024-741-17-3210-LUP-2004-488 Application for Land Use Permit(*Shoreland*) o . ���
• County of Sawyer �
PO Box 676 -Hayward WI 54843 O
715/634-8288 �
*Properiy 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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m��f���-CAl11L. A�/n11/I/�J�IL �
Owner Builder @:
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Mailing Address Mailing Address � O
.�A[Sr�-,� ,C n�� L!J i �"Y�/l> �
City,State,Zip ���L) City,State,Zip 3
/f- 7i� f�� ��1a J i.�J �.r� ����7�i �
Daytime Phone Daytime Phone
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Additional Information: Zone District: �— �
n
Lot Dimensions:
�
Date lot was created: 12-2/' !9 9f� Acres: /.�(o �
Is there wetland near the proposed structure?If yes,how far o Z
Building Land Use Floodplain:O Yes O No � �
O New O Filling Chippewa Flowage:O Yes O No n e
O Addition O Dredging Driveway access off of a(Check one): � R�
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. �
(�Moving On ( ) ( )County Hwy ( )State Hwy °Q �
� � � � N S
Primazy Structure Accessory Building Addition o °
( )Dwelling ( )Garage-attached/detached ( )Deck �
O Year round O#of car stalls O Porch W
( )Seasonal ¢Q Storage BuildingS ( )Enclosed �,
O Frame built on site O Screenhouse O Living room � �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge �,�
� � ( ) ( )#of new � I rt;
AdditionalInformation: W IA
i �
G! �
Type of Constnxction: W
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete .Z �
( )Other � ,�
Construction Cost:Primary Structure$ ,.tiy �
Accessory Building:$ ' f k�z`�t�` Addition:$ � (�!
-_� � �
Deed:Vol_� 3 Z.'-I�gB = Certified Soil Test# q/—OLS�� �, 'z
CSM:Vol /3 Pg 29y Lot#_� Sanitary Permit# Q�'r'�''�' � �
Plat Envelope �r� °` U
Condo Vol Pg Year Installed: n�
�n �
"Loads and Flows": Vol Pg Owner When Installed: �
0
Previous office approvals/actions: �
Variance:# LUP:# `�Z-�3�' SP:# CUP:# �,
Inspection Report:# Change of Zone District � ,�1
�1�;�
3,;c�3 3
_ 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. STdcgl£ SHL�) #2. ST1c�(f-f yf.� #3. #4. �
Size�fr. wide � ft. wide ft. wide ft. wide i
�ft. long �/ _ft. long fr. long ft. long '
Floor azea�sq. ft. _�sq. ft. sq. ft. sq. ft.
HgL firom gade�to peak 1� ft. hgt. ft. hgt. fr. hgt.
Stories � / stories stories stories
# of bedrooms � T
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road ,v.SD�f �1q�1D nJ /QD H 1�
1. Enter lot dimensions and indicate north by arrow. Signat r nei a ythorized Agent:
2. Indicate the location and size of the requested construction
SignaNre ,
activities. /�.q I
PnntName: 1 'IL'n1T£.��-i-�i��w'. O�� �z
3. Also, indicate the location and distance to the well, The above ceRifes that the listed information and intentions are
We and covecl,ihat all work shall be peAortned in compliance
SeptlC tank and clr3lnflelcl, wetland areas, lOt llnes, wiN ihe requiremenis ot U�e Sawyer County Zoning ordinance
and the laws and regulatlons of the State of Wisconsin, and if
centerline of the road and waterbodies. ac�n9 as ow�er�s�ayeo�,na5 me Perm�ss�o�or me owoe�s�io
peAortn the work requested on this applicallon. The above
personsls hereby give permission for access to me property for
onsRe inspection.
Permit fee: $ ']�
Total land azea within 300' of the waterbody: (A) `/(r,i���'
Total impervious surface azea [including this project) (B) �(:.��
(B) / (A) x 100 = % Used 3„y �7�> (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes ( No
,
September 8 2004 't
Issue Date Signafure of Issuing Agent
September 8, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SHORELAND PRESERVATION AGREEMENT ,
(Shoreline Ve�etation Protection Area)
Land Use Permit Na Qy��J (To be entered by the Zoning Office) Index No. �-�
WHEREAS, (list all owners) Montelle and Carol Dinwiddie
, �
owns real estate within Sawyer County that is subject 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, that
� the SHORELINE VEGETATION PROTECTION AREA on said real estate is intact to a minimum depth of '_
s35' landwazd from the ordinary high-water mark of the waterbody. `'
� The owner s hereb a ees to com 1 with the shoreland ve etative rotection azea re uirements of Section
.r � ) Y S� P Y g P 9
� 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 $
. between the hours of 8:00 A.M. and 6:00 P.M. [Section 9.13(1) POWERS, Sawyer County Zoning Ordinance] '
L! to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE x
VEGETATION PROTECT'ION 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 }
N PROTECT'ION 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 Pernut and the removal of all
�. 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 Permit. All parties agree that this Agreement shall be filed with the Sawyer County
'- Zoning Office.
O LegalDescriptionofProperty: �t 4 of CSM vol 13, page 294 located in the NW� _
SE� Section 33, T 39 N, R 5 W, in the Town of Winter, Sawyer County, WI �
032-539-33-4205
Dated this `- day of�'� , �D �
(Owner%�/��� � - (Owner)
e.
(�r4A ) , ^ (Owner) —
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(Owner) (Owner)
This instrument was drafted by: '
Sawyer County Zooing Office
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