HomeMy WebLinkAbout008-146-00-1802-LUP-2004-140 Application for Land Use Permit(*Shoreland*) o o r
Cotmty of Sawyer � -
PO Box 676 -Hayward WI 54843 �
1
715/634-8288 `
*Property that is located within 300'of a creek,river or stream or within 1000'of a � n
flowage,lake or pond or has any of the above waterbodies located within r
the property's boundaries. ���
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PGRMITS HAVE BEEN ISSUED. �_ �
PRINT-USE BLACK INK OR PENCIL M
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Owne��� � Builder °' �
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Mailing Address Mailing Address � �
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City,State,Zip City,State,Zip �"
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Daytime Phone Daytime Phone v�
Additional.Information: � �/ �/� Zone District: ��"I �
(+o;�i��ac�- '7�'d��c�r. - ✓. c '} �
Lot Dimensions: I�.��l,� X �SS�i�[�R'P }
r� 1
Date lot was created: �-�—/%t�L- Acres: `1� ��� ,�
Is there wetland near the proposed structure?If yes,how far 1�:� � ��
Building Land Use Floodplain:O Yes (�No '� �
(}C�New O Filling Chippewa Flowage:O Yes (� No c�
O Addition O Dredging Driveway access off of a(Check one): � �
O Alteration (X)Grading O Private Rd (�Town Rd. �
O Moving On O For'b.�ser„4.:���I� O County Hwy O State Hwy � �
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Primary Structure Accessory Building Addition o °
( )Dwelling ( )Garage-attached/detached (�Deck �'
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(,q Year xound O#of car stalls Porch �
( Seasonal ( )Storage Building �Enclosed �,
(�J Frame built on site O Screenhouse O Living xoom �
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom v �
( )Othex pximary structure � ) ( )#of new�enlarge � �
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AdditionalInformation: � "
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Type of Construction: ^� ^
(�Frame ( )Log� ( )Polehnetal ( )Block ( )Concrete � ���
( )Other � �
Construction Cost:Pximary Structure� ���'�-�n ro �
Accessory�Building:$ A_ddition:$ � �
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Deed:Vol 58p Yg� Cei6fied Soii Test# �"y0� � �
CSM:Vol�_Pg�j�ot#�� Sanitary Perniit# �{G]��2, C���=�� � �
�'�Ct..:..,;GO
Plat Envelope 8 y Or. °i �
Condo Vol Pg Year Installed: ���n� N �
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"Loads and Flows": Vol Pg Owner When Installed: �:
(V�ark � ��iP��t� r (���+�{�c�� "
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Previous office approvals/actions:
Variance:# LUP:# SP:# CUP:# �
Inspection Report:# Change of Zone District: � ���
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Describe the construction using these columns. List the dimensions of each structure in a separate
column. List each story, each �dclitiou, each alteration in a se arate column.
#1. �' #2. �'.f�'c�•� �c�:c.L� #3. ��... #4.���`r't�'C'� c;��''f'��.
�' _�ft. widc
ft. wide ft. wide
Size ��� ..� ft. wide � � ft. lon
�_ft. long I y ft. long (�C� ft. long �_ g
Floor area I�sq. ft. O��^ sq. ft. .S�`l Z_ sq. ft. 3 �. sq. ft.
Hgt.from grade .%�.��e to peak�_ft. hgt. �_ft. hgt. I �, ft. hgt.
Stories_____�____ �_ stories � stories � stories
# of bedrooms �
Lake/Yond/Flowa e/River/Stream Name
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Fire Number and Name of Road ''� (��l ��T I'�I� �-�l�f^ /`}`� �
1. Enter lot dimensions and indicate north by arrow. �ignat r of Own r r orized Agent:
2. Indicate the location and size of the requested construction Signat
1Ct1V1t1eS. Print Name:
The above ce�tifies that the listed information and intentions are
3. Also, indicate the location and distance to the well, �e and correct.,that all work shall be performed in compliance
with the requiremenls of the Sawyer County Zoning Ordinance
septic tank and drainfield, wetland areas, lot 1111es, and the laws and regulations of the State of Wisconsin, and if
acting as owner(s)agent,has the permission of the owner(s)to
centerline of the road and waterbodies. Pe�toR» lhe work requested on this application. The above
personsls hereby give permission for access to the property for
onsite inspection.
Permit fee: $ a�
"I'otal land area within 300' of the waterbody: (�) °� � ���
Total impervious surface area �i:�cluding t?:is 'r't'oje.�tl (Bl�, ��� ��/�-
(B)/(A) x 100 =%Used ��ca (Shall iiot exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigatioii Required? (`�l Yes O No
May 5, 2004 - �
Issue Date Signature of Iss i g ent
May 5, 2005 Sp%Rule: Average Road Setback:
Expiration Date
�Jffice Conunents:
SHORELAND PRESEI2VATION AGREEMENT
(Shoreline Ve�etation Protection Area)
Land Use Permit No. O�I-I�'ID (To be entered by the Zoning Office) Index No. C�T -�Q
WHEREAS,(list all owners) i�lM J I"f o(1P�7�t��J � ��—FJ
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:� 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.
QNOW,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'landward from the ordinary high-water mark of the waterbody.
� The owner(s)hereby agrees to comply with the shoreland vegetative protection azea requirements of Section
3 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
abetween 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
Oon 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 oY 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:_�(�1�y �C C.. C � �W!� 3 � � . � �. _
Lot 2-B csm vol 9 pg 82. Loziers Birch Narrows, Town of Edgewater
Sawyer County,WI
Dated thi 13 r day of l��f� � , , �pU t�
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(Owner) (Owner)
(Owner) (Owner) �
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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