HomeMy WebLinkAbout032-540-35-1403-LUP-2008-097 ti �
Application for Land Use Permit(*Shoreland*) o o v
County oi Sawyer ti �
PO Box 676 -Haywazd WI 54843 � �
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. " �
PRINT-USE BLACK INK OR PENCIL ,
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Mailing Add ss Mailing Address � �
._�)�-�.-��i�p r�,���v. 5489 e //1��i �i�/ .s-s/By�— " �
City,State,Zip �State,Zip
_(i 5— � (,o - a,� o=� 2L�= 7�7 /a.�E�
Daytime Phone Daytime P one
Additional Information: Zone District: ��� "� �
Lot Dimensions: �
Date lot was created: Acres: /, � �= -
Is there wetland near the proposed structure?If yes,how far o ,
Building Land Use Floodplain:O Yes O No � �_�i
�New ( )Filling Chippewa Flowage:( )Yes ( ) No � �o _.
O Addition O Dredging Driveway access off of a(Check one): � �
( )Alteration ( )Grading ( )Pxivate Rd ( )Town Rd. � �
( )Moving On ( ) ( )CounTy Hwy ( )State Hwy � �
O O r,' � S
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Primary Structure Accessory Building Addition ' o °
( )Dwelling (�Garage-attached/detached ( )Deck �
O Yeaz round �O#of caz stalls O Porch L; W
( )Seasonal ( )Storage Buil:ling ( )Enclosed i �
O Frame built on site O Screenhouse O Living room ^ c�
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ` � (��c
( )Mobile/manufactured ( )Other ( )Bedroom � � �
( )Other primazy structure ( ) ( )Relocate/enlarge ��;' U� `
� ) O O#ofnew ,� �� ,
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AdditionalInformation: O {� >
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T�Y�e of Construction: �
U
�4 Frame ( )Log ( )Pole/metal ( )Block ( )Conerete ,~ r�
7"
( )Other <` y
Construction Cost:Primary Structure$ . ;.ti' �
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r�ccessory Building:$ yU�(.�0� Addition:$ � �`
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Deed:Vol �rl-`�� Pg / `�i� Certified Soil Test# O!a-U'-/Z � z
CSM:Vol Pg Lot# Sanitary Permit#_ O(n-0�l� � �
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Plat Envelopa �r� 9` 1';
Condo Vol Pg Yeaz Installed:_ n�
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"Loads and Flows": Vol Pg Qwner•When Installed: �
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Previous office approvals/actions: �
Variance:# LUP:# 05-s�y SP:;# CUP:#_ ;_��
Inspection Report:# Change of Zone District: �j11Lo���
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Describe che construction using these columns. List the dimensions of each structure iu a separatc
column. J ist each story, each addition, each alteration in a separate column.
#1. #2. #3. #4.
Size � � ft. wide fr. wide ft. wide ft. wide
LI rj fr. long ft. long ft. long fr. long
Floor azea // Z� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt from gade to peak ft. hgt. fr. hgt. ft. hgt.
Stories 'i ?� stories stories stories
# of bedrooms_�Z
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road 5�.. . _., T"N 7 e f �� •'"- !--< < •'�
1. Enter lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction ._1'r t. .'� � � � �
� SignaNre
activities. -
PnntName:
3. Also, indicate the location and distance to the well, The above ceNfes that ihe listed information and in�entions are
true and coned.,that all work shall be perfortned in compliance
septlC ta[llt and dTainfield, Wetland aIeas, lot lines, with the requiremenis ot the Sawyer County Zonirg Ordinance
and ihe laws and re��ulations of ihe State of Wisconsin, and if
Centelllne of t110 2o3d and watelbOdles. acting as ownef(s)agent, has Ne permission of the owner(s)to
pedortn the work requested on this applicatioa The above
personsls hereby give permission for access to the property(or
onsite inspection.
Permit fee: $ 5�s-c-.�ci �DD�
—T
Total land area within 300' of the waterbody: (A)�� D��
Total impervious surface area [including this project] (B) /I$4 �- /y4b o?.59Z
(B)/(A) x 100 = % Used .(�° o (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No
_��u zl� 21>U�J '
Issue Date' Signature ofIss in gent
�/ zU09 50% Rule: Average Road Setback:
Expiration ate
Office Co�nments: �'abit�;'t,'.w Li��ing area shal!
n0� b•� C��"d't9d ifi aGCB;:SOfj/
strur.turea.
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} RE F : A E R 1 A L P H O T O P 10 — I 9 7 O SCALE : I INCH = 4 Do FEET FOR ASSESSMENT USE ONLY NOT
U. S, G . S . B l. A I S D E L L 1. A K � Q U A D � 9 7 � DRAWN B Y : D. M . E DATE : � � - � b - � 9 7 g INT ENDED TO SHOW CONCLUSI �/E
COLON ( : ) INDICATES GOVT. LOT EVIDENCE OF OWNERSHIP OR .
80UNDARY LOCATIONS � '
SHORELAND PRESERVATION AGRI;EMENT
{Non-Intact Shoreline Ve e�ation Protection Area
Land Use Permit No.��l�(To be entered by the Zoning Office) ine�x rro. �-D`1
WHERtiAS,(list all owners) ���P�� �' ),' �( .�v�
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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 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 fu[ure,the real estate subject to this Agreement shall comply
with all 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) further agrees to al(ow authorized
representatives of the Governmental Unit to enter onto the owner's property at the following description to
� inspect the structure(s) or uses authorized by said Land Use Permit and to deternune if the SHORELIN�
VEGETATION PROTECTION AREA exists and that it is being preserved.Violation of tlus Agreement will
-�� authorize, in addition to other penalties and relief required under the Savryer 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.
I�` Legal Description of Property: Q�.f 1� ����9�af.d..Se AJ� �o� �S j yO,l/�
�5 Lc� - -Tn cv�n tL lc� w, -�p�.�worC19[�u.�, GJ�--
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Dated this_ �(o day of {hj�ty p
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7Yiis u�swment was drafted by:
Sa�ryer County Zoning Office �
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