HomeMy WebLinkAbout024-741-03-2301-LUP-2008-173 ..
Application for Land Use Permit (*Shoreland*) o o �,X
�� County of Saw��er � � "
PO Box 676 - Hayward V�II 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 G
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL �
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Owner - Buildf�r � �
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Mailing Address , Mailirig Address � O �
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City, tate, Zip City, �State, Zip �
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Daytime Phone Daytirne Phone
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Additional Information: Zone District: �� - Z
Lot D:imensions:
Date lot was created: Acres: ��
Is there wetland near the proposed structure? If yes, how far � GU / o L{
Building Land Use Floodplain: ( ) Yes ( )No � �
( )New ( ) Filling Chippewa Flowage: ( ) Yes ( ) N�� �
O Addition O Dredging Driveway access off of a(Check one;): �n �
O Alteration O Grading O Private Rd (�) Town Rd. v �
( ) Moving On ( ) ( ) County Hwy ( ) State Hw•y N �' �
� ) � ) � � �
Primary Structure Accessory Building Addition � o 0
( ) Dwelling ( ) Garage-attached/detached ( ) Deck ��
( ) Year round ( ) # of car stalls � Porch o W
( ) Seasonal ( ) Storage Building ( ) Enclosed v �
O Frame built on site O Screenhouse O Living room 0 c� (.�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �u� �
( ) Mobile/manufactured ( ) Other ( ) Bedroom N p �.-
( ) Other primary structure ( ) ( ) Relocate/enlarge �' \
� � ( � ( ) # of new �O � �
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Additional Information: � O A
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Type of Construction: � N
(j(�Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete 4 � w
( ) Other � �
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Construction Cost: Primary Struchire $ ���-,� � ,..ti �
Acidition: $ � S�r t��— �
Accessory Building: $ � � �
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Deed: Vol 7p(o Pg 6$r Certified Soil Test# Bq�157 � z
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CSM: Vol Pg Lot# Sanita:ry Permit# $?�I7� �.
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Plat Envelope Or: � �
Condo Vol Pg Year Installed: N
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"Loads and Flows": Vol Pg Ownei•When Installed: �
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Previous office approvals/actions: �o,ZL9 �
Variance: # LUP:# 89-3� SP: ;� CUP: # � �Jd�/o$
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Inspection Report: # Change of Zone llistrict:
LY78a
Describe the construction using these columns. List the dimensions of each structure in a separate ,
colum List each story, each addition, each alteration in a separate column. . .
#1 . �p�' #2. #3. #4.
Size lG ft. wide ft. wide ft. wide ft. wide
� � ft. long ft. long ft. long ft. long '
Floor area � sq. ft. sq. ft. sq. ft. sq. ft. -
Hgt. from gade to peak /�f , ft. hgt. ft. hgt. ft. hgt.
Stories ' stories stories stories
# of bedrooms
Lake/Pond/Flowa e/River/Stream (Name)
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Fire Number and Name of Road 1 ! 96 '-1 �`l r�'��T�=- f r S �i'�%j
1 . Enter lot dimensions and indicate north by arrow. Signa re of C)wner o,�A hori ed Agent:
2. Indicate the location and size of the requested construction � '" `�
Signature �
activities. ����,r� � �-��,��;� ��
Print Name:
3. Also, indicate the location and distance to the well, The above certifies th�at the isted information and intentions are
true and correct., that all work shall be perfortned in compliance
septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance
and the laws and reguiations of the State of Wisconsin, and if
centerline of the road and waterbodies. acc��9 as ow�er�s> a�ie�t, has the permission of the owner(s) to
perform the work requested on this application. The above
personsls hereby give� permission for access to the property for
onsite inspection.
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Permit fee: $ 1 Jr' '-
Total land area within 300' of the waterbody: (A) 3 �(o, Oev
Total impervious surface area [including this project] (B) z5 3b
(B) / (A) x 100 = % Used G � b (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation ReqL�ired? O Yes �No
Z ov� �
Issue Date Signature of Issuing Agent
2� � ZC�y 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SHOYM AS 66-FOOT Nf�TN
� FOR YA�PMIG PURPOSES. `'�
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SHORELAND PRESERVATION AGREEMENT . �
(Shoreline Ve�etation Protection Are�) `
Land Use Permit No. U � / (To be entered by the Zoning Office)+ �I�d�_ ex No. �-�
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WHEREAS, (list all owners) ����C��,� ��'�y -�� �'��
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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 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 Zoning Ordinance, in effect on
the date that the land use permit 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
L between the hours of 8:00 A.M. and 6:00 P.M. [Section 9.13(1) POWERS, Sawyer County Zoning Ordinance]
h to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE
VEGETATION PROTECTION AREA exists and that it is being preserved. This authorization shall terminate
� on the date of expiration of the land use permit. However,the owner's obligation to maintain the SHORELINE
VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION
Zj PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. Violation of this Agreement will
/�'�� authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance,
l�`- 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.
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� Legal Description of Property: 7/�p S lJ Iy N�cJ�yi .Se� 3 �i�C �7�J To�h e F-
�n r�r►c1 ���S �v te r C.t�v,ti,�� l,1J Z. D Z�1� 7'L!- o.� ^ z 3 0/
� Dated this of ,5'v-h. �
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E� (Owner /' (Owner)
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(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sa�ryer County Zoning Office
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