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010-941-28-4303-LUP-2004-272
� Application for Land Use Permit(*Shoreland*) � � 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 1000'of a flowage,lake or pond or has any of the above waterbodies located within the property's boundazies. CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. PRINT—USE BLACK INK OR PENCIL ' �J,A ➢.�\cz.�,r����` P'�a\ �.o,;,. I _�er.-�.\.� c � Owner Builder . � \\ t` S � �c3.S`� 1�Q�r�� ��. U J?(o�. _`�1.. �.� `76 �. Mailing Address Mailing Address � p � k�,���� �3i S���C3 ����>� �� 5'�89� � City,�Zip City,State,Zip ���S� �3`��- `i�lt,`� �-,�i� Daytime Phone Daytime Phone r Additional Information: Zone District: ��� Lot Dimensions:�-�`� �-13 �� ����-'� ��5� �' Date lot was created: Acres: �.�� � Is there wetland near the proposed structure?If yes,how far o Building Land Use Floodplain:O Yes O No � ( )New ( )Filling Chippewa Flowage:( )Yes ( ) No �o �)Addition O Dredging Driveway access off of a(Check one): � )Alteration O Grading O Private Rd (�)Town Rd. � ( )Moving On ( ) ( )County Hwy ( )State Hwy °Q � ) � ) � S Primary Structure Accessory Building Addition o ,��. (�)Dwelling 1�)Garage-attached/detached ( )Deck � (ht)Year round O#of caz stalls O Porch �, ( )Seasonal ( )Storage Building ( )Enclosed � (,e)Frame built on site O Screenhouse O Living room c� f�J� ( )Modulaz/manufactured ( )Greenhouse (`p)Kitchen � �� ( )Mobile/manufactured ( )Other ( )Bedroom � _ ( )Other primazy structure ( ) ( )Relocate/enlarge � � O O O#ofnew � � Additional Information: a � � Type of Construction: �` (j�)Frame ( )Log ( )Pole/metal ( )Block ( )Concrete ' � v ( )Other y Construction Cost:Primazy Structure$ � � Accessory Building:$ �v,�v Addition:$ '�')..'i:>:- � P � � Deed:Vol r/�a Pg �9 Certified Soil Test# �C'3t'`� � z CSM:Vol Pg Lot# Sanitary Permit# GG``���3 °Q � Plat Envelope Or: o, �� Condo Vol Pg Year Installed: +'�„��,,,� �p� i;, "Loads and Flows": Vol Pg Owner When Installed: c�'o � ��ile��l� � ` previous office approvals/actions: ' LUP:# SP:# CUP:# Zeport:# Change of Zone District: ������ . ia�qs 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. Q,�,�,l.�„� #2. v_.._, . #3. #4. Size �� fr. wide �1� ft. wide ft. wide ft. wide �7. Q ft. long �ft. long fr. long ft. long Floor azea �7� sq. fr. S�� sq. ft. sq. ft. sq. ft. Hgk fivm grade j to peak \� fr. hgt. ft. hgt. ft. hgt. Stories�_ �_stories stories stories # of bedrooms � Lake/Pond/F owa e/River/Stream Name ii�' � .� _ i '' ! `` ,i S�.cj �,�, , � I N��a ! �_ , _ :�•� - i ���� _ _ �� 24y�,�- �� ' ------� _- - _ _ I: 1 � � k �� � ��`�'ao _ _ _ _1 ' � ���c �— . � \ � �--- ,�\ J9 � � ��I _ — �� � } M�•r� � t�-��t � " , I �j i i - - - - �I __--------.-'—"�' � � � �➢.ke.. I _ _ ___ � , i�T i - - � ?S � j � ���V'l�¢��.^�-. �.�.lor �lih ..- __. �/ Fire Number and Name of Road �(�\5� �P���� F�r 4 1. Enter lot dimensions and indicate north by arrow. j nature f Own�er or Authorized Agent: 2. Indicate the location and size of the requested construction ����� Signature a.Ct1V1t18S. —r� n Print Name: L��J,A ��o��.� 3. Also, 1ndlCate tlle IoCatlon and d1StanCe to tlle well, The above cedifies Nat the listed intormation and intentions are We and cortect.,ihat all work shall be pedormed in compliance septic tank and drainfield, wetland azeas, lot lines, with the requiremenLs of ihe Sawyer County Zoning Ordinance and the laws and regulations of ihe State of Wisconsin, and if centerline of the road and waterbodies. acuny as ovmer�s�a9eoc, nas cne���5�0� or me ow�e��s>�o peAorm the work requested on this application. The above persons/s hereby give permission for access �o the property for ansite inspection. Permit fee: $ I(;� -" Total land area within 300' of the waterbody: (A) ���. , �' Total impervious surface area (including this project] (B) 3S� (B)/(A) x 100 = % Used >•G.'S �-> (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No � , � Ttm2 1$� ��O�i . - ���' Issue Date Signature of Issuing Agent June 15, 2005 50%Rule: AverageRoadSetback: Expiration Date Office Comments: _ ' ---J , . :�,n. � ,y . , �Q �- - - � �' R,' � .�� . �� i CITY OF HAYWAD � • � . � S I � 010-941 z i -28 1304 ' � 010-941-28 .a3nc. .. 1303 010-941-28 1319 /./ 3.BOAC. 2.48AC. ' /i .82AC. 1,e 3 ,9M� 2 /i �1� 1 .83AC. S�`,P 2 /� i1'� �lC t � 3 � i9�10 . �O ���r� ' O�� .`� �,�I,��PG 90 �9C l SW— N E o,��9� °�o, °s�� ' , S E— N E 9 0 �30s�� �O�9T 78n0e /' /� � �� �,/i O�J9l� �BtqCe'Y � � p�/ O,��y .87AC? ,�y+f � ! * G��\/ �1 ��1�? �� O E�'�� �9 .87AC.e � 070-941 �Jj*i` t. �C Q,� , -28 4208/ �j0 � ?B � i �g J2AC. pA ' P .9 C � _2g � J� fj k1. `� ,O� ,/ `� rye O` _ __� � �/i , �J��; 1.16AC. ,9k\�' � .18AC. .62AC.� 1�i/ G ��gR zan : � -/ �l �Oj�� 1�. °AC �' O j qy .83AC. / N W-S E Q �� /' � `"� /� t � i = k1'�� k'� ^•,� 11 � x`�ti$ � � ���kry � � / ��' 2.66AC. � , 010-941-28 4210 U i.oi,y'`,�9 ;L�ry / p,�0 Rry , �1. s J � �� NE—SE �� , i ,9WO� I.SOAC. 2.11AC. Ib2AC. y,� 1'f"' .-'K"'�". 3 �O �`l' s �i 010-941-28 N t:,��- ^ �.. �,�, �-�� � �. O 124AC. r y 4225 i � �� ��' ' � � 1.50AC. ��a ri ��y m O r \� � ~ np � ^� o��` � �0 a o � � `9 � o �� ��,,.�� _ : r � p 7'�z rJ." , � nc �o F �?' �a w i.sznc. � a � 010-941-28 =�� ��� � � �� �,, � 4226 � Gi�? .^,��r�'. o � � x a ' r�9x� � m = �� ���"_.. �J �2e __'_'_ N 2.34AC. • �� Dt�� 1SMG 9 p� . . \\� V 1B 1.56AC. 8 �.60AC. p J�O� 010-941-28 070-941-28 p 1 4216 4222 .;h �-�:; �� � 'L.�,,.i»«.^` .. 1 JBAC. / i.e6nc. 010-947-28 4402 V 3 � �4� 010-941-28 r."�r,� � 4302 010-941-28 � 4403 I 209AC. 010-947-28 4301 O� az.3��c. 070-941-28 � 4303 �P a.�anc. I i.eonc. �� ry �y. Q' ,r• ��� SE-SE SW-SE ,�,o � 1.14AG � 6}AC. 010— 070-941-28 � 941-28 4404 4304 eanc 010— 010-941-28 941-28 4305 4405 � ssAc. ClTY OF HAYWAD zsnc. — —'-----_— �.� . 010-941-28 � � 4306 _ 1 �•t`�'b - .«.t,� fl I -RAPHIC SCALE TAX ASSESSMENT PURPOSES ONLY aoo soo isoo Information contained on this map is advisory. Map accuracy is limited by the quality of the public records from which it was prepared. It is not intended as a ( IN FEET ) substitute for an accurate field survey. 1 inch = 400 ft. SHORELAND PRESERVATION AGREEMENT (Shoreline Veeetation Protection Area) Land Use Permit No.���z(To be entered by the Zoning Office) Index No. Q�-Z�f� i WHEREAS,(list all owners) C�-v y`� `�`�„����_ �1�t,,�� � '�.� rP� � � li — a 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'landward from the ordinary high-water mazk of the waterbody. � The owner(s)hereby agrees to comply with the shoreland vegetative protection area requuements 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 authonzed 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] L� 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 OPROTECTION 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 Ordinauce, 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. Legal Description of Property: j�y� S�y4 -�� �� �ta�.� �\ �,�,�� �,,., 4 ��e� Dated this �,c�� day of �"„�Q , �x-�e� e���� � er) (Owner) �`���[a,m.YJ(til%/����.lA.��� (Owner) (Owner) (Owner) (Owner) This uistrument was drafted by: Sawyer County Zoning Office 4 �� ( � � R N' t � j . ' 7�. �"b- y ,�i�.�.. � . `. �3` . - r ' , . � . y ��.� � " � � .. t , . ... ♦ f ' �LY' �{ r ., � � � � �- � ' si�_ * 4 � , _„r. �. � '� � �y w � �,. � �.� !1. � •k•. �.� •�? �L� ii , YW ,it ,s� "� `��, �` � �4-.^ '_. .�` \ t . �.w- -i�.. . �A 3 3' P^ . 1' .� '+w�. -. � �ih y � 7� t�' �., � .� � X. ��` � . �.� � � 4' . � � ♦�� �"'���� }.v1T:A( � �� t�;� ' #a�� ��" ♦ .Fe ' : � R � . . ,F �� �. i`�J'�'� . �^:� •. � �y� � �� 1'� � P� . �T� #` �9 - R 'Bs"���>"�,��-k' i / r�'., $� 'Y .� f �� � �;�. , =��� ��� � � . , � . +r�.ci,.a,f''�,es *' �,� `3�. 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