry Zoning Ordinance
and the laws and regulations of the S1ate of Wisconsin, and if
centerline of the road and waterbodies. aa��9 as ow�er�5� ayeot, nas me ver��s5�o� or tne ow�e��s� co
peAortn the work 2quested on Nis application. The above
personsls hereby give permission for access lo the property for
ansile inspection.
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Permit fee: $ �5
Total land area within 300' of the waterbody: (A) /y� `t '� �'
Total impervious surface area [including this project] (B) /c� � �
(B) / (A) x 100 = % Used �-, (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No
April 15 2 004
Issue Date Signature ofIssuin g t
April 15 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
�OW N O � W � IRGC. . .
SEC 10 � WP 37N R7W .
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Waflnar SurvOying Associatas, Inc.
26745 Lakefand Avo. N.
P.O. Box 89
Webster, WI 54893
(713� 866�4295
CERTIFIED SURVEY MAP N0 .
Lanc� ].ocated in Government Lots 6 and 7, Section 10, Township 37 North ,
Range 07 West , Town of Weirgor , County of Sawyer , State of Wisconsin .
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� i"xz4' i.e ser, i.ae �es./Fr. 1 (� 51� , ``'
� I� I.P. SET iOR PREVIOUS C.S.M. ` 1
IDCATICN NAP p-37-07
O SAWYER CA. ALUM. MON. 1 1 LINE TABLE
LINE BEARINO DIST.
SCALE i" = iso' 1 L i N 62° 36� 52�E 45.74� �Rp°�°
L2 N 13° 52 39�W 3000� ��
6.L.6 �
o �s ieo 300' L 3 N 13° 52` 39�W 40.41�
L 4 N 28° 4B� 40 W 99.f6�
CURVE TABLE ax �
CURVE DELTA AAO�US ARC CNORD CHORD BEARINO TANOENT IN TANOENT OUT
C I 14°56�00� 1465.69� 382.01� 380.93� N 21°Z0� 39°W N 13°52� 39"W N28°48�40°W 9r" •'°•
���41wFl�ifv�`1�3 2 �•�O 7`�7 J�1ole�_ .-( PAGE I OF 2
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SHORELAND PRESERVATION AGREEMENT �
(Shoreline VeQetation Protection Area) �
Land Use Permit No. �y-/l�a� (To be entered by the Zoning Office) Index No. �- OG�_
WHEREAS,(list all owners) Brenda Frankenberg
owns real estate within Sawyer County that is subjeot 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,tliat
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
beriveen the hours of 8:00 A.M.and 6:00 P.M. [Section 9.13(1)POVJERS,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 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
PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect.Violation of this Agreement will
authorize, in addition to other penalties and relief required under tbe 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
issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
LegalDescriptionofProperty: That part of Gov't Lot 6 Section 10, Township 37 N,
Range 7 West, also known as Lot 12 of certified survey map recorded in
volume 14, page 286, map n�ber 3570.
Dated this // day of �,,u_(, , o7r��'�
(Owner) (Owner)
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(owner) (owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office