HomeMy WebLinkAbout010-227-00-0100-LUP-2004-099 Application for Land Use Permit(*Shoreland*) r a ` .
County of Sawyer ° � �
PO Box 676 -Hayward WI 54843 �—
715/634-8288
*Property that is located within 300'of a creek,river or stream or within]000'of a �.
flowage,lake or pond or has any of the above waterbodies located within
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTTL ALL REQUIRED PERMITS HAVE BEEN ISSUED. -1
PRINT-USE BLACK INK OR PENCIL �-
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Daytime Phone Daytime Phone �.
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Additional Information: Zone District: �<�-' ,�
Lot Dimensions: 7CJ
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Date lot was created: Acres: I,l5 �
Is there wetland neaz the proposed structure?If yes,how far �c o �
Building Land Use Floodplain:O Yes (v No � �
( )New ( )Filling Chippewa Flowage:( )Yes (t No �
O Addition O Dredging Driveway access off o a(Check one): �
( )Alteration ( )Grading ( )Private Rd (a Town Rd. ?
( )Moving Oq (� / sYnne���-y01�t ( )County Hwy ( )State Hwy °Q �
U�) �14gsione/Cc,K-r� )? 'e �ll��� � �
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�r���s-tr� N S
Primazy Structure Accessory Building Addition o 0
( )Dwelling ( )Garage-attached/detached ( )Deck � �
( )Year round ( )#of caz stalls ( )Porch �;,
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room rn
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge `V
( ) ( ) ( )#of new
Additional Information: p
- �, �
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Type of Construction: " �
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete
�'�vther �/ci�rf�u � C:��a-�.} rc�C-,.'a `J- (�:v�.� `�,'
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Construction Cost:Primazy Structure$ ro �
Accessory Building:$ Addition:$ � _
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Deed:Vol �f �Pg Certified Soil Test# pa-�r�3 � z
vo
CSM:Vol i� Pg �:! Lot# 1- Sanitary Permit# (5a-30� � 7�
Plat Envelope Or. o, ,
Condo Vol Pg Yeaz Installed: i;,
"Loads and Flows": Vol Pg Owner When Installed: rn �
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Previous office approvals/actions:
Variance:# LUP:# 03-S13 SP:# CUP:# ��'
Inspection Report:# Change of Zone District: �
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�clqs
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 fr. wide
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
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road
1. Enter lot dimensions and indicate north by azrow. ignatur�e of 0 r or orized Agent:
2. Indicate the location and size of the requested construction � /�z,,�
SignaNre
activities. ��/' � .�� �
Print Name: ����° ' 1 ' E'--
3. Also, lndicate the IoCatlon and d1StanCe to the well, The above ceRifes ihat the listed infortnation and intentions are
We and correct.,that all work shall be peAormed in compliance
septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning ONinance
and Ne laws and regulations of lhe State of Wisconsin, and if
centerline of the road and waterbodies. a��s as owner�s�a9e�t nas me Pe��55�0� or me o�e��5�m
perform the work requested on this application. The above
personsls hereby give permission for access to the property for
onsite inspection.
Permit fee: $
Total land azea within 300' of the waterbody: (A) %(Fly �25 d'
Total impervious swface area [including this project] (B) �� � S 3
c-,
(B)/(A) x 100 =% Used ] �O (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes (�
April 27 , 2004
Issue Date Signature ofIssuing Agent
Apr i 1 2 7 , 2 0 0 5 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SHORELAND PRESERVATION AGREEMENT
(Shorcline Veeetation Protection Area)
Land Use Permit No. o y- Q 9 9 (To be entered b the Zoning Office) Index No. �- C�99
WHEREAS, (list all owners)_��%'Q 'rto� // /�jFs �S'<%t?�
,
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 cedifies 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 area 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 authoriz.ed
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 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 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.
LegalDescriptionofProperty: lot 1 CSM vol 16 pg 51 , Part of Govt lot 5 Sec 36 , T 41N
R 8 W. Being in the Town of Hayward, Sawyer County, WI parcel numbers :
010-841-36-5512 , -4102
Dated'k�is��f April , 2004
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(Owner) (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instmment was drafted by:
Sawyer County Zoning Office
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