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Home My WebLink About002-940-01-5219-LUP-2004-086 Application for Land Use Permit (*Shoreland*) o o L�.., ` County of Sawyer � � - PO Box 676 - Hayward WI 54843 � � 715/634-8288 �� *Prop�rty that is located within 300' of a creek, river or stream or within 1000' of a (V► r�1� 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. � a�� PRINT-USE BLACK INK OR PENCIL � i �Q,R«'P . `�i��9�1 �►� ��h�� :�� rc� ��C`��''Sr� � �� Owner Builder , � � �3��v �}!r'Yi�iv ic/� l��'S�� E c%�• �<��t�� o: Mailing Address Mailin Address � p ,. .��3 �,9vc�1�,�,r'� c�i <.�'S�� City, State, Zip City, State, Zip � �` 7/S--l0 3 � —��?� � �� -�� '� .s � Daytime Phone Daytime Phon— �� Additional Information: Zone District: ��}S 3 �-.,N�� O � Lot Dimensions: j� � �` �' N � Date lot was created: Acres: �� - ,� � Is there wetland near the proposed structure? If yes, how far o � Building Land Use Floodplain: ( ) Yes �)No � �'� ( )New � ) Filling Chippewa Flowage: ( ) Yes (� No � �}Addition ( ) Dredging Driveway access off of a(Check one): � ( )Alteration ( ) Grading Q�Private Rd ( ) Town Rd. � ( )Moving On ( ) ( ) County Hwy ( ) State Hwy aQ l � l � N � Primary Structure Accessory Building Addition o � ( ) Dwelling ( ) Garage-attached/detached ( ) Deck �„ � � ( ) Year round ( )#of car stalls � Porch s��t�� W � �f Seasonal ( ) Storage Building ( ) Enclosed � �� Q Frame built on site ( ) Screenhouse ( ) Living room � ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � � ( ) Mobile/manufactured ( ) Other ( ) Bedroom � ( ) Other primary structure ( ) ( ) Relocate/enlarge � O O O # ofnew � Additional Information: � � c� � Type of Construction: � Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � ( ) Other ,� Construction Cost: Primary Structure $ 4 � d ,,,� � Accessory Building: $ Addition: $ � � � � Deed: Vol � �a� pg�v� Certified Soil Test# qo?`D 7� � z CSM: Vol Pg Lot# Sanitary Permit# `ly-OYa `�' � � Plat Envelope Or: o, � Condo Vol Pg Year Installed: N "Loads and Flows": Vol Pg Owner When Installed: r; � � ..� . , Previous office approvals/actions: �y Variance: # LUP:# 9�-�8 SP: # CUP: # N ��Q� Inspection Report: # Change of Zone District: ^4 a`�r,� Vt ac�a2 Describe the construcHon using these columns. List the dimensions of each structure in a separat � column. List ea•�h e3c ddition, ach alteration in a separate c mn. � '• #1. P �! �G�L. #3. #4. Size fr. wide . wide . wide . wide _�ft. long fr. long ft. long ft. long Floor area �6G sq. ft. sq. ft. sq. ft. sq. ft. Hgt from grade / 1 'to peak ft. hgt. ft. hgt. ft. hgt. Stories stories � stories stories # of bedrooms � m,.�, R ,�� =>j /��'�v� �' �ake/Pond/Flowa e/River/Stream Name l� � ' �8' S �/�� t"�� r ��_� � �. r. � �� u�� _ ,�"Pe�.0 i-E --�; ��eK �� '��. i � , _� i ' � � � - \ ;� . � �� _� �, ;---- �c� � �-1d�� __ _ � , � � � � % c� �� / � � �'_. `,�';,;; �� '� � C'7 f�2 �E � � �� `�—�— �� , \ 2�� r � '�` e ~ ' ��1 .. �/ A S E �N 7� lt6+T� R� '^' �_ .� �. _._, � . __ ,. ��/�'3 �� Fire Number and Name of Road �� C /� �� LL� �./�N� 1. Enter lot dimensions and indicate north by arrow. Sigi re� e' r Authorized Agent: 2. Indicate the ]ocation and size of the requested construction rF. ig re '� activities. �� c�� PnnWame: 3. f�ISO, indicate the location and distance to the well, The above ceNfes that the listed informalion and intentions are We and correct., ihat all work shall be performed in crompliance Sept1C t3i1�C and dralrifleld, wetl3Tld azeas, lot Ilnes, wiN the requiremenLs ot the Sawyer County Zoning oNinance and the laws and regulations of the State af Wisconsin, and if Cente111nC Of Y.Ile I'o8C1 and WatCTbodles. acting as ownef(s) agent, has the permission ot the owner(s)to perfortn the work requested on this appiicatlon. The above person�ls hereby give permission for access to the property for onsile inspection. Permit fee: $ '��s� ' �r � G o6 Totalland azea within 300' of the waterbody: (A) y3�, s�o d W �y yf`� �Fr�., 9G� Total impervious surface azea [including this project] (B) �'�or�n IS b (B)/(A) x 100 = % Used .5�_�_(Shall not exceed 15%[or 25% with a conditional �e pe�it].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No I April 26 , 2004 - l Issue Date Signature of Issu g g nt Apri1 26 , 2005 50% Rule: AverageRoadSetback: Expiration Date Office Comments: SAORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) • Land Use Permit No. Qy-�'j8� (To be entered by the Zoning Office) Index No. Qy_- 086 _ WHEREAS, (list all owners) �i�i�LjA /y � ��lG'� �/t,p,��16�� > owns real estate within Sawyer County that is subject to the Sawyer County Shareland 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 3�' iandwazd from the ordinary high-water mazic oi tne 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) further 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 913(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 authorizaYion 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 this Agreement shall be filed with the Sawyer County Zoning Office. �-� u� Legal Description of Property: � �E C • � � � �"(J �` /") �` �— �'� _ Gi� �� '� ��!'� �`---r�� " � G"49��f�l�f� Dated this day of (�yuier)` (Owner) T/ � ner) � (Owner) /k i,.�i — wner) (Owner) This ins[rument was drafred by: Sawyer County Zoning Office 1 �' 1 � :1 . I • 1 , �:� , i (� 1 ' — �, i - � . 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