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030-737-25-5208-LUP-2004-262 / Application for Land Use Permit(*Shoreland*) o 0 County of Sawyer ti � � " PO Box 676 -Hayward WI 54843 IV 715/634-8288 � � � *Property that is located wiUun 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 boundazies. '" CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. Q PRINT-USE BLACK INIk OR PENCIL � , ��-r��c►� �- K�T�t�'N �r�t,�7z�. � � Owner Builder � a 94�3 ��sm�N� ��� S�. � �. � Mailing Address Mailing Address � O a��� GRavt, m�l. ��� �' � � City,S�e,Zip City,State,Zip � � ��� ' ) �-/S�� z�a�1 �" -�i Daytime Phone Daytime Phone n� Additional Information: Zone District: R�`�-. � f Lot Dimensions: I 53 x SS3 h rbo �,' � � Date lot was created: � - a�-�� Acres: � •8(p C'' �'� Is there wetland near the proposed structure?If yes,how faz o r Building Land Use Floodplain:O Yes (�No G (Xj New O Filling Chippewa Flowage:O Yes (� No �o O Addition O Dredging Driveway access off of a(Check one): � N ( )Alteration ( )Grading (�j Private Rd ( )Town Rd. � ( )Moving On ( ) ( )County Hwy ( )State Hwy °' � ) � ) � 0 0 N � ln r Primary Structure Accessory Building Addition o 0 (Xf Dwelling ( )Garage-attached/detached ( )Deck � ( )Year round ( )#of car stalls ( )Porch �:, � (?�Seasonal ( )Storage Building ( )Enclosed �, (x)Frar.ie bu:lt o:site O Scree:.house ( 1 Living room � � ( )Modulaz•/manufactured ( )Greenhouse ( )Kitchen �� ( )Mobile/manufactured ( )Other ( )Bedroom p � ( )Other primazy structure ( ) ( )Relocate/enlazge � � � ( ) ( )#of new � (� W R� AdditionalInformation: ;' A � � u, � Type of Construction: � 9� (k)Frame ( )Log ( )Pole/metal ( )Block ( )Concrete D.� U� O ( )Other � .� Construction Cost:Primary Structure$ �'� � . �� .tiy � m Accessory Building:$ Addition:$ � iS� J � Deed:Vol�Pg�(�_ C_ertified Soil Test# Qj�_ � z aT7' 7� °Q 7� CSM:Vol d�! Pg 4 Lot# 1 I Sanit Permit# O / 3 - Plat Envelope D� � a�1��'��' Or. � �7 Condo Vol Pg Yeaz Installed: N �� � "Loads and Flows": Vol Pg Owner When Installed: � � Previous office approvals/actions: � Variance:# LUP:# SP:# CUP:# Inspection Report:# Change of Zone District: �IQIQ"� 3�-�1.�� 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. �-t�iri #3. #4. Size�ft.wide ��ft.wide ft.wide ft.wide �a_ft.long �ft.long ft.long ft.long Floor area ��sq.ft. �I f� sq.ft. sq.ft. sq.ft. Hgt from gade a�� to peak ft.hgt. fr.hgt. ft.hgt. Stories �1 �Z stories stories stories #of bedrooms�_ � Lake/Pond/Flowa e/River/Stream Name C��Pf�C�� ��1�C.�12 /��� � c----- t53� —_ � '1/ � y � � !� 'o � � � �, <-- 63�� h� F-6r'>� � ��;_;�a5�a �,o�' �, i. : /��' 1 v ������ � V ��� �� �� ��a� �, ��, �'�P �, i :� \� 7 � � � �\l / � l.� ��Q i /, --_ /DY/ l I�i/ /� -- '/ �/ ��� Fire Number and Name of Road Db� fl 1�l" K`Ut'.� L/�! �� 1. Enter lot dimensions and indicate north by arrow. ignatur r or Authorized Agent: 2. Indicate the location and size of the requested construction �— Signature activities. PrintName:���K -S R 1�-:,IZE?--. 3. Also,indicate the location and dlstance to the well, The above certifes that the listed information and intentions are We and conect,that all work shall be performed in compliance septic tank and drainfield,wetland azeas,lot lines, wiN ihe requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the Srate of Wisconsin,and if CenteTllne of tlle Toad anCl WateLbodles. acting as ownef(s)agent,has the permission of ihe ovmer(s)to peAortn the work requested on this application. The above persons/s hereby give permission for access to the propeTj for onsite inspection. Permit fee:$ ��O,o c� Total land area within 300'of the waterbody:(A) ySq00 Total impervious surface azea[including this project](B) ;' (B)/(A)x 100=%Used d,, (Shall not exce o 5°/ ith a conditional use permitj.) Shoreline Vegetation Protection Area:Mitigation Requir d?�/Yes No � ���s�� �_��r���� Y� ���M zt3�'+O!� i.c�i A-c F. i' ; �F��'� L��� ,�c.�-,,� I I -�c0� � Issue Da e Signature of Issuing Agent 50%Rule: Average Road Setback: Expiration Date Office Comm�e7 s:�.f1-S,T l�-/D-:;2GU�/. F-4.t� ��L—Q�C 7� �'F) S v�/Q'�� l� ��/!Z�'7 /��d[c:c�-� �� � I .....4�,rLe�.�.. i � ... . . . �� • OJO-737-25 2�01 070-737-25 SSOt ... �i a.oua —�—��—��'� a7.77AC. 1 FOR �\ I 030-737-25 5502 � I � :'�� � � ao.ee�c. � i � G. L. 5 ° � S 2401 „ < ci < 0 1 I 1 I030-737-25 5503 1B.97AC. 1e n �6 ts � 030-737-25 5675 030-737-25 030-737-25 030-737-23 z.ia�c. �04 5604 �� OJO-737-25 2.40AC. �� 030-737-25 5615 2.67AG yJOAC. 2 2.S6AC. 1.93AC. � 3 030-737-25 5814 1.SBAC. _�S �VIM _ 'tl11PPEWA TRL 1ATQfRIRPPIRI�7l1R��ZGCr�'—_� 6 5 4 IO 9 B 7 0 030-737-25 � 030-737-25 m 4.SSAC. �- Q3�-�3�-2J u - O 561� � 5201 ? 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'm Cartified Survey No. (p a 3 S �2 2 `�, ��������� . 18 � .a � ��\ �`������� ,,.:• \ . : . . . . .-. •� •� � ) �� ..•.� ' r , I ,/ � � -----_— " '� .. ZONE X .. . ,:;:�.�:���:',�; .. ..,,..:;;::� .:�:;:. � ��� .����� � ::.; J . :.:.; , ;.:. . �- .. ��:;:.�"�� �� . �::' ZONE A � �� �..�;:.��:3�'.' �.:��:..�. �. .� .�.4. �'�.. . � II �`:�:�:�::�: . �:�:: 23 .'�.:�:''�: '. : � � ':�:� �':�. ' .. ;: :I '� 19 0 I 20 � .'...'.' •Q,.....'.•'. ... 24 �o,:. ' � II : : � _ �� II ��� :�:o:�: :�: •.•' �� O II p ���— .•::::�»� I C� / � --� -- -- � - ° - � ZONE X ,:: .:: I �`` '�<�:.�':�< I I 26 :'.�� II �__�� 25 � � � :` � y 3o ZONE A 29 I �'<� _\�4 . .�. .�..�� ���. �������, ,. �f .��:�: ��:�— . --- ..'.�';��';:�';:'�. 4� .::: — ':'''•'W H I TE:y:�.'•�`•: ,— �:�:BIRCH�:it;i;•:c� 1 � �'' :�:�LAKE.'::;:'�'" ZONE X —_J _� '. ,�--- -- � . �� . .� �:;:.::�- , - 1 ....:...� �'''`';�'•'''�����`����� �_____ .�,}:�:::�:•:•:::... P �::�:� >:»:: ::�;:���::::�:.:.. ��;.'''�' .':':':•'�.'��•':':';''� � 3 0. Geek .�:�'';.: :;;�;':::. Q ^ 'O •` Q � °` � ; 35 � `�� . ::: :� � �36 . � I �`�� .....::�':.•:•.'� ...•::�'��'�I �S,..::.:.:::::. . : o:.:.:;:� . ZONE A � ;;::';�� 31 32 ,•.:• :. • .'.�. . .. ��e. � �•:•`�:•�' — — '�--�:.� �.�� — — -- — I COUNTY BOUNDARY � � SHORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) � Laud Use Permit No.�'y 2(O,� (To be entered by the Zoning Office) Index No. �-�� WHEREAS,(list all owners) _ �Rl-2t L}< S I�t,t E'12C"'YL - KRT-��y h! `��u^�R� �y owns real estate wrthm Sawyer County that is subject to the Sawyer County Shoreland Regulations, and c� 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. �a 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 Govemmental 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 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 OPROTECTION 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 removai of all skuctures 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. Legal Description ofProperty: 5C-� �S�, Sa5'� '7�3"j/�! p��W LDT JJ �Sirl �'� Oa ��{� 70c�n O`� I,J'Qif`mtr/'� cS3��Y �c9Jn�'�V E �tl�4�GYLSi✓1 _ .�-- Dated this (O y of J u NL= �pp�/ (Owner) (Owner) t� (Owner (Owner) � (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office