HomeMy WebLinkAbout024-741-20-1208-LUP-2008-322 /,
Application for Land Use Permit (*Shoreland*) o o • �
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 7�
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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Mailing Address Mailirig Address � O
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City, , Zip City, ,Sta , Zip
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Daytime Phone Daytirne Phone �
Additional Information: Zone District: �R-I �
Lot D:imensions: `rC7o � � "�S� � �
Date lot was created: Acres:: '� .�� c�, � �s�o�_ �
Is there wetland near the proposed structure? If yes, how far r� o r
Building Land Use Floodplain: ( ) Yes (�f No �
( )New ( ) Filling Chippewa Flowage: ( ) Yes (�'N�� �
(�Addition O Dredging Driveway access off of a (Check one): �
( ) Alteration ( ) Grading ( ) Private Rd (�'Town Rd. V' �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � �'
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( ) ( ) ..T'c N ,.°���
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Primary Structure Accessory Building Addition N o �
( ) Dwelling ( ) Garage-attached/detached ( ) Deck � �
( ) Year round ( ) # of car stalls ( ) Porch , W
( ) Seasonal ( ) Storage Building ( ) Enclosed � �
O Frame built on site O Screenhouse O Living room � �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen o �
( ) Mobile/manufactured (�Other ( ) Bedroom � .-
( ) Other primary structure ( )'L�v�� o��c�°�c`c�-� ( ) Relocate/enlarge � �'j �
� � ( ) ( ) # of new N .L �
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Additional Information:
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Type of Construction: �
( ) Frame ( ) Log �jPole/metal ( ) Block ( ) Concrete � � �,
( ) Other °a ,,.�
Construction Cost: Primary Structure $ ,.ti �
Accessory Building: $ Acidition: $�' � _�CSC� � C� O � .�
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Deed: Vol z. $5 Pg /�� Certified Soil Test#_ 8Z-!2 ? � z
CSM: Vol Pg Lot# Sanita:ry Permit#_ , I!7 �iS-/�/_ �' �
Plat Envelope Or: � �
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Condo Vol Pg Year Installed: N � �
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"Loads and Flows": Vol Pg Owner•When Installed: �;
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Previous office approvals/actions: ,
Variance: # LUP:# OI-( �5 SP: ;� CUP: #
Inspection Report: # Change of Zone I�istrict: �a�p�
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Describe the construction using these columns. List the dimensions of each structure in a separate
column. List each story, each addition, each alteration in � separate column.
#1 . #2. #3. #4.
Size aC3 ft. wide ft. wide ft. wide ft. wide
��y ft. long ft. long ft. long ft. long
Floor area 'a-$� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from grade � � to peak ft. hgt. ft. hgt. ft. hgt.
Stories �. stories stories stories
# of bedrooms ��r��
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road �o�� � v� C��o� L.� ��i7���-�
1 . Enter lot dimensions and indicate north by arrow. Signatu of C)wner or Authorized Agent:
2. Indicate the location and size of the requested construction '
Signature
activities. '
Print Name�av��� ��'�i`�� —
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�n9 as oW�er�s� a�ie�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: $ �.�
Total land area within 300' of the waterbody: (A) S"S� 3ov
Total impervious surface area [including this project] (B) '�3 Q. �
(B) / (A) x 100 = % Used � , z °% (Shall not exceed 15%[or 25% with a con�iitional use permit].)
Shoreline Vegetation Protection Area: Mitigation Requ�ired? O Yes (� No
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Issue D te Signature of Is in gent
4 _ ,.�r.� o.a,,., �,(,Q � Z 6Dq 50% Rule: ___ Average Road Setback:
Expiration Date
Office Comments:
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SHORELAND PRESERVATION AGREEMENT
(Shoreline Ve2etation Protection Area)
Land Use Permit No. ��j-3 2 2 (To be entered by the Zoning Office) Index No. C'S -3�z
WHEREAS,(list all owners �.�� �rv\.e�s-L..�c_
owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
WI�EREAS,in order to secure a Land Use Permit.
NOW,THEREFORE,the o�*mer(s)hereby certifies that,as a condition of issue of said Land Use Perniit,that
the SHORELINE VEGETATION PROTECTION AREA on said real estate is intact to a minimum depth of
35'landward from the ordinary high-water mazk of the waterbody.
The owner(s)hereby agrees to comply with the shoreland vegetative protection azea 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 Govemmental Unit to enter onto the owner's property 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 stmcture(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
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,
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 Description of Property:_��g(�(�J/�f' �p,� 2� %�//y /�}j// �},�,,, ,/
, � � � v-�y/- 20 - i2n�S
,�r Dated this a� day of����\,p�s ,�
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/'� (Owner) (Owner)
t ����s.,,:._���y,.s
� (Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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