HomeMy WebLinkAbout022-739-09-5404-LUP-2008-257 /
Application for Land Use Permit (*Shoreland*) o o X
County of Saw��er � �
PO Box 676 - Hayward V�I 54843
715/634-8288 �
*Property that is Iocated within 300' of a creek, river or stream or within 1000' oi.'a D
flowage, lake or pond or has any of the above waterbodies located within �
the property's boundaries. � , 1
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE(ZUIRED PERMITS HAVE BEEN ISSUED. �
PRINT-USE BLACK INK OR PENCIL
4,. ��94 y �2 :Na�+q��s,-
d6er4' c�. /I��ra�ssT � vbe,-tir �s l�Qt'i4�% S� �
' Builder �'- �
Owner
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Mailing Address Mailir�g Address � O �
�ac� �I.a«c f,J.� 5U7Q 3 �a� �l4�r-e . ��. S�l 703 �
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City, State, Zip City, ,�tate, Zip
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Daytime Phone Daytirne Phone �f
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Additional Information: Zone District: � � � �
�,o x3�t0 x��x3� Z7
Lot D:imensions: QS.5 X �b 2, x�aa r 3
�ec� �AQ�ti��
Date lot was created: ) :Z, I 5�Q'2• Acres:: .,�G� #- �51� = /'e :Z-'�_ �
Is there wetland near the proposed structure? If yes, how far /�/Q o �
Building Land Use Floodplain: O Yes (�O No � �
(jO New O Filling Chippewa Flowage: O Yes (j� N�� �
O Addition O Dredging Driveway access off of a(Check one): J � I
( ) Alteration ( ) Grading ( ) Private Rd (�j Town Rd. ' �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � °G
� ) � ) N t`� �
1� �, r"
Primary Structure Accessory Building Addition � o 0
( ) Dwelling (� Garage-attached/detached ( ) Deck „o �
( ) Year round (i�# of car stalls ( ) Porch o �., '
( ) Seasonal ( ) Storage Building ( ) Enclosed `� �
O Frame built on site O Screenhouse O Living room � c�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � �
( ) Mobile/manufactured ( ) Other ( ) Bedroom (r� � p .-
( ) Other primary structure ( ) ( ) Relocate/enlarge o N � �
� � ( ) ( ) # ofnew � � �
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o ��
Additional Information: '� „v''a-0 A
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Type of Construction: d � � �
(X) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � �
( ) Other l�^� ,-3
Construction Cost: Primary Structure $ A �
o�o � �3
�
Accessory Building: $ �B,�dQa Ac�dition: � N/i4 ,�
07�o �
Deed: Vol yQ4 Pg /�(p Certified Soil Test# 5f�Sa3 " ����� � z
CSM: Vol Pg Lot# Sanitary Permit# �O 3 Q ► " L u re�T °° 7�
Or: ~
Plat Envelope O1 �J
Condo Vol Pg Year Installed: � �7� N
�, �
"Loads and Flows": Vol Pg Ownei• When Installed: �
�'2�o i�R��,1 e l ( `:
Previous office approvals/actions: '�
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Variance: # LUP:# SP: ;� CUP: # . , , n
Inspection Report: # Change of Zone l�istrict:
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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. ^Qf-a #2. #3. #4. .
Size�,(e ft. wide ft. wide ft. wide ft. wide ,
�_ft. long ft. long ft. long ft. long _
Floor area 7� sq. ft. sq. ft. sq. ft. sq. ft.
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Hgt.from grade�_to peak ft. hgt. ft. hgt. ft. hgt.
Stories ` STor�je �'�X�`� stories stories stories
# of bedrooms �//s t
Lake/Pond/Flo�v� e/River/Stream (Name) ���c:.6err �.A���
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Fire Number and Name of Road (� '7�� ��/ a 2 E e K� L/�
1. Enter lot dimensions and indicate north by arrow. Si nature of C)wn r Authorized Agent:
2. Indicate the location and size of the requested construction .� l tt�
Signat
activities.
Print Name:Rvb 2r�" } Pg �� a,r��5�
3. Also, indicate the location and distance to the well, The above certifies th�at the listed infor ation and mtentions 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�ie�c,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.
a-L3
Permit fee: $ ��� �
Total land area within 300' of the waterbody: (A) ��t��
Total impervious surface area [including this project] (B) ,C � �r�
(B) /(A) x 100 =%Used �0� (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Requ�ired? O Yes �No
z 2��$ c _
Issue Date Signature of Issu g A nt
.�,,�, 1 Z , Z�9 50% Rule: Average Road Setback:
Expiration D te
Office Comments:
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SI�ORELAND PRFS�RVATION AGREFMENT
(Non-Intact Shoreline Veeetation Protection Arca)
Land Use Permit No.b�-�7 (To be entered by the Zoning Office) Index No. � -zJ'r7
WHEREAS,(list all owners)�a�e�T ;, 9- /�zy q� Q /1�Qro v�s�
owns real estate within Sawyer County that is subject to Ute 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 PROT'ECTION AREA on said real estate shall be restored in accordance
p-� 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 shali comply
' with all shoreland vegetative buffer requirements of the Sawyer County Zoning Ordinance in effect on the date
� that the Land Use Permit is issued by the Zoning Oft'ice. The owner(s) fiuther agrees to allow authorized
� representatives of the Govemmental 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 determine if the SHOR�LINE
(�C VEGETATION PROTECTION AREA exists and that it is being preserved.Violafion of this Agreement will
� authorize, in addition to other penalties and relief required under ihe Sawyer County Zoning Ordinance,
N 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 Pernut. All parties agree that this Agreement shall be filed with the Sawyer County
� Zoning Office.
Legal Description of Property: /�ararl s `
Qt �o7�SK f�rz�citE �� S'ec: `� T«�� 3q QQ�4ed7tJ tl:?2.-739-09-�9oy�
Q _See UQ Ta.�n 39 IZc�ee U7CJ -�d22.-'1 9-04 Stie3 ,�
Dated this__�_day of f�4 ,.,3 C— , �(,'+�,i
_/�� n � ,..�^ c�i
(Owner) �p
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� (Owner) (Owner)
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This instrument was drafted by:
Sa�ryer County Zoning Office
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