HomeMy WebLinkAbout024-741-19-5609-LUP-2008-331 Application for Land Use Permit (*Shoreland*) o o �
County of Saw��er � �
PO Box 676 - Hayward V�II 54843 ;
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715/634-8288 �. ��'�
*Property that is located within 300' of a creek, ri��er or stream or within 1000' oi'a �
flowage, lake or pond or has any of the above waterbodies located within r
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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Daytime Phone Daytirne Phone �,�
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Additional Inform�tion:� �`" Zone District: � � � ��
Lot D:imensions:
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Date lot was created: Acres: � �=` �"
Is there wetland near the proposed structure? If yes, how far o ='
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Building Land Use Floodplain: ( ) Yes ( )No �
(�New ( ) Filling Chippewa Flowage: ( ) Yes ( ) N�� � � �_
(� Addition O Dredging Driveway access off of a(Check one;): J �
( ) Alteration ( ) Grading ( ) Private Rd ( ) Town Rd. N �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy r °" �
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Primary Structure Accessory Building Addition o o °
( ) Dwelling (X,�Garage-attached/detached ( ) Deck � �
( ) Year round ( ) # of car stalls ( ) Porch '
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( ) Seasonal ( ) Storage Building ( ) Enclosed � �
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( ) Frame built on site ( ) Screenhouse ( Living room c,� c�
( ) Modular/manufactured ( ) Greenhouse (� Kitchen � �
( ) Mobile/manufactured ( ) Other ( ) Bedroom
Other rimar structure Relocate/enlar e A
( ) p Y ( ) ( ) g g �
( ) ( ) ( ) # ofnew o �
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AdditionalInformation: a �, A
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Type of Construction:
� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � �
( ) Other ``;
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Construction Cost: Primary Structure $ � �
Accessory Building: $ —¢- Acidition: $ � � ����� ��'�' � ��
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�701 � � �,� � �
Deed: Vol%��� �� Pg / %'_�_,' �z Certified Soil Test# �� --��/ ,� � Z
CSM: Vol Pg Lot# Sanitaxy Permit# �8 — ����_ �Q 7�
Plat Envelope Or: OS ` z 5/ 'o\ >
Condo Vol Pg Year Installed: �,
"Loads and Flows": Vol Pg Owner•When Installed: � �
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Previous office approvals/actions: 1'� �`�,
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Variance: # LUP:# ��-_�' �� �,� SP: �� _ CUP: # ,--- �-�
Inspection Report: # 9g- Og�, Change of Zone I�istrict:
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25588
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. Sec� �J(� .
#L ,,� , , ..._ #2. �% . , s� #3 . � � F- f`"" t: , < � , � ,
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Size � G7 ft. wide . �� � ft. wide �a_, ft. wide� r" ��` � ft. wide � �
�7 ft. long _�( -� ft. long '�-�` ' ft. long � 12 r� ft. long
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Floor area r� ��, sq. ft. C � sq. ft. �� � : �' sq. ft. sq. ft.
Hgt. from grade �(� to peak f �- � ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms �TS a�. r . ,;- �, � -
dw — i �elv d Jng a,d d+� .
�v � 1258 !� Lake/Pond/Flowa i�/River/Stream (Name)
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Fire Number and Name of Road � ��� � ! �� l� �t � = � ',�,t� �� �� : /-{ ,� !
, � _ ,
l . 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 �.�;�.v�-c.� G���r(�.�c�-
Signature
activities. / v
Print Name: GGG�^t/�(✓� �'��.
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 regulations 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
r � ,-�;� �. � , , .' , �,� ;;; �� ,:;� :j ; ! !� persons/s hereby give permission for access to the property for
`-' " � �: onsite inspection.
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Permit fee: $ � �?� • '�' �
Total land area within 300' of the waterbody: (A) z 1 , 703 y
e.J F_.. Q.� L!� �t�i..f ,.. �,��,.,. ,.....�
Total impervious surface area [including this project] (B) z(o�/�
(B) / (A) x 100 = % Used I z � 1 °� (Shall not exceed 15%[or 25% with a con��itional use permit] .)
Shoreline Vegetation Protection Area: Mitigation Requ�ired? (k} Yes O No
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Issue Date Signatur�e of Issui g nt
(�is 4,�k�,; ;' � � �;vy 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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GRAPHIC SCALE TAX ASSESSMENT PURPOSES ONLY
o zao aoo eoo �e� Information contained on this map is
advisory. Map accuracy is limited by the
quality of the public records from which
was prepared. It is not intended as a -
( IN FEET ) substitute for an accurate field survey.
1 inch = 400 ft.
SHORELAND PRESERVATION AGR�EMENT
(Non-Intact Shoreline Veeetation Protection Area)
Land Use Permit No. ' -
J� J! (To be entered by the Zoning Office) Index No. �-�j�;
WIiEREAS, (lisf a11 owners) �� �( ' � � ��J �cj�
E ,
owns real estate within Sawyer County that is subject to the Sawyer County Shorelazid 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�CTION 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
Gr, . with atl 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) furtlier agrees to allow authorized
� representatives of the Governmental Unit to enter onto the owner's property at the following description to
� 1 inspect the structure(s) or uses authorized by said Land Use Permit and to deternune if thc SHORELINE
U VEGETATION PROT'ECTION AREA exists and that it is being preserved. Violation of tkus 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 Pemut 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.
� I,ega1 Description of Property: 1 y T�// N /�7CJ 7n� �v, o� l'ou;�ro � /fo
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�� Dated this Z 5 day of S'r;,1�- ��
:�n�� �il�,��-
�. (Owner) (Owner)
�
r� (Owner) (Owner)
i
� (Owner) (Owner)
This insWment was drafted by:
Sa�ryer County Zoning Office
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