HomeMy WebLinkAbout010-941-23-3420-LUP-2004-059 v'=� �
Application for Land Use Permit(�shoreland*) o 0
County of Sawyer �
PO Box 676 -Haywazd WI 54843 O
715/634-8288
*Property that is not located within 300'of a creek,river or stream or within 1000'of a s �
flowage,lake or pond or does not have any of the above waterbodies located within
the property's boundazies. r '
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN iSSUED. �
PRINT-USE BLACK INK OR PENCIL � �
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Owner Buil er �
I o s r�� aJG�,,. k N, i r 4. 1 l�r 6 6 � D� , �n/ �' �
Mailing Address Mailing Address �
�(I L.�i SY��� w u,�I (,.�, � V 3 rn
City, tate,Zip City, tate,Zip
('7 rs) G 3Y- 7/0/ (� �5 ) � 3y- `/`/S�
Daytime Phone Daytime Phone �e_�9� -
Additional Information: Zone District: �`�
Lot Dimensions: �
Date lot was created: l�'� '7 SJ Acres: � n
0
Is there wetland near the proposed structure?If yes,how far �
Building Land Use Floodpkain:� j Yes �'}No =+
( )New ( )Filling �
Dred m Drivewa access off of a(Check one): �
�Addition ( ) g� g Y .
O Alteration O Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy �,"', �
� ) � ) o �
C'
Primary Structure Accessory Building Addition � °
uC)Dwelling ( )Garage-attached/detached ( )Deck `^
( )Yeaz round ( )#of car stalls ( )Porch �
O Seasonal O Storage Building O Enclosed �
O Frame built on site O Screenhouse Q�Living room m
( )Modulaz/manufactured ( )Greenhouse (�Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom C �
( )Other primazy structure ( ) ( )Relocate/enlarge � '�
� � ( � ( )#of new i `'�
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AdditionalInformation: — p
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Type of Construction: ' �
(�Frame ( )Log ( )Pole/metal ( )Block ( )Concxete �
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( )Other � ,b y
Construction Cost:Primary Structure$ o �
o� :°
Accessory Building:$ Addition:$ �(o ��� � � �
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Deed:Vol�_Pg_ 1 5 _ Certified Soil Test# h(e'C'3 3 tl4
z
CSM:Vol__�Pg��Lot#_� Sanitary Permit# 2�- -�C(r�A o, �
Plat Envelope �r� N �
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Condo Vol Pg Year Installed: �c
Aff of ex septic Vol Pg Owner When Installed: " �
�;
Previous office approvals/actions: *'
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Variance:# LUP:# �J� C5� SP:# CUP:#
Inspection Report:# (^�3- C�� Change of Zone District: �1 '��
l:�`~
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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. #4.
Size�_ ft. wide ft. wide ft. wide ft. wide �� ..
� o ft. long ft. long ft. long ft. long
Floor area �� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt. from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories .
# of bedrooms N�n� ,
Rear Lot Line
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Fire Number and Name of Road �� �� ������d� ����-
1 . Enter lot dimensions and indicate north by arrow. Sign re of Owne or A orized Agent:
2. Indicate the location and size of the requested construction
Sign re
activities. ��, : �, ��r� ,� ���
Print Name:
3. Also, indicate the location and distance to the well, The above certifies that the listed information intentions are
true and correct., that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin, and if
centerline of the road. 3 g 7 (� � acting as owner(s) agent, has the permission of the owner(s) to
'�h��'u" "_ U�.t.Q GtJ�lLq t t 1 /p perform the work requested on this application. The above
� persons/s hereby give permission for access to the property for
5 I a� � onsite inspection.
Permit fee: $ '75� �� `�
b^ � . .- � Q �.o �u.���.,nn IIYh n o o mvn.� Ci
A r i 1 1 2 0 L%�� � � ��C -
Issue Date Signature of Issuing Agent
A ril 13 , 2005 50% Rule: Average Road Setback: _
Expiration Date
Office Comments: 5 � j�
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�'� SHORELAND PRESERVATION AGREEMENT
' (Shoreline Veeetation Protection Area)
�:_'Land Use Permit No. ' n�- (�.j� {To be sntered by the Zoning Office) ' Index No: ��-�
WHEREAS, (list all owners) __� )Q,f ' M . ���C�e�O✓1
I
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 ordinary high-water mark 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) 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 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
VEGETATION PROTECTION AREA exists and that it is being preserved. This authorization shall terminate
on the date of expiration of the land use pemut. However, the owner's obligation to maintain the SHORELINE
VEGETATION PROT'ECTION t1REA 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.
Lega1 Description of Property.f/vi"�l� '1'YL �����} (�-�����r} ��p,�1 a3 � ��'lShi�'
� � �� QP (IhC�' - C.C1� d! 1.lWl.Q_
�r �i � rJ `1S- u a= D
ted this � day of , o�C�
Sl.a_'�` . � 9,0
Owner) (Owner)
(Owner) (Owner)
(Owner) (Owner) �
This instrument was drafted by: �
Sawyer County Zoning Office \
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