HomeMy WebLinkAbout024-541-30-5519-LUP-2008-027 � . �ry
Application for Land Use Pernzit (*Shoreland*) - ' �
�
County of Saw��er � � � �
J�� PO Box 676 - Hayward V�II 54843 � k
715/634-8288 f
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*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.
CONSTRUCTION SHALL NOT BEGIN UNTIL A�,L REQUIiaED PERMITS HAVE BEEN ISSUEA �
PRINT-USE BLACK INK OR PENCIL �
�
�c3., •� �e.to .r w e� �e�e.r S �_c�..c"� e.al��_ � � ,
Owner � Builder �:
� �.
�' � � �:.U�{_�V 1..o�-a r-t-��h L���cl.o.
Mailing Address Mailirig Address ° � p
,�..�. 1,� e. ��, e ,� � �v� .S�S-��Lf � �=�� wo�rc� � C�t �`� ��-I � �
Cit , State, Zip City, ��tate, Zip
9.S� - U a-.� - L) � �� � ( S- �-! � � - `i � ,;-- ,� �
Daytime Phone Daytirne Phone '�
��s �
iti nal Information: Zone District: � I.
Add o � �
�
G
Lot D:imensions: / � � �
Date lot was created: ___���� Acres:: [,0 Y �i�
Is there wetland near t�e proposed structure?If yes, how far o r�
Building I�and Use Floodplain: O Yes ( t��SG59/a/5613 � � �
(�ew ( ) Filling Chippewa Flowage: ( ) Yes ( �'1�1�� � � ` �
O Addition O Dredguig Driveway access off of a (Check one�): � � -�
( ) Alteration ( ) Grading ( ) Private Rd ( ) Town Rd. O �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy �' �
� ) � ) _ � � o
� N �
Pri ary Structure Acce sory Buildin Addition � o �
(�Dw lling (�arage attache cletached ( ) Deck � N
(�ar round (�) # of car stalls ( ) Porch � �
( ) S asonal ( ) Storage Building ( ) Enclosed , �
( Frame built on site O Screenhouse O Living room p c
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �j, �
( ) Mobile/mai,ufact�ured ( ) Other ( ) Bedroom � �
( ) Other primary strur,ture ( ) ( ) Relocate/enlarge ��j, �
� ) ( ) ( ) # of new o �
4 �
Additional Information: c3� �" �
\ 1 A
�
� ( � C.a�� ,�, c:; �,.�; �,y d�.�.,� �.,. o �
Type of Construction: o ' ,
(�rame ( ) Log ( ) Pole/metal ( ) Bloc:k ( �ncrete o ��
( ) Other, N
�
Construction Cost: Primary Structure $ </�Or ODO �
b
Accessory Building: $ Aclditiort: $ �
C"
�3�91 f1 �
Deed:� � Certifi��d Soil Test# d O/ �
---��—�----- '� Z
��
CSM: Vol �_Pg �c� � Lot# Sanita:ry Permit# fj�•3� b�5- � �
Plat Envelope Or: � ` �
Condo Vol Pg Year Installed: �,
"Loads and Flows": Vol Pg Owner When Installed: � �
�
�
Previous office approvals/actions: �
tk�-� ��,o� yo'1-oZ �
Variance: #�.. LU:P:# p�-y3� SP: ;� CUP: # lv
Inspection Report: # ' Change of Zone I�istrict: �ZI�I��
�
� �� �-t�►t�c.
Describe the construction using these columns. List the dimensions of each structure in a separate �
column. List each story, each addit�on,,e�ch�lteration in a separate column.
#1 . � ,� � �'���r° #2.`' � ti� � c �. , #3. � b � � �,(� #4. c�o�s �� �.� e..
,; .� i w'�Y C�i
Size �z, ,a, ft. wide ,� �, ft. wide ,� � ft. wide �� � � y i�. wide
.��;" ft. long �_ ft. long �_ ft. long ,� d ' ft. long
� �z
Floor area �►�y � sq. ft. f � $�j sq. ft. � 7 '� sq. ft. � � a R O sq. ft.
C�vs�'a e,
Hgt. from� �_ to peak �_ ft. hgt. ft. hgt. � L ft. hgt.
Stories � �_ stories { stories I stories
# of bedrooms �_
� �{� Lake/Pond/Flowa ��/River/Stream (Name)
�� � t o � � 1 °.. `r�,
� �, e�
Fire Number and Name of Road � �j y ,S' �j f�/ pi r. e. P °�, �1e,.s�
1 . Enter lot dimensio:�s and indicate north by arrow. Signature of Owner o Authoriz�d Agent:
2. Indicate the location and size of the requested construction ���`;�x.�,.;#�.,.. `� . <, `�
Signature
activities. � � ( `' `
Print Name: JV 0.� t��� r� � � 7 O a �G f
3. Also, indicate the location and distance to the well, The above certifies th�at the listed information and intentions are
true and corzect., 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 requested on this application. The above
persons/s hereby give; permission for access to the property for
onsite inspection.
Permit fee: $ Z � —
-,
Total land area within 300' of the waterbody: (A)�-�. � �. �'
Total impervious surface area [including this project] (:B) � � `� Co
(B) / (A) x 100 = % Used '� . � ��o (Shall not exceed 15%[or 25% with a con�iitional use permit].)
Shoreline Vegetation Protection Area: Mitigation ReqL�ired? O Yes ( ►�'�o
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Issue Date Si �natur�e of Issuin A ent �
g g g G�-�!e� �
�ryl Q,�-�,h ,� [ Z, (>D 9 50% Rule: Average Road Setback:
Expiration Date
i��n�e.,�7— �3� r� �2ev �� ��, ,;� s�i�. s^ o �Q ``
Office Comments: � � � q � � ��V /��' 'y �
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OF SHEETS
DATE:
REVISED:
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HAYWIRD. Itl. 51843
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. ATfACHMEM A:LEGAL DESCRIPTION �
Page 2 of 2 pages.
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��PETEA$ON H � SET 11/1�%30"IflON PIPE
S� Juoe 17, 1983
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3an 31 08 11 : 03a Hate Yoder 715-462-9049 P• 2 �
SHORELAND PRES�RVATION AGREEMENT
(Shoreiine Vegetation Protection Area)
Land Use Permit No. 'd (To be entered by the Zoning Of.fice� Index No. �- OZ, 7
WHEREAS, (list all owners)
s��4���'� �u�y�t� ,�i� �r�eU.s;t�i�G���
owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
,� WIiEREAS;in order to secure a Land Use Permit.
� NOW, TI�REFORE, 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
� 35' landward from the ordinary high-water mark of the waterbody.
� The owner s hereby agrees to comply with the shoreland vegetative protection area requirements of Section
� 4.410 SHORELAND VEGETATION PROTECTION AREA, Sawyer County Zorung Ordinance, in effect on
V
the date that the land use pernut is issued by the zoning o�ce. The owner(s) further agrees to allow autharized
� representatives of the Governmental Unit to enter onto the o«ner's properiy 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]
to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELTNE
-�� VEGETATION PROTECTION AREA exists and that it is bein�g preserved. This authorization shall terminate
on the date of expiration of the land use permit. However,the owner's obligation to maintain the SHORELINE
S VEGETATION PROTECTION AREA in accordance vvith Section 4.410 SHORELAND VEGETATION
�' PROTECTION AREA, Sawyer County Zoning Ordinanc,e remains in effect. Violation of this Agreement will
�
� authorize, in addition to other penalties and relief required under the 5awyer 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 Savvyer County
� Zoning Office.
� y �fr
`3 Legal Description of Property: �� / ��C°` L � �� � ���
� 30 ` �Q� 30 7 / �'�
� -�S �/_-�o�5'd Z
� Dated this .� i day of � � dl%' —
�
� (Owner)
� (Owner)
�
� (Owner) ��
(Owner) (Owner)
This insmiment was drafted by:
Sawyer County Zoning Office
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