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Application for Land Use Permit (*Shoreland*) r ,�
County of Saw��er ° � , �
PO Box 676 - Hayward V�I 54843 `"
715/634-8288
*Property that is located within 300' of a creek, river or stream or within 1000' oi.'a �
flowage, lake or pond or has any of the above waterbodies located within
the property's boundaries. R'
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL
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Owner Buildf;r a�.
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Mailing Address Mailir�g Address � p
Co/(%f t� r��/7" �J� .����b � �
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City, State, Zip City, ,State, Zip �`
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Daytime Phone Daytirne Phone �
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Additional Information: Zone District: R R`l� �
Lot D:imensions: ( �� ' Z '� Z1� �C Z<G�'� �
Date lot was created: D - z 3 " Z ��° Acres;: � � 7 �
Is there wetland near the proposed structure? If yes, how far 7 7� o ��
Building Land Use Floodplain: O Yes QG�No � a
�.'�New ( ) Filling Chippewa Flowage: ( ) Yes Q� No � � �
,
O Addition O Dredging Driveway access off of a (Check one): � �
O Alteration � Grading O Private Rd �� Town Rd. o �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy ��" �
O O N � °
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Primary Structure Accessory Building Addition o 0
(� Dwelling ( ) Garage-attached/detached ( ) Deck Q �
( ) Year round ( ) # of car stalls ( ) Porch q� �;,
��J Seasonal ( ) Storage Building ( ) Enclosed � �
(� Frame built on site ( ) Screenhouse ( ) Living room ^ c�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � � �
( ) Mobile/manufactured ( ) Other ( ) Bedroom o 0
( ) Other primary structure ( ) ( ) Relocate/enlarge �' "
( ) ( ) ( ) # ofnew ' � �
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AdditionalInformation: � J �
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Type of Construction: W y
� Frame ( ) Log ( ) Pole/metal ( ) Block �.Concrete d o N
( ) Other ,�
Construction Cost: Primary Structure $ � -% vo o � �
Accessory Building: $ Acidition: $ � C�
s o8 3 z� `� .�
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Deed: Vcl 838 Pg 4Lz- Certified Soil Test#_ �✓ �` _,___ ^ �-,-
�a_ g�� � Y °° 7�
CSM: Vol P t Lot# Sanitar Permit# O 3—�S g �
Plat Envelope
Or: -Z�S�IIt�. �
Year Installed: N �
Condo Vol Pg �
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"Loads and Flows": Vol Pg Ownei•When Installed: � ,�
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Previous office approvals/actions: j�
Variance: # LUP:# SP: ;� CUP: #
Inspection Report: # Change of Zone District: I q D�
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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. '
#l. f`'i/= I N #2. y/°p�r #3. #4. �
Size z�ft. wide �ft. wide ft. wide ft. wide
7--(P ft. long Z� ft. long ft. long ft. long
Floor area �,Zy sq. ft. ( z�/ sq. ft. sq. ft. sq. ft.
Hgt.from grade z �� to peak Z o ft. hgt. ft. hgt. ft. hgt. ,
Stories Z �_stories stories stories
;
� of bedrooms Z �
1 Z`l8 Lake/Pond/Flowa e/River/Stream (Name)
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Fire Number and Name of Road ��t P l�/� �'/'S L Al,lf�-- ��n c��n�,�r� �p�j;-� ���
1. Enter lot dimensions and indicate north by arrow. Signature of C)wner or Authorized Agent:
2. Indicate the location and size of the requested construction ��...-�' �«�>r�e,
Signature
activities. ,�/
Print Name: A`��/�'+'�>'�'!�h
3. Also, indicate the location and distance to the well, The above certifies th�at the listed information and intentions are
true and correct., that all 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 requlations of the State of Wisconsin, and if
centerline of the road and waterbodies. a�t��9 as ow�er�s>a��e�t, has the permission of the owner(s)to
perform the work re�quested on this application. The above
persons/s hereby give� permission for access to the property for
D
onsite inspection.
Permit fee: $ zDD
Total land area within 300' of the waterbody: (A)_�'L8�y
Tota► iinpe:vious surfuce ar�a [includina t?�is project] (B) i38lp _
(B)/(A) x 100 = % Used 3% (Shall not exceed 15%[or 25% wit�i a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Requ�ired? �) Yes O I�To
Zoo� G�G���,�
Issue ate Signature of Issuing Agent
�.1 3 �, a4�� 50% Rule: Average Road Setback:
Expirat on Date
Office Comments:
Page 1 of 1
Real Estate Properry �isting Current Year �
Real estate�ecord updated on 1/3/Z004.
Property Description Billing Address
57-018-2-37-08-21-4 02-000- PAUL J&JODI L NEUMAN
PIN' 000030 9230 JERGEN COURT SOUTH
Legacy PIN: 018837214203 COTTAGE GROVE MN 55016
Record ID: 19886 Ownership (lastupdated:Z/6/Z0077.•59:10AM)
Map ID: .14.3
Municipality: (018)TOWN OF MEfEOR PAUL J&]ODI L NEUMAN
COTTAGE
Public Land SECTION 21 T37N R8W 9230 JERGEN COURT SOUTH GROVE MN
Survey: 55016
Quarter: SE
Quarter- NW
Quarter/Tract: Current Assessment Valuations (/ast updated.•Z/6/2007
Plat/Entity Name: 7.�58:Z8AM)
Description: PRT NESW&PRT NWSE LOT 3 CSM
22/127#6170 Assessment Type Acres Land Improve Total
G1 -RESIDENTIAL 1.170 55,800 0 55,800
Recorded Acres: 1.170
Calculated Acres: 0.000 Totals: 1.170 55,800 0 55,800
LotteryCredit � Districts (lastupdated:2/6/20077.•57.•IOAMJ
Gaims:
Waterbody(s): Deer Lake(08-37-08) District Name Type Code
Zoning: (RR2) Residential/Recreational Two State of Wisconsin STATE 1
Sawyer County COUNTY 57
Town of Meteor MUNICIPALITY 018
Documents Birchwood School District SCHOOL 0441
Doc#:308321 /Vol- Technical College TECH 17
WARRANTY DEED page:WD838/422
Parent Property(s) Child Property(s)
(where the p�operty came (p�operties this property
��� U( '�r r�� fiom) created)
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http://sawyerfs6/System/REAL_PROPERTY/listing.asp?pid=19886 6/4/2008
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CERTI � IED SURVEY MAP
PART OF THE NW ! /4 OF THE SE Il4 AND PART OF THE NE I /4
OF THE SW ! /4 OF SECTION 21 - T37N - R8W - TOWN OF
METEOR - SAWYER COUNTY - WISCONSlN .
CURVE �ELTA AlJGI.E RAD 1 US ARC TANGE1+17 CHORD CHORD BEAR 1 NG
C i 27'03'S4' S31 .5fl" 25t . 11 ' 127.94' 248.78' N 13•53' I6'E
C 2 !4'41 'S5' S31 .59' I36.37' 68.56' 136.�0' N 20•04' i5'E
C 3 t2'21 'S9" 531 .5fl' ] I4.74' S7.59' 114.51 ' N 06•32' 18"E
LEGEND � I 1 . �%
• 3/4' X 30' 1RON BAR SET I ' I O�%
(WT. I .50 LBS. PER FT. ) � a�
0 3/4' I RON BAR FOUND. � �I 3 ��� OF_.EX 1 ST t NG��'
290.�� N
� MONilM�ENT FOUNDR COl1NTY � _ K 82•45' 18�� �'� ^
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/ a `� 'c�; ,�, R 1 CHARD A. STOWE DATE
� � 1 REOISTERED LAND SllRVEYOR
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WISGONS2N REG. NO. S-1775
/ �q 5��6Q SCALE - I " - I00'
/ � �2 � � O 50 100 200
'u '�• � l��� L I AfE BEAR E NG D I STANCE
�$ •� � Q L I N 00'21 ' 19'E 27.23'
�N L 2 !�f 6I'3S' 17'W 84. 1 O'
�N L 3 TJ 27'25' 12"E 44.03'
z SOUTH LIt1E OF SECTION 2i
S 89•06'39'W 2S72.o8' .. -. —�
�" WITNESS TO S 1/4
SW CORNE£t OF SEC. 2i SHEET I OF 2 CORNER OF SECTION 21
c�a sunre�►No. Cv 1 '�o �z 7
SHORELAND PRESERVATION AGREEMENT �
(Non-Intact Shoreline Ve�etation Protection Area) .
Land Use Permit No. _�-z2�f (To be entered by the Zoning Office) Index No. Q� -ZZ
WHEREAS, (list all owners) �� / t f Q�1 �e t,�rt?q H
�
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 shall be restored in accordance
with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
The owner(s)hereby agrees that at all times in the future,the real estate subject to this Agreement shall comply
with all shoreland vegetative buffer requirements of the Sawyer County Zoning Ordinance in effect on the date
that the Land Use Pernut 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 to
inspect the structure(s) or uses authorized by said Land Use Permit and to deternune if the SHORELINE
VEGETATION PROTECTION AREA exists and that it is being preserved. 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 removal of all
structures 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 Descnption of Property: OQr� 4� �?� �VI� �� � �► i' S � � d
� � e�' �� " ' a-�` l�iY SW f y d� SPc%�on �- 1 — �'3�1V
� ��' �' fn/ - d r� ��']�7-�D/'-. �,q r,,�►�/��^ ����j,� .,. i s c o n s i�r
� Dated this -Z�' o g day of ,
o� , �� �.�:��y��i � ---1
� (Owner) ( er)
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C� (Owner) (Owner)
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� (Owner) (Owner)
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This instrument was drafted by:
Sawyer County Zoning Office
Neuman-Deer Lake-SVPA Intact 6-4-2008 '
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