026-939-11-5111-LUP-1998-385 Application for Land Use Permit r y �---
County of Sawyer � � '
PO Box 668 -Haywazd WI 54843 �
715/634-8288 ���
The undersigned hereby makes application fc.a La;.� Use Permit and aerees that all work �' �
shall be done in compliance with the requirements of the Sawyer Counry Zoning Ordinance ,
and the laws and regulations of the State of Wisconsin. "
PRINT-USE BLACIk INK OR PENCIL �
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JPIJ 1 l\� �/� � �
Owner Builder
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Mailing Address Mailing Address �
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City,Stat ,Zip City,State,Zip
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Daytime Phone Daytime Phone �
Building Land Use ,� ,
( )New ( )Filling Zone District ��i" � "
( )Addition ( )Dredging
O Alteration O Grading Lot Size J
( )Moving On (�)�� � '
( ) ( ) Acres � (�`� ,� � .
�
Primary Structure Accessory Buiiding Addition ; �
( )Dwelling ( )Gazage-attached/detached ( )Deck �
O Year round O#of caz stalls O Porch � o
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room � -
( )Modular/manufactured ( )Greenhouse ( )Kitchen `
( )Mobile/manufachued ( )Other ( )Bedroom
O Other primary structure O O Relocate/enlazge U
( ) ( ) ( )#of new � �
Type of Construction
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete .-
�
(�OYher ! ^
. , ro �_
�
Constrvction Cost$ � " � =
�
-�
Vol '��,;� Pg ���v of Deed Certified Soil Test# � �� �
CSM Vol Pg Sanitary Permit# `
Plat Envelope Or: — z
Condo Vol Pg Yeaz Installed �
Aff of ex septic V P Owner When Installed: � `,
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Application for Land Use Permit — Page 2 .
Describe Constructi��n: List dimensions oF each structure, story, addition, e�r alteralion.
# l ' #2. #3. #4.
Size � Ct. wide Cl. wide (t. wide ft. widc
` � � ft. long ft. long t��. long f[. long
F1oor area sq. ft. sq. ft. sq. ft. sq. ft.
Hgt finm grade "'-� _ �e-� ft. hgt. ft. hgt. ft. hgt.
, . .: ; � ,
Stories � • ` stories stories s[ories
# of bedrooms `1 ,-, ,
rear lot line or waterline of � H1 < �-- `�- �� •. ; � t: ' lake/river
[n the box sketch in: �
Location and size of all
existing and proposed structures. � ,
�' 1
�� J /� (� l I �._
Location of septic system. �_---- J � i , � �- �
' ,.��- ' ' ,
[ndicate distance to : �'1 ' -�����,��� �'.r ;�;�`�'• � � ' �
Waterline �
Road - � - - _ . _ ,
I ,� .� � `
Lot tines 7 � � ____—�
Septic system ; �s w� �. '� , � � � -
. �
Distance between structures. c � 8 ��$ , \
�' c�
[ndicate [Vorth. � ��
N � ..
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Fire [�lumber: �� c� v �' �l _ � \ \`
vIC�CI � F � � I�nfS (f , �
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Signature of Owner
T�e at�ove certifics that the listed
mformation and intenuons are true and
uorrect. The above person/s/ hereby `
g�ve permission for access to d�e , �'
--, . .
prupc:rty for onsite inspcction. ------ - c:entet'line of _� , __ J , . _. _ _road- - - - - -
[ssuc Da�c ____ ____ Ju�__ 23� _ 1998 _ ___ __ Expire Datc _ July_ 23, _1999__ _
- Lil✓ 4/� L>Z%�' __ _
011 ►ce Cc�mmcnts: ----------- -- ----
Signalurc oC7��ning A�lmini�lrator
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Stnte of Wlsconsln APPLICATION/PERMIT FOR RIPRAp pR0 Y
De�nrtmerit o[Nntural Resources 1�� a
, Pursuant to secUon 30.12(3)(A)3,Wis.Stats.Form 3500-91
This form is required under Section 30.12(3),Wis.Slats.Re(usal to prwide this inlormation may resul[in the dismissal of your application.
Pcrsonally idcntifiablc informalion on this(orm will be used Cor no other pur�xxse.
[anduwnda Nnme Projcct C.c�tion
Da�r - " ,���.P r� ��d�, �8�a� ��«E, t��5nts �d
Strcet or Route ��',v���� �`�ke' �`�Z�
��1 ���X �j�9� C-ev . l�r �
1/4, ]/4,S<ction T��_N,R�_ �� ���
c�v,s�a�q zfp c«lc � )c�ry (�)7'mvn O vfuagc o[
k�� �,��r�� vJz ���r���13 ����,. �
c�L� k.c�
Flomc'i�elepiione No. Work Tclephone No. f i¢Number Taz Parcel No. Counly Name of Wa�erway
('�l?�)�L3LI-�IOI�� (�)CS)C� [�-�I�u �0� C)
� I�C 'zb-'F-i Sau���e.�' L�K� (�ouC�e2z�
1 hercFN cenifv tliat the informaiiai mniained hcrcin i�Irve and�cnmle. (am Ihe owner of the riparian pm�;icnv or am Ihe duly authoriud rcpresenlative and
mny slgn Ihi�applinlion on behalCof Ihe owner(s)o(said prvpeny. I have read anJ unJeraland nll o(Ihe conditions of Ihi�pertnil lisled on Ihe reverse eide and
will ennsWrl the atrove mention<d pmject in eomplian<e with alI such mndilione. I undersiand Ihal[ailure lo comply with any or all o(�h<pro�isior.n oC[he
permit rcndcry ihr au�hori�a�iom m�taincd herein null and void and may mcull in a fine and/or imprisonmenl undcr the prnvisions of s.Ul.t:{5),Wia.Sla�s.or
[n�f�hn.�u.._s..Z:Li`, in.i1iu.
Frimed or'iypnf full Name of Applicant Signaiure o(Applicant Dnle eigned
l���v� I�� � CtCo� SPrI - � � � - (�� -ZZ-`��
ATCLNI'IONII YOU NIUS'C CO��IPLY tiVI'I'II TIIE CO� ITIOIYS ON THE BACK OF TTiLS PERMIT
FiNn�rvcs or Fnr,r �
L lhe applicint hne mmplicYl wiih alI prczedunl and leg�l requiremenb of Wiscronsin L w.
�. The propmed pmject will not�nult in a ma�enai obstruction Io navigation,wiil not adverscly a[Cen w�1er quaiity,wi11 no�inem.ee water pollu�ion in
aurfaco waicrs and will not c�use emironmen[al�Ilulion as defineJ in e.]A4Al(3),Wis.Sia�s.,if�he pmjttt is constructed in accorclance with Iliie
pern�il.
7. 7lie Departmenl hae Jclerminnl Ihat the gnnting of thie permit woulJ nol be a major sL�te action aignificantly affecting�h<quality oC Ihe human
cnvironment.
4. �Ihe Depanmenl anJ Ihe applicnnt have complelesl all prcxeJural requiremenls and[he pmject ae pemiiticd will mmpiy wilh.�II applicabie requiremenis
o(Wiemnsin Adminislralivc C«lc and Nismnsin Siatmn.
5. 'ihe pmject will not impact wellanAs.
CONCLiJSIONS OF i,A�V
1. "Ihe Department has aothodty under a.J0.1'.(3),Wis.Slats.,nnd applicable Wisconsin Administrnlive Codet lo issue a permil for ihis project.
2. Thc Dcpnriment haa rnmplicd with s.LII,Wi�.Sta�s.nnd NR 107,Wie.Adm.Cafe
NOTICG OF APPGAI,RIGIITS
If you hclicve Ihat yon have a dghl fo challenge Ihi�decision,you shonld know Ihal Wisconsin Admipislnlive CoJea and Wisconsin Slaluies establish time penodt
wiltiin which rcqucle to�eview Uepnnmenl decininns musl be Gled.
To requcst a mnlesied caxe hearing pnr�uant fo a.227.42,Wis.Slale.,you have 90 Jaya atler Ihe decision ia mailed,or olhenvise servN by fhe Uepartmenl,Io
scrve a pclilion for he�ring on Ihe S<crciary o(Ihe Deparlmenl oC Natural Resourm. 'Iliis nolim is provideJ pur9uanl io e.227.48(2),Wis.SIa1�.
L[AVE IILANK-DFPAR'[MFN'P OF NA7URAL RESOURCE US�ONLY
STA"IE Of WISCONSIN-DEPAKTAILNT OF NA�IUR�C.RESOURCES
For the Secretary
I�sucJ�y �'V��""�( �� Dn�e Signcd �✓ Z"F"-_CG"/
ii�lf' __�11.4�.� �.�1'I.tk_L1Go ���'(��F7;c�pJ-�'
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PF:RMCP CONDITIONS: RIPRAP PERRIIT
f'AGE 2
�— LEAVE BLANK - FOFi DEPARTMENT OF NATUfU1L RESOURCE USE ONLY �
7. Your acceptlnq thls permlt and beqlnnlnq to construct the prolect means that vou have read, understand
and aqree to follow all conditlons of lhis permlL
2 A photograph of the completed proJect shall be submiried ro the Department within 10 days of pro�ect-complalion.
3. You are hereby authorized to place c!ean fleldsione or quarry stone 6 to 24 Inches in diameter along � Ilneal
feet of Ihe shoreline. The stone may extend up lo .Z teel waterward as measured from the exlsling bank. Tha
stona shall follow the na�ural contour of�he shorellne and shall not be placed hlgher Ihan � Inches above the
ordinary hlgh watermark. The flnal rlprap slope shail not exceed 2 feet horizontal Io t toot vertical.
4. All grading and exr,avation mus� be confined to the minimum area necessary for construction and shall not exceed ihe
maximum area allowed by ihe local shoreland zoning ordinance or 10,C40 =quare fsot, whichever is less.
5. The use ot filter cloth, or a filter layer, under the riprap Is recommended to extend the life of Ihe structure and to Improve
efiectiveness.
6. The project shall be constructed in a manner that prevents upland soil Iosses and sedimentatlon ot the waterway. Temporary
erosion control measures such as mWch, silt fence, and/or straw bales shall be used as needed and shall be put in place
prior to any pracipitation or if work ceases for longer ihan 24 conseculive hours. Any upland areas disturbed during
construction shall be properly stabillzed Immedlately following project completlon by seeding and mulching.
7. The removal o(irees, shrubs, and other shoreline vegetallon shall be kept to a minimum and any vegetatlon removal above
the ordinary high watermark of the waterway must comply with the shore cover removal requirements of the tocal counry
zoning ordlnance.
8. No waterward extension ot ihe upland property is permitted othar than what Is reasonably necessary for the placement ot
rlprap to stabilize and protect tha exlsting bank. No lill matenal may be placed in a wetland or below ihe ordinary high
watermark of eny surface water.
9. Thls permit Is nol valid unless you have ob�alned all requlred approvals from other LOCAL, STATE and FEDERAL
�urisdictlons.
10. Thls permit explres on November 1 of the calendar year followlnq the date of Issuance. No construdlen
may take placa aftor Ihat date unless you o6tain a written extension ot ihis permit from lhe Department before ihe date the
permit explres.
11. You must keep a copy of this permit at the proJect site at all times unlil lhe project is completed.
12. You must allow Department employses access lo the project site ro make inspedions at any Ilma to determine whelher the
work Is In compllance with this permit and any other legal requiremenls.
13. If necessary, the Department may:
a. Amend Ihls permi� by changing or adding conditlons to ensure ihat Ihe project is In compllance with all applicable
legal raqulrements.
b. Revoke Ihls permit to protect the publlc Interest or prevent matedal Impairmen� ot navlga0on.
14. You must malntain Ihe rlprap In good conditlon.
15. Other condiGons� �¢.���c`� So� �S �.('e w p�.fiJeQ,�, /' t�" �G-� C� � 1
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Copl��af thb �
permit�enl lo: Comervellon Warden h.^.,� ✓�-f .�.o�G.� C'S — h�� 1'�^�' �'^ � � a "� �
County 2onlnp Adminbtratar S ` —U
U.S. Army Corps of Enpineen 5'�"�
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; DOCUNtENT No. STATE BAR OF WISCONSIN FORM 6 - 1882 TH15 SPAGE RESERVEU FUH HGCUNDIN�. UAIA
; PERSONAL REPRESENTATIVE'S DEED ;
' � :�. 4 � 0 � I
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t1eq10IJrtl l�tl1(,c ( . !� I
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_DAVID__JACOBSEN____________________., as Personal Representative of the estate of Qi k�" .�,,, .,,, , •,.�� _ ��0 3 �
.__EVALD_AAGE._JACOBSEN-------------------•--------------------------------------------------- �. `Zs� -�e--- '
, _�. .__ �__..._.._— �
----._ R�i
•------•-------------------•--------•----•---------------•--•---------•---------------------•------------•- ;
------------------------------------ ----------------------------------------•-----•------ ���Decedent"),
for a valuable coneideration conveys, without warranty, to ______________________________ ��
DAVID A. JACOBSEN '
�---------------------------------------------------------•- -
----------
-----------------------•----•-----------------------------•-----------------------•-•-----------� Grantee� RETURN To '
the following deacribed real estate in __...___Sawy_er____________________________County, I '
State of Wisconain (hereinafter called the "Property") : �
— — —= I
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.� Tas Parcel No: ..------•--------------------- ,
� A part of Government Lot One (1 ) , Section Eleven ( 11 ) , Township Thirty-nine (39) '
i North , Range Nine (9) West , specifically described as follows : Beginning at the
I ! intersection of the North and South quarter line of said Section 11 with the shore �
I � line of Lac Court Oreilles ; thence along said shore line in a Northwesterly direction
' ' a distance of approximately 2167 feet to an iron pipe on the shore of Lac Court
IIOreilles , the point of beginning ; thence in a Southwesterly direction at nearly right
angles to said shore line , and on a line parallel with the Southeasterly boundary
i line of a parcel of land conveyed by Mae S . Fisher and J .F . Fisher , her husband to
Charles M. Rudolph and Stella Rudolph , his wife , as �oint tenants by Warranty Deed
datd July 31 , 1939 and recorded August 17 , 1939 , in the office of the Register of
� Deeds , Sawyer County , Wis . , in Vol 67 of Deeds , page 424 , approximately 404 feet to
� the center line of said public highway known as Victory Heights Road ; thence along
the center line of said public highway a distance of approximately 70 feet ; thence at
nearly right angles and parallel with the Southeasterly boundary line of the parcel
� described in Vol . 67 of Deeds , page 424 above mentioned , a distance of approximately
404 feet to an iron pipe on the shore of Lac Court Oreilles ; thence in a South-
easterly direction along the shore of Lac Court Oreilles to the point of beginning • ;
This deed is given to correct the description in a document recorded June 30 , 1989 , �
in Vol . 435 of Records on page 320 , in the office of the Register of Deeds for Sawyer
County Wisconsin. ' '�
� ��
I I
Personal Bepresentative by this deed does convey to Grantee all of the estate and interest in the Property which �
the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the
Personal ftepresentative has since acquired. 8 9 �
d�
July
Dated this - day of ----•--•-----
•---------•-•---�-------------•------------- • ----•----------------------------------------------- - � �
._ 19----•---• II i
r�E �� i
,k � � �,
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.='^'�'�•---••----•----• (3EAL)
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------•-•------------------------------•-
---•--
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� . DAVID_JACOBSEN---------•-------•------------------
---•----- ------•---------------------------- _
. . • Pereonal RepresentatIve
'�" Pereonal Aepreeentative
�
AIITHENTICATION ACBNOWLED (� MENT
Signature(s) --------------------•--------------------•--------------•---
STATE OF WISCONSIN I,
sa.
----------------••-•---------------•----------------------------•--------------- •------Sawyer-----•-------------County. I
: 7��
suthenticated thia _____.__day of___________________________ 19____._ Personally came before me this .____._...._____day of
-------------x -••------------' ----89----------------•------------ il ,
Jul ------------
---•-------•-------•-----•---------------------------------------•-------------• -----David Jacobsen
- - --••----------------------- 19----•--- the a ove nam � ,
�, --------•-----•------•--...__. .
I '
•--•---- ------•-•----•---•--•----••----•----------------------------•----••- .. -
TITLE : MEMBEft STATE BAR OF WISCONSIN _____________________ _____ ________________________________ __
,
� `,����� u�:�� . ---....._
------•--•---�•------ - --- 11 --•-• -• -•--•-----
(If not- ------------•---•-•----- � ' �'
- --- - -- - ----------------------- � - - � ,:._ -��-- _;----=�
authorized by § 706.06, Wis. Stats.) ta e kn e tha� ��,i�`oi�,,,....._,=r='cl' ecuted the ,
I �re � 'a � xo'kn �me.
/ � �•
I THIS INSTRUMENT WAS DRAFTED BY ;� Y .__. _
-- -�-- -�-- - •------------. . ....--•-
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.__ arman._I._._. � "
H x�3CJse_�--------------------------------------------- afik 1 __`_ z fK /
� Dl man--- -=-----•--- � -------• -
I ._--=-_----------- �a �� � ,.
Attorney at Law Notary Public � '
-----------------••--------- -•--•%--- �•+-• ---;� - ----,,�ounty, Wis.
--•---•------- ------------•--••----•--------------- • . � I
My Commissi is � ngAt (If�,no�,�Clatgte expiration
' (Signatures may be authenticated or acknowledged. Both ___ '�� �`�' �` _. � 19__.__._..)
� are not necessary.) � j��-- -------- ---._.�'t�� _�f.�ISS��`,t�`-• I
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� ���" Q � ° _ . :- _--- = _-_ � I
I •Namee of Dereons si¢mng in any capac�tY should be tyPed or printed below their aignnturcy.
S'fATls ISAR OF WISCONSIN Wiaconain I.e¢al Blenk Co. lnc.
111ilwuukcc. Wia.
pL�RSONAI. REPRE9ENTATIVF.�s nr:�n
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