HomeMy WebLinkAbout004-839-08-5118-LUP-2004-643 . 3 � r
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Application for Land Use Permit (*Shoreland*) o o � �
County of Sawyer � � �
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PO Box 676 - Hayward 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 ('j S
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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Owner Builder �
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Mailing Address � Mailing Address � �
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City, State, Zip City, State, Zip �3�, �apc� �
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<9s�� �s�y �=�'�. 7 ( �rs',) SSs� /� r I -
Daytime Phone Daytime Phone 1 �
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Additional Information: • �6ne District: �� '-� '�
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' Lot Dimensions:� IC�O x �t y�G
�; si�� �o, _ : /,f�!' dih✓c . »�z�vc� c...�l
�'�'r^ ��� 7"u l�^);:2 c�� I✓/a ,•JiL 6 �vr Y�r��,<<'. .
Date lot was created: � Acres: ( � (��c �
Is there wetland near the proposed structure? If yes, how far /.S�f� ��• o
Building Land Use Floodplain: (x) Yes O No �
O New O Filling Chippewa Flowage: O Yes Q�1 No �
('�1 Addition O Dredging Driveway access off of a(Check one): �
O Alteration O Grading Q� Private Rd O Town Rd. �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy �"
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Primary Structure Accessory Building Addition o 0
(� Dwelling ( ) Garage-attached/detached ( ) Deck � ry
( ) Year round ( ) # of car stalls ( ) Porch �„ 'i`�
( ) Seasonal ( ) Storage Building (� Enclosed � �
�
( ) Frame built on site ( ) Screenhouse ( ) Living room c�
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom �
( ) Other primary structure ( ) ( ) Relocate/enlarge (� �
� � ( ) (�) # of new i
�
AdditionalInformation: � .�
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Type of Construction: oQ �
(� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete �
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( ) Other ,..�
Construction Cost: Primary Structure $ ,..d �
Accessory Building: $ Addition: $ � ��=� � � �
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LCCd: `v'oi���r g y�9 Ctr�iiicd �c�ii i e�i� q�J'S7� •-•
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CSM: Vol�Pg �`�l Lot#� Sanitary Permit# �5��z � �
Plat Envelope � ���J Or: � ro
�, �: �
Condo Vol Pg Year Installed: /9�� N
"Loads and Flows": Vol Pg 3�� 'Yr�� Owner When Installed: � �
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5ft✓� ���.�•,�l s`�..,
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Previous office approvals/actions: QS� �7 -'
Variance: # LUP:# ��� -�C'3 SP: # CUP: # �
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Inspection Report: # Change of Zone District:
�a� �$ �o'�
p,V
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. '
#I. / '� �/o:• #2. .2�`� ���'-� #3. #4. "
Size f3'i(� ft.wide /(, ft.wide ft.wide ft.wide
��� ft.long �_R.long ft.long ft.long
Floor azea (�Y a sq.ft. 3�� sq.ft. sq.ft. sq.ft.
Hgt.from grade�to peak �y ft.hgt. fr.hgt. fr.hgt.
Stories / 2 stories stories stories
#of bedrooms�_
Lake/Pond/Flowa e/River/Stream ame
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Fire Number and Name of Road ������{�r'�� S nowS���e L a�
1. Enter lot dimensions and indicate north by arrow. Signature of OwneP or Authorized Agent:
2. Indicate the location and size of the requested construction �..-�l -� ���'�
SignaNre
activities.
PnntName: %7o�'E/�r — ML�E:2
3. Also,1ncliCate flle�oCation and d1StanCe to the Wel�, The above ceNfies mat the listed intormation and intentio�s are
true and correct.,ihat all work shall be performed in compliance
septic tank and drainfield,wetland areas,lot lines, with the requlrements of Ne Sawyer Counry Zoning ONinance
and ihe laws and regulations of the State of Wlswnsin,and if
centerline of the road and waterbodies. aca�9 a5 owr�er�s�ayeot nas me Perr��ss�oo or me ow�eds�io
peAortn the work requestetl on ihis application. The above
personsls hereby give pertnission for access to ihe propery for
onsite inspection.
Permit fee:$ �0 D'
Total land area within 300'of the waterbody:(A) 3 Y��_
Tetal i:::pervi^::s surfac�area[iacluding tH+s p.oject;{p) i�6��'�
(B)/(A)x 100=%Used �¢��b (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area:Mitigation Required?O Yes (�No
November 9, 2004 Gfi
Issue Date Signature of Issuing Agent
November 9, 2005 50%Rule: Average Road Setback:
Expiration Date
Office Comments:
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SAWYER COUNTY ZONiNG ApMINISTRATION -
r, ; _ , �._,; .
Statement'.of POWTS CapabiG'es
(Private Ons3t�W�ste Treatment System) ,
I(wc) Doug and �aula Mi11er � �
understand the POWT� serving the structure located at `
14094 W Snows�oe Lane
was desi�d for the following capabilities:
Trearment Tank(s)Approx. 4 5� GPD
Soil Absorption Ccll(s)Pc�"c��GPD Avcragc GPD '
220 mg/L BOD 150 mg/L,TSS 30 mg/L FOG
Permit Number 9 5-510 2 Yeaz in�ralled 8-14-9 7
The POWTS setvin�t}�is structure is presently sized to '
� accommodate a tatal af 6 people, in a dwelling Return To: Sauryer County 7nning
contatnirig 3 bedrooms. PO Box 676
Hay�vurd?JVI 54843
3 bedroom S .T. 1000/600 field 15-43=6G5
WI Dept. of Comm 8�;54 outlines the management s q f t '
requirements for these�'OWTS and I agree to Tstx Parcel N�umber: 0 0 4'-8 3 9-0 8-5 J.l.8
comply with those maii�tenance provisions as they apply to this system. '
2004-Building 4' Bdrm new dw, 4 persons in household. '
Should my use of the�tructure descri6ed above increase flows above the capa�ity of the YOWTS,
I agree to upgrade nn�system to meet the standards requ'rred In WI Dept. �f C'iomm 83.
Should my POWTS fiail, as defined ln Section 145.01 (16) W�sconsin Statutes,;I will obtain the required
�ermit for the inst�liAtion of a code-compliant POWTS with the installatioa completed as ordered.
LEGAL DESCRIPTION+-See arrached page . '
SIGIVATUI2E(" �l�- " 'v�
*Type orprintname her . �,� �. �„t���� ����q �(� � �'-r
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llATED TIfIS 3 � DAY O� /�3JP.�✓��.cr- ' , �2c���/
�l` ACKNQ,W-LF.DGM�NT
STATE OF:1�r��''�v'�-��'f'� COUN1"Y OF: t�11�'�-+� ` (/L
-"
Subscnbcd an�ewom to bdforc�,,by thc abova d '
on this �J`� � clax uf �'j ��^'';'f^��-� ,20 ��.
� �/ � '"�`• JANE M.RIEF
NOTARY PUSLIC � V �1 • I` " �n NOTARv �IC MINNESOTA
*Tj�pe or prinf name here: , ;_�` MY CG`,'. �SION EXPIRES
.,,M�o
; t• JAhUARY 31.2005
MY COMMISSION EXP�IIt� : � � � �� (�� ��V^��Y �T.
*Narrtes of persons signirrgiin any capacity must be ryped or prinled betuw their signature.
TI�ISINSTRUM.�M WiLSD1G4FTED BY: Sawyer CountyZoning O,Qice;PO Boz 676,flayward N!I 54843, i13/63Q-81d8
SHORELAND PRESERVATION AGREEMENT �
(Shoreline Veeetation Protection Area)
Land Use Permit No. ��-��/3 (To be entered by the Zoning Office) Index No. �-__�{j�_
i �
WHEREAS,(listalLowners)�/ql �, /'/L.��,t- � !"n✓�s� k �«F>C _
owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
�j 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
-oJ 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 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
qbetween the hours of 8:00 A.M.and 6:00 P.M.[Section 9.13(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 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
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 Pernrit and the removal of all
J-structures approved by the issue of said Land Use Permit and the revocation of any other uses approved by the
0 issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
Legal Description ofProperty: �✓T Go-� na�r� � Se-� � � iw� .39�✓ � � f-✓
�
���9 y r�u:,���a�, ��� 7'�.,n e�R- � �d�� 4��- i� ;.,
�� ��) ��y�j 3y� � J��� ��YIOf 011� �.L �d�������VO�5��
Datedthis �� dayof �/p,/?,-,��P� , ZO��j
_�
� r),� % (Owner)
C,C,c�P.l
(Qwner) (Owner)
(Owner) (Owner)
This ins[rument was drafted by:
Sawyer County Zoning Office