HomeMy WebLinkAbout032-538-04-4102-LUP-2008-389 ✓ .
Application for Land Use Pernlit (*Shoreland*) o o X
County of Saw��er � �
PO Box 676 -Hayward V�lI 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 ���� ' �
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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 � � �
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City, State, Zip City, ,�tate, Zip -' �
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Daytime Phone Daytirne Phone �`�
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Additional Information: Zone District: /f�/
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Lot D:imensions: /;��a�/LC �<'co�,�� . _. �
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Date lot was created: ��'O� Acres: - G��'
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Is there wetland near the proposed structure? If yes, how far �';-s -'S o �
Building Land Use Floodplain: O Yes (�<.) No �
(=�)New O Filling Chippewa Flowage: O Yes (�) N�� �
O Addition O Dredging Driveway access off of a(Check one;): �
( )Alteration ( ) Grading ( ) Private Rd (.kj Town Rd. �
O Moving On O O County Hwy O State Hwy a o �
( ) ( ) � ►� S.
Primary Structure Accessory Building �-, Addition w o �
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( ) Dwelling (.k) Garage-attached/detached�� ( ) Deck � �
O Year round (z) # of car stalls O Porch 1`� �,
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( ) Seasonal ( ) Storage Building ( ) Enclosed �,, �
O Frame built on site O Screenhouse O Living room � c� �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen a � "'
( ) Mobile/manufactured ( ) Other ( ) Bedroom � C� �
( ) Other primary structure ( ) ( ) Relocate/enlarge Q �-� "
� � ( ) ( ) # of new -�C �`�" �
� � �� '.
Additional Infarmation: r �;nti���� �����1��:«.� ����� SQ:�;E���� M��`s ��'^�= � �
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i5.s4��d �<2 �,'�o�J � � ��� �
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Type of Construction: � ' r.
( ) Frame ( ) Log ��) Pole/metal ( ) Block ( ) Concrete ��'.
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( ) Other , ,�
Construction Cost: Primary Structure $ p ,.d ��
Accessory Building: $ 4'-,";�'�,^, `'�`' ��l�lition: $ C � �.:
N �. `.�.
Deed: Vo13zz83� Pg Certified Soil Test# �`'� '�'�� d � z
CSM: Vol �� Pg ;'� �' Lot# !> Sanita:ry Permit# .�5'�'�y3- QO- '70 � �
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Plat Envelope �3�3 Or: � `'�
Condo Vol Pg Year Installed: �x�"'�%;'� N
"Loads and Flows": Vol Pg Owner When Installed: � �
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Previous office approvals/actions:
/.�f SP: ,� CUP: # �J
Variance: # LUP:# (�'i- _
` �b
Inspection Report: # Change of Zone I�istrict: ,Z1�o`�
.33BL 9
Describe the construction using these columns.List the dimensions of each structurc in�sep�rate ,
column.List each story,each addition,each alteration in a separate column. �
#1. `.'�.�s�'. #2. :>.ir�.:� EW #3. f�.t;o #4. t�err,��
Size ft.wide �=' ft.wid�� ,'7 ft.wide �_fr.wide
7� ft.long „ ft.long sy fr.long � ft.long �
Floor area "2�s sq.ft. �7 G sq.ft. •x"'= sq.ft. "�� sq.ft.
Hgt.from gcade /g to peak 1 i ft.hgt. �J ft.hgt. � ft.hgt.
Stories � � stories stories stories y
#of bedrooms �
.la,4r �j;;�t�� Lake/Pond/Flowa�e/River/Stream(Name)
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Fire Number and Name of Road �%6 s p' .�«�i�'c��_ �'(,
1. Enter lot dimensions and indicate north by arrow. Si nature o C)wne Authotized A ent:
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2. Indicate the location and size of the requested construction �� ,�„'���„�� 9
Signature
activities. y -�
PrintName: ///i'/�.r5✓��i���'�"'/
3. Also,lndlcate the loCatlon and d15tanCe to the Well, The above ceNfies that the listed intormation and intentlons are
Uue and conect.,lhat all work shall be pedormed in compliance
septic tank and drainfield,wetland areas,lot lines, w�m me requ��ements of ine sawyer counry zon�n9 om'�nance
and ihe laws antl requlations of the State of Wisconsin,and if
COnYCTllne of tbe Io3d 3Cld WateCbodles. acting as owner'(s)agent has the permission of the owner(s)�o
peAortn the work requested on this appliration. The above
personsls hereby give permission for access to the property for
onsite inspection.
Permit fee:$�_�;Z, ��'
Total land azea within 300'of the waterbody:(A) d?50� ��� %.
Total impervious surface area[including this project](B) � 7K Y;�,f f.
(B)/(A)x 100=%Used � �.� � (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area:Mitigation Reqciired?O Yes No
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Issue Date Signature of Iss 'ng nt
�2Po,�u,,- ll i Z�9 50%Rule: AverageRoadSetback:
Expiration Date
Office Comments:
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GRAPHIC SCALE Tax ASSESSMENT PUF
aoo 0 20o aoo eoo �eoo Information contained on
advisory. Map accuracy i
quality of the public rec�
was prepared. it is not i
( IN FEET ) substitute for an accurat
1 inch = 400 ft.
SHORELAND PRE5ERVATION AGREEMENT
(Shoreline Veectation Protection Area) �
Land Use Permit No.�(To be entered by the Zoning OFfice) Index No.Q�-W 9
VJHEREAS,(list all owners) it,l ca e���r p��vf
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 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 azea requirements of Section
4.410 SHORELAND VEGETATION PROTECTION t1REA, 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 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 struchue(s)or uses authorized by said Land Use Permit and to determine if the SHORELINE
� VEGETATION PROT'ECTION 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
Sauthorize, 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 Pernut. All parties agree that this Agreement shall be filed with the Sawyer County
� Zoning Office.
�
/^ Legal Description of Property: L,o T i3 �� C s✓�� r�o r ,2 P�s s��•h��5`G 6�:�'n.. rn�! c�� tG,a �/E,��
C� O� t-G�z 5.E y c r StcFioc, y - T�3�V -h�S cc� %�«J w o�Gcl•�{A-� Sawu�r- Co. CCIL
63Z-S3R-oy-YloZ
� Datedthis da of �e�e��E� a,�p�
� ����< < .G�l�--'.
� (Owner) (Owner)
I
� (Owner) (Owner)
�
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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