030-737-03-5707-LUP-2004-306 Application for Land Use Permit (*Shoreland*) rt' ,
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 �j, �
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 � �
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City, State, Zip City, State, Zip
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Daytime Phone Daytime Phone
Additional Information: Zone District: I�►2� �
Lot Dimensions:,X�j('J/(J�X�I ��(��,.�r �
Date lot was created: 5' �9-9z Acres: ��3�
Is there wetland near the proposed structure? If yes, how far /1/(� o
Building Land Use Floodplain: ( ) Yes (X)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
� ) � ) � �
Primary Structure Accessory Building Addition o 0
( ) Dwelling � Garage-attache etached ( ) Deck �
( ) Year round (�) # of car stalls ( ) Porch �, J
( ) Seasonal ( ) Storage Building ( ) Enclosed �
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O Frame built on site O Screenhouse O Living room �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom O• �
( ) Other primary structure ( ) ( ) Relocate/enlarge � A
� � ( ) ( ) # ofnew ;
�
AdditionalInformation: '� A
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Type of Construction: `�
� ( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete ��
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--� � Other w�1� �nl` '�v� � 1�4 u�-u Kv���� � `� ,�
� Construction Cost: Primary Structure $ ,..d �
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- c�ces�:;ry�ui�di:.�: i Addi+ion: �
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��- Deed: Vol Pg� Certified Soil Test# ��``-� — � � � � — z
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�_ CSM: Vol�_Pg��_Lot#_�_ Sanitary Permit# .�. �S =���'7 _ ���°G ^
� Plat Envelope �' 35�2 Or: � ` �,
Condo Vol Pg Year Installed: ����� N
"Loads and Flows": Vol Pg Owner When Installed: � �
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I�t;iC�,� ��T,I �ra h k�n���ra "
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Previous office approvals/actions: �
Variance: # LUP:# y5-3��1 SP: # CUP: # �
Inspection Report: # Change of Zone District: ' ' 6�
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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 . • C � #2. #3. #4. '
Size ft. wide ft. wide ft. wide ft. wide
� ;�C� ft. long ft. long ft. long ft. long �
Floor area �Lsq. ft. sq. ft. sq. ft. sq. ft.
Hgk from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms �
Lake/Pond/Flowa e/River/Stream ame
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Fire Number and Name of Road ��� �
l. Enter lot dimensions and indicate north by arrow. Signature of 0 n or Authorized Agent:
2. Indicate the location and size of the requested construction � �
Signa re
activities. � v
Print Name: /.' l i r �� /LJ�J^ ��
3. Also, indicate the location and distance to the well, The above certifies that the listed informati and intentions are
hue and correct., that aii work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin, and if
centerline of the road and waterbodies. acting as owner(s) agent, has the permission of the owner(s) to
perform the work requested on this application. The above
persons/s hereby give permission for access to the property for
onsite inspection.
Permit fee: $ ��(��
Total land area within 300' of the waterbody: (A) _
Totul impervious surface area [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 ( ) No
, �
June 28 , 2004 .���' � � `�'y'
Issue Date Signature of Issuing Agent
June 28 , 2005 50% Rule: Average Road Setback: _
Expiration Date
Office Comments: C or��['uC��01'� gr�a�l.e� �.n �Od -��'e� r , �� '
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i SUBOIVISION ��-178-� �
"` ` " `�`" LOTS 1 THRU 19 030-737 03 5103
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GRAPHIC SCALE
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waprwr 8nnroytnp wssoclates, inc.
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P.O. Sox o9
W�bsbr. WI :i4893
(715)86G�4295
CLIENT: Four Seasons Realty
SOB: B-1875-3-37-07
CER7IFIED SURVEY MAP N0.
Located in Government Lot 7, of Section 3, Township 37 North, Range 07 4dest, Town of
�7eirgor, County of Sawyer, State of tiJisconsin.
� UfdPl_/tiT�l>
I EL. 1185.35
cov'r �.or s S 89�00�00°E 710.00�
GW LQi 7. ISS'♦
..,, � I i GOV'T LOT LINE �
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�Y ��`����`�V��V//y/��� I " �� P�N
�� ' PROPOSED q/W LINE I �88,200 Sry Ft, � ��;�
;� MARK E. ,✓� � ' °—
KRAUSE �" 'L1' U NEANDER LINE--� I�
� $-1P08 _ `�' S 86°08'54��E � �l
- WEBSTER, � / 683.07'
�� WISC. �; / � / � e�. rias.o�' �3 so: su EE
���/� 5-7-92 y0.;. / /; z 168,300 sa.Fr. "gfN
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2 NOTE: ELEVATiON$ BASED ON THE NOTiONAL 6EODETIC
-""�"�'$88���23�E 591.03�•���-M'C' 2� �R�EY BENCNMARK N-147 AY ElEV4TI0N 1237213�.
pp,�, '` y __� N.O.S. B.M. H-147 LOCNTED 300�±N. OF V4 COR.FOR
SECTIONS 3 AND 10.
N V4 COR.SEC.10
RIVER EI,EV.Il74.0�� 4PRIL 14 �1992.
CURVE TGBLE
CURVE DEL7A � R40. 4RC ClI�RD CFpRD BRG. T4NGEMT IN . 7qNGENT OUT
CI IT°01 39' 1418.14' 421.45' 419.90� N 10°22�32 E 1 N IB°S3�21�E N 01°51�43"E
'�G2 8'23'39� 1418.14 20776� I �7.58 N14°41 32"E I•
REFERENCE oEARINO:, � 8°38'OQ 141B.14� 213.68� 213.48 NO6°10 42°E
YNE L1NE FRON TME NI/4 �
lD M.C.24,SEC.10(S)A7 n,�r..�
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NORTH - ' �'+'���d� �
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IAUTION MAY 3-37-07 d w-�'�`���/� _/ �
sca� i"= zoo' r.�� �Iv.�J.� __,�
0 10p' 200' 400� 9TM �
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LEGEN D ��o�WA
O I"x 24' I.P. SE7, I.sB lea./ft. �.� a�ven
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O SAWYER C0. ALUM. MON, �
�_��� ��i� PAGE I OF 2
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