HomeMy WebLinkAbout026-939-12-5808-LUP-2008-332 Application for Land Use Permit(*Shoreland*) o 0
County of Sawyer � �
PO Box 676 -Hayward�!I 54843 X
715/634-8288
*Property that is located within 300'of a creek,river or stream or within 1000'of a �
flowage,lake or pond or has any of the above waterbodies located within �
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
nCaH�I tP,n � PRINT-USE BLACK INK OR PENCIL � 1
1�Ct.�Cf '�f' �:` �Gtr�-�Sa�ra�C c�S.t� � f� �
Owner Builde,��� A-
qa�c�N N, `~
i;�3 u�c��, �,�,� S� �,4.. Qa� °� �
Mailing Address Mailing Address � O
/�Iy:�C�'�.�,+F ��c��s 'V�1d� `J5 �I�Y' Navwa�� k/.�� 5—�l£�W�. � �
City,State,Zip City,�State,Zip �
���3 � �'S�oo � a3(orl "Ii5 Co'��l -��lcoS— �
Daytime Phone Daytirne Phone f
M
Additional Information: Zone District: �(L�l
Lot Dimensions: �G�ri X �� S ;
Q�.
Date lot was created: �c 7Z I 9�`� Acres: i.S
Is there wetland near the proposed structure?If yes,how far_��J n
0
Building Land Use Floodplain:O Yes (�j No c
( )New ( )Filling Chippewa Flowage:( )Yes ( ) N� �
(�Addition O Dredging Driveway access off of a(Check one): � �
O Alteration O Grading �Private Rd O Town Rd.
( )Moving On ( ) ( )County Hwy ( )State Hwy �
O O `� � �
Primary Structure Accessory Building Addition N o 0
( )Dwelling �c.)Garage-attached/detached ( )Deck c,i � �
O Year round O#of caz stalls O Porch "�' W
( )Seasonal ( )Storage Building ( )Enclosed � �
O Frame built on site O Screenhouse O Living room � co
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � �
( )Mobile/manufactured ( )Other ( )Bedroom L, �
( )Other primary structure ( ) ( )Relocate/enlazge � K�
� � ( ) ( )#of new � �
i ��
AdditionalInformation: p -° p
e � �
m s� �
Type of Construction: p � —
OO Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � 30 �-
( )Other � ,�
Construction Cost:Primary Structure$ � ,� �
Accessory Building:$ Addition:$ �UOC� � �
�
�
Deed:Vo1�3�8a�s Pg Certified Soil Test# 46-'l39 �; 'z
CSM:Vol l�e Pg z(uo Lot# 7 Sanitary Permit# 41-e33 � �
Plat Envelope Or: � �
Condo Vol Pg Yeaz Installed: N �
"Loads and Flows": Vol Pg Ownei•When Installed: �
�
Previous office approvals/actions:
q���tv4
Vaziance:# LUP:# 92�Dy� SP:� CUP:# (bl�ID�
Inspection Report:# Change of Zone District: �
a�'d3o
Describe the consYruction 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. #2. #3. #4.
Size a`1` ft.wide ft.wide ft.wide ft.wide
�a� ft.long ft.long ft.long ft.long
Floor area��sq.ft. sq.ft. sq.ft. sq.ft.
Hgt.from grade �3 to peak ft.hgt. ft.hgt. ft.hgt.
Stories stories stories stories
#of bedrooms
Lake/Pond/Flowa e/River/Stream ame '�'��r ��� �� �
%i
`
r
1`�
---�=--,
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�_____-- -
Fire Number and Name of Road (D���(�) Fb����' � �•.r
1. Enter lot dimensions and indicate north by arrow. Signa ure of Owner,or Authorized Agent:
2. Indicate the location and size of the requested construction �'-����/�/��,��
( 3fgnature
2Ct1V1Y10S.
Print Name:
3. A1So,1ndlCate 2�1e loCatlon and diStanCe to the Well, The above cadities that the listed iniormatlon and intentlons are
irue and corred.,that all work shall be performed in compliance
Sept1C t2T11C and CII'ainfleld,wetland 3Teas,lot llnes, with the requirements of the Sawyer Counly Zoning oNinance
and the laws and re�ulations of the State of Wisconsin,and if
CenteTllne Of i11e Yoad and Watelbodles. ading as ownef(s)aqent,has the permission of the owner(s)to
pedorm the work requested on this application. The above
personsls hereby give permission for access to the property for
onsiteinspection.
Permit fee:$
Total land azea within 300'of the waterbody:(A) ���� �-`(v
Total impervious surface area[including this project](B)�L;3.�(
(B)/(A)x 100=%Used .� ��CJ (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area:Mitigation Requiixed?O Yes (,r)No
C�C��i'�.%,r / %G2��% ' Z�
Issue Date � Signatuxe of Issuin e t
������1 y '% �l�7 50%Rule: Average Rotid Setback:
Expiration Date
Office Comments:
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GRAPHIC SCALE
TAX ASSESSMENT PURPO`.
aoo o zoo +aa aoo isoo Information contained on this
advisory. Map accuracy is lim
quality of the public records
( IN FEET ) was prepared . It is not intenc
substitute for an accurate fie
1 inch = 400 ft.
�-� � '
SAWYEFI COUNTY CEHTIFIED SUR�EY MAP
LOCATfO IN GOVERAPfE'NT LOT$ SECTIQN 12, T. 39 N., R. 9 M.,
TOMN OF SAND LAKE, SAMYEH COI�VTY, MISCONSIN.
�o��
LOT 9 MI[L QE SlXO 70 71E OY/ffA L3�7NE LAM O£ShcIBEO
IN YCC(IE 107, PA6E 1�B Mp.;E CAAO[IfS IMEDIATQY TO
II�E d`�RA6 O757MLF TlE SR/1H O�LOT 9.
Cl S 6f'.i5'6'Y 7B.F.� �
f2 N 4'13'N'Y 56.56 \
9,.'�'` � AWE
(� 7/E SIRWECINE DIS7IAC'f5 AAE APPN0.YIMA7E MD/pY£
�.�Ly /� �6�/i �� A07 BE£N MEIS(MED. /HfY ARE FOR IMFMMA7IONAL
�1� Q�- 4�` Y �d'��'6 '���s atr.
/ y
�'�.� � ,���51 f�'
��f /iS ''��` ,�� i�-
7
4�/ �1% / �'.,� \ 4, 1§��'''
����� ��� ���a�P�'
a�\ v / B
� ,�� �'� �%' SEC. !2
� �i 9 G> >1f''i
pCl9 �145.50 2I3.A7 AS -- _-f629.61"- _ �_�
BY/'hEAf@.'lN CCYiIER LYJ .IO-� •� -_
s�rN[Ing c�SfC. 12 ---N e�'S5'55'E 2rs5.s.�'—-- SEC. 13 SE COH. SEC. 12
H06EfIrs ��,1`�� �q.,.,.nw,y,�i
��SGONS
i�
, AfEA LOT SfN4�1/�Y
LqRRY i.
' � NELSON
COT 6�G�700 SO/fT+/-, t.5f AfJl`S+/- f RSMUNO, �
C07 7=b�300 SO/FTt/-. l.50 Al3ES+/- � wis. ¢
�or a=n.�oo so/F�+/-. �.n acr�s+/- �'p �-��
ca�9-s aoo so/fr+i; 023�c�s+/- .y,s U R�
70TAL =717,900 SO/FT+/; 5.01 A!lAS+/-
�`��-� `��;s� SCALE.' 1 INCN=200 FEET
sw�r er.•
ua+r r.n¢sov-as i:z�s
ar hn nus�� a r� �F c' • , tsv�. 0 �0 400 600
LEGEND CLZENT: HOBEFT R06ERTS HEART OF THE NORTH
JOB NO.: H034/91
�FOLND 3 1/2'CAP. AL. MON. �ALE: ! INCH-200 FEET
�FOIM�O 3/4' IRON PIPE OA7E DECEMBER 2l, 1994 SURVEYING OF HAYMARD INC.
�SET 1 1/4'ZHON PIPE �
MT- l.69 LB/FT 6EAR7 "ANE REFEAENCEO TO THE S
LINE 0'F SEC. 1T N B9'55'S5' E. HW��o. eoX 2si-� l7fsJ ss�-z��2
lXJ1�I[F:� SlIO-3 51£Ei 1 Li�2 SfEETS /GYMAN4 MISCdSIN N913 FAX: 691-6��I
r'........-. .m..��Mn,.. �/�� ��U
SHORELAND PRES�RVATION AGREEMENT
(Shoreline Vegetation Protection Area)
Land Use Permit No. �� (To be entered by the Zoning Office) Index No.� -�%�'C—
WHEREAS, (list all owners) � �i�C�� 1<FS� �� C����,�p�:d� 12�S e � 1
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 VEG�TATION PROT�CTION AR�A 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 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) fiuther agrees to allow authorized
representatives of the Governmental Unit to enter onto the owner's property at the following description
between tt�e 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 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 ttus Agreement shall be filed with the Sawyer County
� Zoning Office.
c� �,egal DescripYion of Properry: P,,� (�, f L f S L�r f 7 L�S vrr ��/ i� p� Z 6� ,.d e c �Z�, T ai,(/
�
2 Fal Tnwn a� � d �w/lr � � w�,�� C'o�,, �-. GvL
� �
� �9/ - 93F— �Z- Sao�,
Dated this 0 �� day of (7 C'��e�� �U � ,
� (Owner) (Owner)
� .�� , .��_
�
� (Owner) (Owner)
�
(Ownec) (Owner)
This instrument was drafted by:
Sawyer Counry Zoning Office �
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