026-939-21-5303-LUP-2024-011 SUBMITCOMMElEO FYVIICAiION RND
reeTo: APPLICATION FOR LAND USE PERMIT
SawyerCounty SAWYERCOUNTY WI$�O.�I511�{ cN
Zoning 8 Wnservaban Depart. L1 �r '� `' �I�� 1 I I'� '�l.� �-
30630 Main St Surte 09 I i_ �� , u.{e�kmq�U ieYr _ ____��_
HaYward,WI54843 I" ���.'—.�... .- � 1
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iNSTRU(i10N5:Nopermibwillbeissued�ntilallhesarepaid. - �
[Ae�ks are made papble m�$awyer[au�M1yion ng Department ��� �.��, ,�
�''ry`, )\`�h lS�NIJiS;�..�i)1'F
DONOTSIqRTC�NRP Ci�NIINII �vEPM�SHAVEBE:N�SSJEDIEff(�FLIC.ANT OngindlApplica[ionMUSTb¢SUbTIttPd FILLOUTININK�NOPENCIL)
SuCmitta l of iFis apo l�iq�'�on or roceipi of lei�>does not cons�itute permit iss�rance-
Owner(s)Name: Cont�Mor{5�Name
Jar�eo����uUc�- ls•r�.,� �s�>,�
MailingRddress: ,..(pb Mailingqddress:
�z3 �5�' S�{xe 1` WeS+��s N1 a.nes,i� �3 985 �/ �o� � ���
Phane:� I l _ z I 4.'1 I I I v Phone: �j� SS� 7���
� �r-i o
'Ema,�: c*�ere t lac�.@ a�I. c rrn Em„�: Gs�.u��,o.GrF/�G����c•Corv-�
r ' 3� 5ar�a LaK� R�acL �Le 4iKi-, ,
Site aAdress: 5� or Date aD011ed lor:
«N o�N» 6- 3 - 2-1- 5 3 T�,�a: G�a�e..
Permit deliuery MNAod r.Call Owner ��Mail Owne/ �UII Cantroctor �Mail Contractor
xls Proper[y/land wi[hin 300 feet of River,Stream�mn. Distan<e Swcture is irom Shoreli�: is yovr Propercy
`��� � feet in Fioodplain p�e Wetlands
[reekorLantlwardsideafFloodplain? i`yes—con[inue O' i� � Presen�� i
"�Shoreland -
��Is Vroperty/Land within 1000 feet of Lake,7and ar Flowage Distance Structure is from Shoreline: �(Ves Yes
Ifye.continue� leet No VNo
!`
�:.!Non-ShoreWnd
DesMbe Project
Value at 7ime of 7ota1 N oi
Project type Foundatio� What Type&Capacity is the
Wmpletbn House, ara e shed,deck, Number bedrooms
indude Aona�en ( 8 8' of Stories (Basement, post Sewer/Sanitary System(s)
nme&o,acer�ai Addition,etc...) Crawlspace,
Lirtseparately Slab) �onsVu<tion
5 ,/
,�,ORT r/oa5� � S.C-�(� v I
owenin6 --'— ,
S ;c fi"i� �
.-
Rcc Bld�
5�G/Il'✓
ndEkbn/Al�eration
HeigM:
TotalSquare Lowest
Vroposed Use � Proposed Structure Dimensions Footage Gnde to
�multiplyper Highest
story) Peak
Residence ( X �
Ft.
with 2"d story or loft ( X �
Ft.
with Basement ( X �
Ft.
Attached Garage ( X �
esidential lse Ft.
Aecessory5trueture;e.a�a�N ( K 1 �
]Agriculturat w.�.m.es..�.�,�n.e. „ne�.. a��� �Q �� /pjU Ft. �
Use Temporary Guest quarten or Bunkhouse(a.cie rype� ( x 1 Ft.
❑ Commerdal/ � Deck/Porch �atio �,. .. tt =: i.,��_,,,.,;�L � X � �.�;l F[. �
industrial Use ' � ` �
�2^��Oeck/7orch/Patio� `'r✓� �{ � [;S ' % ,
{ .p.n;.� �� R C j Ft.
J Municipal Use
Other�e=niaml ( x �
Ft.
- Other ( X �
Prineipal Strueture(ng.m�e�.ai,[ommerciai,nn„��ciosL e�c1 Ft.
Addition/Alteretion Ie.oi+��l f X ' Ft. .
7otal habitable squarefeet: Total Non-habftable square(eet: _ �C I;
(decks,patios,garages,sheds,storage area&other stmctures) �
Original Application MUST be submi[ted
Attach a via�or Skec<n your Property on 8.5"K 11"or 8.5"z 14"paper:•MusN Include lacation and setback M Oroposed and e�IsUng atructures,roads, �
driveway.sanitary components,well.Iake,firer,stream,and wetlands.
�I o Se[bock Sethadt
' -��0� Measurcments Descripdon Meawrements
Setback irom the Centerline oi Platted Road and/or �i Feet Setback irom the Lake(o�dm„�m�n-wa�er m.rw) � Feet
Setback from the Esta6lished night-of-Way Feet Setback from the River,Stream,Creek Feet
. SetbackfromtheBluff �nappit,e�e Feet
Setback from the North Lot Line Feet
Set6ack trom[he Souffi Lot Line Feet Setback fwm WeNand Feet
Setback from the West Lot Line — Feet Slope within area of construction/dizturbance %Slope
� Setback from the East Lot line J Feet Elevation of Floodplain Feet
I Setback to Septic Tank or Holding Tank Feet Setback to Well Feet
� Set6ack to Orein Field Feet
Sethack to Privy(Porta6le,ComOosting) Feet
, I' t_ . .,..�.i- ,..��ri_.� last�aau�:w^InYive;5lfcct , i n..- � i � ' . ��G �.- �u,rwni. -_ wr,�,�F.esetbackmustbemeasu�edmustbevsCehomone
i �
e.i�. .
. � .i... r o��e'.[� I =v�Ci'l�i r �l ..iun, F iM1. .. . - i �'.r _i .aVvi��.�
Pr�rbt�eplacem_M1o ...nsbuco �a.bu3..-., -orettanha�..514Nt ,�lles�i', �cr.il01(ea�mciM1em- . �. .u �tl=si�ark ....naeryllnelnmw�l�t'�'hz• ._.._.
. .. S.tC 5I'Is�L , �2uc. �)S�r��'1t'J(J'le".OLIirOI.2�0lC.p'.I.�VS vCl'��C�f !..] JC'i(id�l�'�1'[��JPr.iM1TP��Y::' i . �d�0�•2C(PCCOIItp235�i0I1121`.WIICOI���
i.nn 5901ee�N�M1e yioposaa inx r 1ie s�m�W ie,oi inest be mo�4ed Ly a hcensetl»veyo�a�!he ownrr's e+c�nsF.
[alculate impervious surfaces.(Roofed,concrete,paved,and other surfaces that water cannot penetrate.The Zonfng�ce can help you determine it a
wrface is considered impervious)
� Calculate lot area:/�� p 7
Indicate bt size frdm(i�M qr NOVUS(cirde one): �. d � Acres;MWtiply by 43,560=Lot area: � � � /� Square Footage
—� �—
, Calculate impervious surface area:
.L� vy
Determine the total size,in square feet,of your projects listed above(indude eaves): �� 1 � I� sq ft.l 3 1
q( ��CJ
� Determine the total si<e,in square feet,of all existing roofed structures(indude eaves�, � ��n sq ft.�� ) �
�... l�V i
Determine the to[al size,in square feet,of all euisting paved/bricked/blocked surfaces: sq h. '
/� Q "��.`[� l�'J.�
Add these measurements[o determine total impervious surfaces: �I��v sq ft.
l.� p;l �S�
Calculate impervious lot percentage 1',fL� �(, �`
� ?ntal�mpervious surfa;e'. _���"�Z� .s Lot area: �S,( 1 75 Sp ft.X 100=�mpervieus surface � I , 3 %
iMhn.twnurev�!F':+4..�eWcxsftl __
. __
•••Noti<e a separate grading permit needs to be obtained if disturbed area is within the Shoreland district as indiwted on previous page and meets aiteria bebw'"' �
Grading on a siope greater than 20% Gradin of more than 1,000 Sq.R.on 12%-20%slopes
Grading of more than 2,000 Sq.Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft.
n�,WP �n r�inaFir: �-.u�FJ ♦ �. ,.-ItU�icN.: r�i.:U7, IL=vt'��VIRGC�.,i� l'�ITNnILi9
I�we)dedare that thls application(induding any accompanying information)has heen enaminetl by me�us)and to the best of my(our�knowledge and Eelief it is[r�e,wrreR and
complete. 1(we)acknowledge that I(we)am(are)responsible for the de[ail an0 accuracy of all information I(we)am(are�Providing and that it will be relied upon by Sawyer
County in determining wheMer to issue a permit I(we)further accept liability whic�may be a resWt o(Sawyer Counry relying on ihis information I(we)am(are)providing in or
� wi[h thls application.I(we)consent ro cowty offlcials charged wiN administering<ounry ordinances to have access to[he above described pmpetty at any reasonabk time for the
purpose of inspeRio7rt Additionally,Ihe underzigned person�s)hereby give permission for access ro Ihe property for onsite inspection by Municipal Officlals.
Owner .�P-� �. 1��1Q� Owner �✓1� 1�f' I ���.1���. �'�lf- /—�
Signatu� Printed name � Date
i
NOTiCF r,e� . i. _ , � .-roih<<,,:i�r;.
ri .i-
F�.:riheCoro�nic[ion0+ � .��irRTwc� ��6u; ti i �... .. �..,.. 'TcEnton_�rn , .r -G.u:.,'I ,�.oda
IhP�VC2l JWi.$LJ'.�•�1'�al�C'.il i.i . .�iP i..
You are responsible for complying with the requirements of the Sawyer Counting Zonind Ortlinances and law and regulations ot the State of Wisconsin.Vou are alm responsible for
complying wtth State antl Fetleral laws conceming conshoction near or on wetlands,lakes,arM streams Failure ro comply may resWt in removal or modi(cation of construc[ion
thatviolatesthelaworotherpenaltiezorcosts. formoreinformation,visltthedepartmentofnaturalre5ourcesweHan0litlen[ificationwebpageorcontactadepartmentof
naNral resources service center(6061 Z6]-3125
Issuance Information(County Use Only) Sanitary Number: N of 6etlrooms:
Permit DenieA(Date�: Reason for Denial:
Permit A: �i 155uing agent'. Date:
:� � � -;� i � ' � h a
Is Parcel a SubStandard Lot '.i Yes (Deed of Record) Mitigation Flequired �es I!No
Is Parcel in Common Ownership i'Yes �Fused/Contiguous Lat�s�) �''Na Mitigation Attachetl �es I.-.No
15 Structure NamConforming :'�Yes 'No
Granted by Variance(B.O.A.� Gonted by Conditional Use
�-�.Yes '�No Cat!N: :'Yes -�No GS¢N:
Was Parcel Legally Created ..�Yes '."'No Were Property Lines ReDresented by Owner i��,yes No
Was ProDa�d Building Site Delineated i t�Ves :No Was Property Surveyed ',Vn No
OfficeComments: 2oneDistrict: Fee:
9a ��l ! 0 5:� .5'��Gf1�r�� �.Q - � -G � � S
I HvIC ForSanica Ilold For IOa�. ,_ _ _ yi;�i:Por Alf��ca:r,. � Hold Fo�Fees�
ry'
oF�emz� �.l�ff�/ F �n fi 0
� ���
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12/14/23, 10:56 AM Novus-Wisconsin Access rev. 13.1108
Rea) Estate Sawyer County Proper[y Listing PropeKyStatus:Cunent
7oday's Date: 12/14/2023 Created On: 2/6R007 7:55:48 AM
�Description Updated: 2/26/2020 � Ownership UOdated: 2/26/2020
Tax ID: 28790 ]ANENE A POLLACK REVOC TRUST WEST DES MOINES
PIN: 57-026-2-39-09-21-5 OS-003-000030 IA
Legacy PIN: 026939215303
Map[D: :3.3 eilling Address: Mailing Address:
Municipality: (026)TOWN OF SAND LAKE ]ANENE A POLLACK REVOC JANENE A POLLACK REVOC
STR: 521T39N R09W 7RU5T TRUST
Des�rip[ion: PRT GOVT LOT 3 LOT 2 CSM 25/3ll 923 65TH S7 923 65TH ST
#6600 WEST DES MOINES IA 50266 WEST DES MOMES IA 50266
Recorded Acres: 0.810
Lottery Claims: 0 w Site Address 'indicates Private Road
First Dollar: Yes 15832W SAND LAKE RD STONE LAKE 54876
Waterbody: Sand Lake
Zoning: (RRl)Residential/Recreational One J property Assessment Updated: 9/28/20ll
ESN: 423
2023 Assessment Detail
Code Acres Land Imp.
�� TaX Districts Updated 2/6/2007 Gl-RESIDENTIAL 0.610 2D2,100 274,400
1 5[a[e of Wismnsin
57 Sawyer County 2•vear Comparison 2022 2023 Change
026 Town of Sand Lake Land: 202,100 202,100 0,0°/
SR478 Hayward Community S�hool Distric[ Improved: 274,400 274,400 0,0°/
O01100 Technical College 7otal: 476,500 476,500 0.0%
• Recorded Documents Updated: 9/22/2014
� TRUSTEES DEED ����Property History
DateRemrded: 2/25/2020 422690 N�A - �� � �� ������ �
O WARRAN7Y DEED
Date Recorded: 12/7/2018 415709
O WARRANN DEED
Date Recorded: 10/3/2005 333682
O CERTIFIED SURVEY MAP
Date Recorded: 7/20/2004 323414
https:lltas.sawyercountygov.orglAccesslmaster.asp ���
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REGIONAL FLOOD ELEV.
/ � CONTOUR AT 1303.76'
,
-------- - .
r —r I�
--------
'Tj
N86°31'20"E P.L. --- ---� ------—�.1 i --- ♦ , � r
♦ + . �, 0 f /-ORDINARY HIGH WATER MARK
-------------- 271.41' r i
_ ----- -----r � J,, � � ; _+ .' � J ♦ + + ►!' � ♦ � SURVEYED BY L. NELSON PLS 41276
'� ♦ ++ /+ I II l%,� JUNE 6, 2023
N 7s Fr o/s ' i ++ r/+ 35Fr o/S. ' A.,
1 ROM OH - FROM OHWM ♦+� rr ' �� _��TY
r / NOTES:
#
W /
THIS IS NOTA PROPERTYSURVEY.
J f �� ♦tq`� I UNLESS OTHERWISE NOTED, ALLTOPOGRAPHIC FEATURES SHOWN ON
♦r �� THIS MAP WERE SURVEYED BY NWBE, INC. ON OCTOBER 18, 2023.
' f
SCALE, FEET _ ! G r+ ♦t _ -'
0 7.5 15 / - Y - :I r
JANENE A. POLLECK REVOCABLE TRUST ` '� r ► 4-1.7%
LOT 2 VOLCSM #6800 OF U-AVI
51
DOC. #422690
j•.F•Is1 �� J
� - - ,
i
BOATHOUSE LAYOUT POINT TABLE
POINT NO.
Y COORDS
X COORDS
EXISTING GROUND
ELEVATION
DESCRIPTION
1
375537.216
616700.606
1303.88
SW EAVE COR.
2
375548.178
616705.489
1304.22
NW EAVE COR.
3
375544.108
616714.624
1302.79
NE EAVE COR.
4
375533.147
616709.741
1303.S8
SE EAVE COR.
251.67' -----------------------
---
S88"08'16"W -
PROJECT NO: NWBE 2343 1 HWY: 15832W SAND LAKE RD
FILENAME: W:INYVBE_j'ROIECTSiQMNV343_POLLACK-SAN1)[ EKE-5A, VERCOSHORELINEPERMfT1C3D•77\SHEETS\D54201_PN-P0ILECK.DWG
d
FIRE FIT. —�'
I•Ir�IG
COUNTY: SAWYER
PLOT DATE: 12/7/2023 2:47 PM
THE REGIONAL FLOOD ELEVATION (RFE) OF SAND LAKE IS 1303.76.
HORIZONTAL POSITIONS SHOWN ON THIS PLAN ARE WISCONSIN
COORDINATE REFERENCE SYSTEM (WISCRS), SAWYER COUNTY NAD83
(2011), IN U.S. SURVEY FEET. POSITIONS SHOWN ARE GRID COORDINATES,
GRID BEARINGS, AND GRID DISTANCES. GRID DISTANCES ARE THE SAME AS
GROUND DISTANCES. ELEVATIONS ARE REFERENCED TO NAVD 88 (2012).
GPS DERIVED ELEVATIONS ARE BASED ON GEOID 12A.
LEGEND
LOCATION OF SPLIT VIEWING CORRIDOR
IN 35VEGETATIVE SHORELINE BUFFER
SETBACK. 34' ALLOWABLE TOTAL
VIEWING CORRIDOR WIDTH.
12' x 10' BOATHOUSE.
(DIMENSIONS TO EAVE LINE)
REMOVE EXISTING GRAVEL AND
RE -VEGETATE.
BENCHMARK
CONTROL POINT
CONTROL POINT TABLE
POINT NO.
Y COORDS
X COORDS
ELEVATION
DESCRIPTION
400
375462.454
616523.813
1333.18
CP/SPIKE
401
375494.366
616703.126
1302.26
CP /SPIKE
402
375496.321
616705.654
1303.73
BM /SPIKE IN 181N OAK SET BY OTHERS
403
375496.5751
616658.393
1321.58
CP/SHARPIEXONLANDSCAPINGSTONE
PLAN -TOPOGRAPHIC, BOATHOUSE, AND VIEWING CORRIDOR MAP
PLOT BY: G. COLBERT PLOT NAME:
PLOT SCALE: 1 WAS FT
ORIGINAL PLANS PREPARED BY
Am.w.� ,I�
MW T.
00
WORK PERFORMED FOR
JANENEA. POLLACK
PREPARED BY
Surveyor NWBE -B. ZEMBO
Designer NWBE -G. COLBERT, PE
Project Manager NWBE- H. HARRINGTON, PE
SHEET E
WISDOT/CADDS SHEET 44
5
�
Sawyer County Application for Grading �D
1061 G Main St. Suite 49 ��
�
Hayward WI 54843 �
715/634-8288 ;�
Q
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN �-
ISSUED. SIGNATURE OF PROPERTY OWNER IS REQUIRED. o
�
� �
Owner: -✓���Nt ���t�,�. Contractor: �� �� L.4 iC j rt, �
/�� �> `,�, �?
Mailing Address: q� (�""' � Mailin Address:,23�r �.fh�/LlO��1 � �
Sv�G� � ��� / '
Cit , State, Zi : ��(/cyi I�!'s � ;� `v.� Cit , State, Zi : �m-��(.. !�l 5 `��� �
Phone: / �'.�/ - d 6 � Phone: '�f/ S S 5� �� �� �
�
�
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Email:.,T � - ( � Clv , f��1 Email: /L�(��(/� �
Site address: 1�7 � �'Z �`�� 1-�- �- � °c`� $'
6'
Calculate grading area: (Total area disturbed including excavation, fill, grading, �
landscaping, equipment rutting, and/or other areas vegetation will be removed resulting �
in exposed soil) �
i �
Determine width of disturbed site in feet: �4 ft. x depth of disturbed site in feet: /'� ft. �
Total = /O sq. ft. (this is the area calculation) w
Determine Slope of disturbed area: Vertical height in feet Z = Horizontal distance in �
feet�= Slope X 100= % Slope �
(1V/1H= Slope X 100= Percent Slope) �
�
*For any filling or grading of any area which is within 300 feet landward of the ordinary
high water mark (OHVVM) of navigaf�ie wate�s��u v��ich has surfac� drain�ge teward t�e �
water and on which there is either: p
(1) Any filling or grading on slopes of more than 20%. ._
(2) Filling or grading of more than I,000 sq. ft. on slopes of 12% 20%. �
(3) Filling or grading of more than 2,000 sq. ft. on slopes less than 12%. �
(4) A Grading Permit is required for any filling or grading in excess of 10,000 sq. ft
within 1,000' OHWM of navigable lakes, ponds, or flowages OR within 300' of OHWM of
navigable rivers or streams.
Date activity will begin if permit is issued: `�'n'�� � date to be
completed: ���N'"�� �Y
Attach engineering design or complete the following using additional sheets:
1. Describe proposed erosion control installation, construction phases, and finished site grading. N
Include timeline, methods, and materials. (Silt Fence alone is not ample erosion control for c
most sites) �
D
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2. List temporary seed type and rate,permanent seed type and rate,fertilizer type and application rate
(if applied),and mulch type and application rate.
��._. �._���,�h� ,:� � j._� ! � �'.��'�><<( /��:
r
C�, 5 tL�; G�� i<� — � L a����
3. Attach a plot plan of project area including location of any wetland(s)and/or watenvay(s)(indicate
area between grading project and water body to be left undisturbed),location of excavated material,
location of all storm water and erosion control Best Management Practices(BMP's),property lines,
existing drainage,post grading drainage pattern,and north arrow.(Silt Fence alone is not ample
erosion control for most sites)
aosio.,
AMPLEEROSION � COMROIPI.AN
SCONTROLPLAN � � EGENO
coau'.�i�v� �\� a � � ———une-.v
aVv�iH�s � I � —www,ce
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a�,.,�E-�-�-- - �J-— ��,'�`
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eg '', SCALE�".�o'
4. Attach a cross sectional view of project area including the existing and proposed slope of the bank,
water level of any existing waterway,and horizontal and vertical scale.
-. _ '_ � �-�
Initial below
��1J All BMP's and erosion control devises will be inspected weekly and after rainfall of'/'or
greater within 24hr period.
In accordance with the Sawyer County Zoning Ordinance section 4.281(Adverse Effects On
Adjacent Properties).I hereby declare that the construction andlor grading permitted under
this permit will not affect or interfere with neighboring properties drainage patterns.Any change in
drainage patterns which are determined to be detrimental to neighboring properties will be
corrected at the expense of the property owner referenced on this permit.
The undersigned certifies that the listed information and intentions are true and correct,that all work
shall be performed in compliance with the requirements of the Sawyer County Zoning Ordinance
and the la�vs and regulations of the State of Wisconsin.The undersigned person(s)hereby give
permission for access to the property for onsite inspection.
,
%r;�n.C�L �� �l l u(,K.
Ori inal Signature of property owner(or agent with Power of Attorney).
PermitFee: /�" >`a-: -t�f�-�.a �,..�� �t ����. ��
Rev-1/2020
� ..
e . . _ � „ � � � Illl
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�I�IIN
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�f-��R�L.»�NI� �ii�'1��,`�f��t A������1f��i�i [�Tx � ���'�7�T
• 4049689
� 448Z15
� Ovmec's Name(s} as ahawn ori dxed: PAULA CHISSER
���� �` /� — _ REGISTER OF DEEDS
/¢_ yr //�G--/� ��G/S j SAWY�R COUI�ITY, WI
parcc(tdeniifiea�iAn Humber 01/16/2024 11:06 AM
(tzotq;stegaey�o) .Q�,� '�,���/� �. ' �-��� `� RE�ORDING FEE 30.OU
.,�..�..,..,.__,..�..... .
Tht� Agreem�tn! n;___us4 in�fucia 41�� fc�l(axying €�xhibiS�: PAG�s: 4
ExhlDit A:��gal t3e�piian o1 U►e real a�#ais far whlr,� Uiia Agr�emani a�pres ('pmparty') •
ExhJlaft 8: h�GGtiUaation ChecScfr�-pmletrc�m}t3galien praciir.c..ss m�t bfl seler�cl at�rnn �
doaimcni k rocorc7ad.
ExhIb3t C: localJon Mapfsl-sh�'�S ati�catratn Er�alfatt(s)of cactt m�igarnn prac?�(s) •
aatetied and setved by this Agr�ement
Relum lo: Sa�vyer Cozmty�onlnp and I:onaa�rvv�ilan Atipartmea� -
;d:'Iv" u3au�a`i.SuI�rl a:t, t•i��uvattt,NH1 ' ,SdFt�:� � .
� ..
I �(�.Yle.�`1R- .� '► � �C� t�re�y �n4�r intp an AgreemenP for Share�ne Mltigatlon
on (date of�gr�emer� i - '2' Z
for property to�ated at (addre.�ss) � �S � ' �"•�-ti"' � ' c �c'�,p
as destxibed and atiar.hed hereto. '
This agreement, signed by awner p!pmperty �itar,h�, her�by cectlfies 4hal lhs sefec�ri mlUgation practices on said proPerty
will be wmpfeted//cn�Intaine�. Mi�gafion pr�dic�s shail ba s�lec��c� �y�ign�r af �is a�emertt ar�d 'mi�a(ed �rt fo�cawi�9 Ra9�•
The or�mer(s) hereby agrees the property subject tc� t�s Agreeme.�l �h�Il hav� aq �e��cted mi�gation campleted sEx montfis
afle�Land Use PeRn►�is tssc�ed. Tt�e pnaperk� (� �ubje�t to ��,� A�r�:�man¢ in parpetulty, regart!(Pss ef owriershlp
transfer. �
The oKmer(sj furthec agr�es to aflov►r ac�ihorized. r�pr�.sentaGv�s oP Ih� �v�mmental Unit t9 enier onta the owne�r's praperty at
lhe above des�rip�on behv�en tha haur� Af�:0f1/�M �d �:pOPM, M�nd�y thr�,.agh �riday. [SectiAn 9.13(1) PAWERS, Sawyet
Courrty�en�tg 4rdmanr,�j ta dstamiine if��1�.ted m�tiga4lr�n f��amplefg and Chat !t is b�ln� pr�sservecL . .
'vi�iatian cf u'�Mg�eemer:wi� auiizcrize, in araGi�qn taa�er p€n�lU�s �nd r�fi�i r�q�ah�d under t�e Sawyer Courtt}r Zaning
ot�nance, injuncttve r�liet, t�sb�ratlan af said prope�4yr, �ttatlan far Falsifyin� P�rmit AppCcaUons. All parttes ag�ee that this
Agreement shaa be fli eti with the Sawy�r C��rnty �ning � C:or�ervatior� Clep�rtment and rerxarded with �� Saxyer t�aunty
i:E3ic.ii:a 'vi!:.".�ti5.
.
_ pn ana ownar a( aturo ro airnd � �9CKNOVVIe�I7�aM�tdT
Uwn r's Signatur�: ��g� Q� �vw�`
1i'L�VUL � � �i10 C.K-- - C,�tmfy ��: !�i �.�
er's td�me Print):
-� Subse,n'6�d �nd �w�,m ta bsftire ms on thls
�N �iV �c .'� . �0 (.LN C� ��.�Sf e� �.��y o��� � ,�,,, �o ��i
pate: sy (�wwrj��s N�m�): A . K
� ' Z- Z� . 1�okary Put�lic Signature: _ "
(�rafted by: Pcab((G N�tary Name (Prin ): ,
-�c�y Ko zl o w 5 f ` � `
My �ammi:�sian �xpires orc (73 / � �� �
Personal informatinn yau pr�viCe may be used for secondary purpases (PriEraa�y I�-nv, § 1z,[}4 {n (m)J
�P�� <s LAUREN (ANI
o � Commission Number 831007
z °°. '� My Commission Expires
�owP March 29, 2024
That part of Govemment Lot Three (3), Section Twenty-one (21), Township Thirty-
nine (39)North, Range Nine (9) West, more particularly described as Lot Two (2) as
recorded in Volume Twenty-five (25) of Certified Survey Maps, page 317-318,
Survey No. 6800, Document #323414
Mitigation points are required for developing Property owneroptfons to eam mitigation points
property under the following eonditions. inc�ude:
� Impervious surFace coverage is greater Removal of a strvcture within shoreland setback
than 15% but less than 203'�-3 po(nks ❑ ❑ 5100 Ft2-1 Pt.
❑ ZO]. Ft�-250 Ft�-2 P[s.
❑ 2251 Ft�-3 Pts.
o Impervious surface coverage is greater Ins2allation of a rein garden
than 20% but less than 309'r a points ❑ � Treats 0-250 Ft� -1 PL
❑ Treau 251-500 Ft2-2 Pts.
❑ Treats greater than 500 Ft�-3 Pts.
e 5 200 ftZ Lateral F�cpansion of ❑ Passive Restoretion (Naturel Recovery) of a
Nonconforming princlpal structure wikhin compiiant shoreland buffer- 1 point
4he shoreland set-back-2 points ❑ ❑ Reducing width of allowabie view and
access corcidor(s)- Jl poin4 for every 10
foc�f reduCion
a Relocation of Nonconforming principal ❑ increasing depth of an existing compliant
structure within the shoreland setback- shoreland buffer-1 poin4 for every SO feet of
depth
1 point ❑ �
❑ Eliminate shoreline lighting 5 35' from lake
shore- 1 point (Must submit before and after
A Open sided structure requiring at IeasC phocographs)
70% of the half of the shoreland setback [' �i�ng compliant shoreland buffer- 2 points
area that is nearest to 4he water is covered
by a vegetative buffer zo�e as per ❑ Active Restoration (Accelerated Recovery) of a
5.59.692(lv), Stats. 35' shoreland buffer-2 points
;
❑ Sea Wall Removal and Bank Stabilization-2
� E �� ���,� ) � paint� �DNR permits may be requlredJ
❑ Reqlacement of steei sepUc tank- 2 points
(Tank must be instalied before SMA is
recorded)
❑ Instailakion of a Storm water Infiltrati0n
System-3 points
� Increasing Shore(and Setback-1 point for
every i.5 foot increase beyond required.
(maximum of 3 poin4s)
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