HomeMy WebLinkAbout002-840-28-5103-LUP-2004-054 Application for Land Use Permit(*Shoreland*) o o �
County of Sawyer �
PO Box 676 -Hayward WI 54843 O
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. T ,
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Mailing Address � Mailing Address � O �
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City,State,Zip City,State, ip
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Daytime Phone Daytime Phone �
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Additional Information: Zone District: ���� �..
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Lot Dimensions:
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Date lot was created: Acres: _���5',}�" �Z c r=.i r�
Is there wetland near the proposed structure?If yes,how far o
Building Land Use Floodplain:O Yes O No G �
(�New ( )Filling Chippewa Flowage:( )Yes (� No % ^
O Addition O Dredging Driveway access off of a(Check one): � �T7
O Alteration ��Grading O Private Rd �j Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy o ��
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Primary Structure Accessory Building Addition o
(�Dwelling (�Garage-attached� ( )Deck � �
( )Year round ( )#of car stalls ( )Porch �„
(y�Seasonal ( )Storage Building ( )Enclosed �
(y�Frame built on site O Screenhouse O Living room co
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ",
( )Mobile/manufactured ( )Other ' ( )Bedroom
( )Other primazy structure ( ) ( )Relocate/enlazge � \
( � ( ) ( )#of new �
AdditionalInformation: ���,�,�. ��'X�y ' 'Ja p
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Type of Construction: Q�
(xJ Frame ( )Log ( )Pole/metal ( )Block ( )Concrete `� �'
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( )Other ,�
Construction Cost:Primary Structure$ � �
Accessory Building:$ Addition:$ ^
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Deed:Vol �!j� Pg Sy� Certified Soil Test# (';_� -G 3Z: �, z
CSM:Vol Pg Lot# Sanitary Permit# O y- O��j � �
Plat Envelope Or: `�'`"`�,� o� �•,�,
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Condo Vol Pg Yeaz Installed: �;, I�
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"Loads and Flows": Vol Pg Owner When Installed: �
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Previous office approvals/actions: °.
Variance:# LUP:# SP:# CUP'# � - �
Inspection Report:# Change of Zone District: U'
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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.
#1. #2. #3. '�c, � � � #4.
Size ft. wide /,�� ft. wide ��e ft. wide
ft. long ft. long �' I\ ft. long ft. long
Floor azea �' sq. ft. sq. ft. sq. ft. � sq. ft.
Hgc from gade to peak ft. hgt. ft. hgt. ft. hgt.
Stories _�stories stories stories
# of bedrooms
c � ' Lake/Pond/Flowa e/RivedStream ame
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Fire Number and Name of Road (� ��������� ��'r�I L � r �,=�s.a�c.�' �I�,'��'
1. Enter lot dimensions and indicate north by arrow. Signature of Owner oC Authorized Agent:
2. Indicate the location and size of the requested construction t�( �'� �-Z,-c �
SignaNre
8Ct1V1t10S. PnntName: �-�t.���(�� ��. Ewf.2�
3. Also, indicate the location and distance to the well, The above certifes ihat Me listed infomiation and intentions are
true and correct., that all work shall be performed in compliance
Sept1C tffi11C anCl ClLalnf eld, wetland 8I'eaS, lot lines, with the requirements ot the Sawyer County Zoning ordinance
and Ne laws and regulatlons of the Siate of Wisconsin, and if
centerline of the road and waterbodies. a�n�9 as owner�s>aye��, nas me�e��s5�o�or me ow�e��5�ro
perform the work requested on ihis applicafion. The above
personsls here6y give permission for aceess to the propedy fo�
onsite inspection.
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Permit fee: $ � �]J
Total land azea within 300' of the waterbody: (A)
Total impervious surface azea [including this project] (B) � ~ � (,�j�
(B)/ (A) x 100 = % Used a•5°�{Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes )No
March 24 , 2004 � �
Issue Date Signature of Issuing Agent
March 24 2005
' S0% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SHORELAND PRESERVATION AGREEMENT
(Intact Shoreline Veeetation Protection Area)
Land Use Permit No. 04-054 (To be entered by the Zoning Office) Index No. 04-05 4
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WI�REAS,(list all owners) �E��/C� �,r'? �r,i���i" �- ,`�ar./� �, �"w zY
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 ordinazy high-water mark of the waterbody.
The owner(s)hereby agrees that at all times in the future,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 Permit is issued by the Zoning Office. The owner(s) further agrees to allow authorized
representatives of the Govemmental Unit to enter onto the owner's property at the following description to
inspect the strucriue(s) or uses authorized by said Land Use Permit and to deternune if the SHOREL,INE
VEGETATION PROTECTIOI�T AREA exists and that it is being preserved.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: (�a�' �� .�„v, 1„f � :5,2�'/ 7'1/a N,� ��W
`7�x .YO � ao,�-3'�/t�- �8- "s'>v3
Dated this day of -
(Owner) � � �_ (Owner)
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(Owner) � (Owner)
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(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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