HomeMy WebLinkAbout010-941-26-2118-LUP-2004-069 \.
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Application for Land Use Permit(*Shoreland*) r ,�
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 -r
the property's boundazies. � �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
� PRINT-USE BLACK INK OR PENCIL �-� ,
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Owner Builder � a
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Mailing Address Mailing Address � p
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City,State,Zip City,S te,Zip �` 1
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Daytime Phone Daytime Phone
Additional Information: Zone District: ��"�
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Lot Dimensions:
Date lot was created: Acres: . 9 0� `
Is there wetland near the proposed structure?If yes,how faz o �
Building Land Use Floodplain:O Yes O No � �
(>j New O Filling Chippewa Fiowage:O Yes O No � �
O Addition O Dredging Driveway access off of a(Check one): � �
( )Alteration ( )Grading ( )Private Rd ()Town Rd. � r
( )Moving On ( ) ( )County Hwy (�)State Hwy °Q �
� ) � ) N
Primazy Structure Accessory Building Addition o �
( )Dwelling ( )Garage-attached/detached ( )Deck �
( )Yeaz round ( )#of car stalis ( )Porch W
( )Seasonal ( )Storage Building ( )Enclosed �
(�)Frame built on site O Screenhouse O Living room �o
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � ��
( )Mobile/manufactured (�)Other\�� ( )Bedroom ��'
( )Other primazy structure ( ) ( )Relocate/enlazge _
( ) ( ) ( )#ofnew � � �
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AdditionalInformation: ` �r
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Type of Construction: i �
(�)Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � �
( )Other �
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Construction Cost:Primary Structure$ �—z'f' ,ti d
Accessory Building:$� /(�[" Addition:$ �
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Deed:Vol��Pg�L Certified Soil Test# $/ -/�`� �
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CSM:Vol�_Pg �9 9 Lot#�_ Sanitary Permit# �'i�-' ��` tl4 �
Plat Envelope Or: b. �
Condo Vol Pg Year Instalied: c;�
"Loads and Flows": Vol Pg Owner When Installed: �u �
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Previous office approvals/actions: gs ,c��� L�
Variance:# LUP:# Jd D�`y SP:# CUP:# �
Inspection Report:# Change of Zone District: I 1
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Describe the construcHon 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�� #2. #3. #4.
Size .' a ' ft• wide ft. wide ft. wide fr. wide
,S �a- ft. long ft. long R long ft. long
Floor area ,5 7y sq. ft. sq. ft. sq. ft. sq. fr.
Hgt from grade �F�to peak ft. hgt. fr. hgt. fr. hgt.
Stories�_ stories stories stories
# of bedrooms - �
Lake/Pond/Flowa e/River/Stream ame % 1 C�Y
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Fire Number and Name of Road ,[�j�f FO it/ .'C�L['��St dc J�c���
1. Enter lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction - j,�1•-! ,:/== �
,Signature � �
activities.
Print Name:
3. A1S0, 1nCIlCate the IoCatlon and diStanCe to the well, The above certifies Nat Ne listed intormation and intentions are
We and cortect., that all work shall be pertortned in compliance
Sept1C taTllc and dI'3itlfleld, wetland azeas, lot lines, WiM the requiremenGs of the Sawyer County Zoning Ordinance
and Ne laws and reguWtions of the State of Wisconsin, and if
centerline of the road and waterbodies. a�aoy as ownet�s�aye�t na5 me�erm�ss�o�or me owne�Is�co
perform the work requested on this application. The above
personsls hereby give permission for aaess to the property(or
onsiteinspeclion.
Permit fee: $ /<n'.- °"`
Total land azea within 300' of the waterbody: (A) •-;� r] ']i O
Total impervious surface area [including this project] (B) 3/a'-j
(B)/(A) x 100= %Used � � �o (Shall not exceed 15%[or 25%with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? Yes O No
April 17, 2004 '
Issue Date Signature ofIss in gent
April 17, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SI�ORELAND PRESERVATION AGREEMENT
(Non-Intact Shoreline Veeetation Protection Area)
Land Use Permit No. 0'�/-�(D9 ' (To be entered by the Zoni�g Office) Index No. C�Y - OC�
WHEREAS,(list all owners) Ronald Pankratz and Marlene Pankratz
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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.
� 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 shall be restored in accordance
�„ with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
The owner(s)hereby agrees that at all times in the future,the real estate subject to this Agreement shall comply
� with all shoreland vegetative buffer requirements of the 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
a representatives of the Governmental Unit to enter onto the owner's property at the following description to
� inspect the structure(s) or uses auihorized by said Land Use Permit and to detemune if the SHORELINE
VEGETATION PROT'ECTION AREA exists and that it is being preserved.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 Pernut 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: ��7�7 5'��7 �/f K c E� � ��(.
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-=�� � - � � `- JL ' �2 0 5 _l� � L �� C'sirl ��ii'9 . 5:10 A�en�,
Dated�this �J-� -� y,-d�y of f��'%:/L
<--�-� %- .� -
(Owner) /� / (Owner)
/�'�a��.� ,(! -���-e�
(Owner) (Owner)
(Owner) (Owner)
This u�strument was drafted by:
Sawyer County 7.oning Office