HomeMy WebLinkAbout032-540-30-3409-LUP-2008-038 Application for Land Use Permit (*Shoreland*) r � :
County of Saw��er � � ,�
PO Box 676 - Hayward VII 54843
715/634-8288 �
*Property that is located within 300' of a creek, ri��er 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. � _�
PRINT-USE BLACK INK OR PENCIL
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Owner Buildfx ¢:
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Mailing Address Mailing Address � O
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City, Sta Zip City, ��tate, Zip �
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Daytime Phone Daytirne Phone �
Additional Information: Zone District: �,�
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Lot D:imensions:
Date lot was created: Acres:: � •Q� �
Is there wetland near the proposed structure? If yes, how far o �
�Bu' ding Land Use Floodplain: ( ) Yes��No �
D�ew ( ) Filling Chippewa Flowage: ( ) es �N�� �
�ddition O I�rPdging Driveway access off of a(Check�one.). �
( ) Alteration �ading ( ) Private Rd ��own Rd. �^ �
( ) Moving On , ) ( ) County Hwy ( ) tate Hwy 'J �" n
( ) ( ) w �, �
N �, r
1'r�mary Structure A essory Building Addition � o 0
Jwelling Garage-attache cietached ( ) Deck � �
Year round ) # of car stallsa O Porch � W
Seasonal ( ) Storage Building ( ) Enclosed + �
'F'rame built on site O Screenhouse O Living room � � u�
� ) Modular/manufactured ( ) Greenhouse ( ) Kitchen , ;� Ci
( ) Mobile/manufactured ( ) Other ( ) Bedroom � .-
( ) Other primary structure ( ) ( ) Relocate/enlarge ' �''` �
� � O O # ofnew �c � �
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AdditionalInformation: o � �
C' W^, �
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Ty e of Construction: , W
Frame ( ) Log ( ) Pole/metal ( ) Bloc:k ( ) Concrete 8; �O p�
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( ) Other �� —C ,...,
Construction Cost: Primary Siructure $ G � �
Accessory Building: $ 9j �L'���. �Sa Acidition: $ � �
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Deed: Vol y / Pg Certified Soil Test# Oz' (�°I � � z
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CSM: Vol Pg Lot# Sanita;ry Permit# D2-�7� �
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Plat Envelope Or: � (n
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:# SP: ;� CUP: # '
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Inspection Report: # Change of Zone District:
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3�381
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 se arate column.
#1. ��muc- 's-�� auc�, #2. U���vSC� #3. (9G #4.
Size�_ft. wide y•� ft. wide _�_ft. wide ft. wide
;�; 31; ft. long y• � ft. long �ft. long ft. long '
�F�r area 1p�d sq. ft. /�O sq. ft. pl V� sq. ft. sq. ft.
Hgt.from grad��to peak�_ft. hgt. ft. hgt. ft. hgt.
Stories � stories �_stories stories
# of bedrooms a
"Lake/Pond/Flowa e/River/Stream (I�Tame)
no,v��ble.w c�-�
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.Fire Number and Name of Road -1 11 � i� �p„��a C,� �-�r►12�nr���
?. Enter lot dimensions and indicate north by arrow. Si nature of C)wner or Autho iz d Agent:
2. Indicate the location and size of the requested construction
gnature
�Ct1V1t1eS. 1
Print Name:
3. Also, indicate the location and distance to the well, The above certi ies that the listed rmation 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
personsls hereby give� permission for access to the property for
onsife inspectior.
Permit fe�: $ ��� . �-�
Total land area within 300' of the waterbody: (A)�U
Total impervious surface area [includ��ing this project] (B) 1
(B) /(A) x 100 = % Used q � (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Req�.�ired? '�'es �No
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Issue Date Signature of Issuin Age t
�1� `( � �DOq 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SCALE: I INCH=400 FEET FOR ASSESSMENT USE ONLY MQl
DRAWN BY:NK DATE:6—II—$4 INTENDE� TO SHOW CONCL.WSIVE
COLON (:) INDICATES GOVT. LOT EVIDENCE OF OWNERSHI�P OR
BOUNDARY LOCATIONS
SHORELAND PRESERVATION AGREEMENT
(Shoreline VeEeYation Protection Areal
Land Use Permit No.��(To be entered by the Zoning Office) Index No. �-�
WHEREAS, (list all owners)
owns real estate within Sawyer County that is subjeot 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' landwazd from the ordinary high-water mazk 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) fi�rther agrees to allow authorized
� representatives of the Governmental 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]
Q to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE
� V�GETATION PROTECTION AREA exists and thatit is being preserved. This authorization shall terminate
on the date of expirarion of the land use permit. However, the owner's obligation to maintain the SHORELINE
sd VEG�TATION PROT'ECTION [1REA in accordance with Section 4.410 SHORELAND VEGETATION
a7 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: T1'�C l�L�ck c.,� C��So���� � � �l e Sot�l�U2S�Q�)n�
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� Dated ' �day of /hGf� , 8(5�g
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7 (Owner) (Owner)
� (Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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