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Home My WebLink About002-940-28-5501-LUP-2004-358 Application for Land Use Permit(*Shoreland*) � o � County of Sawyer � - 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 (n � the property's boundazies. � CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. 1 PRINT-USE BLACK INK OR PENCIL ��£s P l�htU��Y ETA� /Ji��»�Ds Con��nvcT�U�' a- �' � Owner Builder Q- � P 0� (�ix �so G�/3nl .�� /�� : s� Mailing Address Mailing Address � O � �a��,�!.�R fl i,uT. 5`I S`i 3 Gc,/,ti�-T�l Gv� �y��G � City,State,Zip City,State,Zip �7i� �3`l �1�� 7is-,�� - z>�i� Daytime Phone Daytime Phone � Additional Information: Zone District 'R,iZ1 Lot Dimensions: c Date lot was created: Acres: Z5.�S i Is there wetland near the proposed structure?If yes,how far,�75 (y��cr� o Building Land Use Floodplain:O Yes (�No � (�Q New O Filling Chippewa Flowage:O Yes (�No � O Addition O Dredging Driveway access off of a(Check one): � ( )Alteration ( )Grading �(Private Rd ( )Town Rd. � ( )Moving On ( ) ( )County Hwy ( )State Hwy � � ) � ) � � �, r Primary Structure Accessory Building Addition o 0 O Dwelling f�Garage-attache detache O Deck � ( )Year round (�#of car stalls ( )Poxch �., �� ( )Seasonal ( )Storage Building ( )Enclosed � O Frame built on site O Screenhouse O Living room �o � ( )Modular/manufactured ( )Greenhouse ( )Kitchen V ( )Mobile/manufactured ( )Other ( )Bedroom C. � ( )Other primary structure ( ) ( )Relocaze/enlarge � � � ( ) ( )#of new � Additional Information: p � � 0 Type of Construction: �! � �Frame ( )Log ( )Pole/metal ( )Block ( )Concrete c ( )Other ,� Construction Cost:Primary Structure$ „y � � �C Accessory Building:$ /s � Addition:$ ^ �� Deed:Vol .5(oa Pg�_ CertifiedSoilTest � ��-3�g � Iz CSM:Vol Pg Lot# Sanitary Permit# � d -�� . � � Plat Envelope Or. � � Condo Vol Pg Year Installed: N � �-^ � "Loads and Flows": Vol Pg Owner When Installed: � ci Previous office approvals/actions: � $z-c�� Variance:# LUP:# SP:# CUP:# Inspection Report:# Change of Zone District: �Igl� 3 8 a-o 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. ' #L (T�� #2. #3. #4. � �, Size 2�'�ft. wide fr. wide fr. wide ft. wide 3 0 ft. long ft. long ft. long fr. long , Floor area �y0 sq. ft. sq. ft. sq. ft. sq. ft. Hgt.from gade �3 , to peak ft. hgt. ft. hgt. ft. hgt. Stories p,v� stories stories stories � # of bedrooms �%/1 Lake/Pond/Flowa e/River/Stream Name N� ,, `��,� s? � � __ , .� _ � << } - � , �._a�r� T —..�,—�—_— _ : 7 . I � "� ti �l , � f ,�12� , - . �, :' , �� a r + � ��h i Ex�sr��> � DM�N � � � � FieLO ��' n r � � � `r' 3 6� i .. i .' U / q��C >F�� °� r1� i �. i �:�� ., � � � �\ . 'i , ?' �` (Y� ; z i 04':, � >��, v I cx,s7�,:�. Q�'' " � ,, �'aa ` � yo` ii�,�r� � � �� R��`.� � .t;�,��p T i �� /�___ �°a i . . � ��C �-� - v , , � �_ � �,.„�. -,: , ti� r �.,� zs � , o .�y .� :D2 �V�� . , � � a 1 �`' UNrJA{. �(� ��S f. i� . L_ ., - Nr� i ,.c:',t [� Fire Number and Name of Road �9 I 8 N � I�oAo i s �N N�M r il c'�:�v�� zono� S�qfe 2d 2'J 1. Enter lot dimensions and indicate north by arrow. Si ture of 0 e)%t�P�pthorized Agent: 2. Indicate the location and size of the requested construction f n3-a ��ef /SignaWre activities. � n PnntName: �� s /J C t�� 3. f�ISO, indicate the location and distance to the well, The above certifes that lhe listed infortnation and intentions are true and correcl.,ihal all work shall be pedortned in compliance septic tank and drainfield, wetland azeas, lot lines, with the requiremenis of the Sawyer County Zoning Ordinance and the laws and regulations of ihe State of Wisconsin, and if CCIItEfI1riE Of YI1C 203d ffi1C1 W&YCrbOaICS. acting as ownef(s)agent, has the permission of the ovmer(s)to perform ihe work requested on this application. The above personsls hereby give permission for aaess to the property for onsiteinspection. Permit fee: $ /Op Total land azea within 300' of the waterbody: (A) Total impervious surface azea [including this project] (B) 3 � y o (B) / (A) x 100 =%Used (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes QC)No ''�°"`""2 " ` ' :�r:��-:,�..; �,�i� . July 15, 2004 _ _ Issue Date Signature of ss in gent July 15, 2005 0 50% Rule: Average Road Setback: Expiration Date Office Comments: �, SHORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) Land Use Permit No. L "� (To be entered by the Zoning Office) Index No. Q y -� WHEREAS, (list all owners) �q�.�s (� �l-4 V D � � 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 � 3Y landwazd from the ordinary high-water mazk of the waterbody. o, � 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) fiirther 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] .� to inspect the struchue(s) or uses authorized by said Land Use Pemut and to determine if the SHORELINE U VEGETATION PROTECTION AREA exists and that it is being preserved. This authorization shall terminate on the date of expiration of the land use permit. However, the ownet's obligation to maintain the SHORELINE � VEGETATION PROTECTION AREA in accordance with Sec6on 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 Pemut and the removal of all � structures approved by the issue ofsaid Land Use Pernut and the revocation of any other uses approved by the Q 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: �v' t Lot 5 , NW of the SE Section 28 T 40 N, R9 W, Town of Bass Lake , Sawyer County, WI D d this 7/`( �G day of k �wner) (Owner) (Owner) (Owner) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoniag Office = BA S S LAK E � P 40 N . R . 9 W�. f �I . I LAKE � "'� :2.5 ,.,� �2.ii r=° INDI� µ» :2.io , (.Yt � j./L 1 S.iC .'L.�Lf /.IC Z .G.1 .2.2 -Z.J :2.9 i.,, Y./) y .Z. l . .Z.� :Z.B rJ 3a7 3.Z ,. yfI :'S.4' ir �.1r :3� ia >.e. � � .� HUB ,``. �7. I � 3. I LAKE O � �5. 1 � 4. 1 16.3 .l6. . 15J 16.6 162 16. I � 16.7 .152 ,�� . 16.4