HomeMy WebLinkAbout010-841-35-5404-LUP-2004-417 � Application for Land Use Permit(*Shoreland*) o 0
County of Sawyer �
PO Box 676 -Hayward WI 54843 �w
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 boundaries. ¢.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �, +
�iCK /J�°I So�l, PRINT-USE BLACK INK OR PENCIL ^ �
�'�ne Sn.yh�r �
�r�4� �l�a (.��n � T�1� lle�no�and Cr4s�b./ �/e/so� � `
Owner � ��7�/ /�/Gc.) ���.�� Builder �;Fe ES/u�e a
I'�7��' .l��.f! ._� �" o• �
Mailing Address Mailing Address � O
'-v�c�� �IZ 5�il�3S-fs�t,,�� �
City,State,Zip City,State,Zip
�
—7ii 5!a`/-S 4/3 +�a�: c'
Daytime Phone Daytime Phone
Additional Information: Zone District: ���L
Lot Dimensions:
0
Date lot was created: Acres ��c`�
,r
Is there wetland neaz the proposed structure?If yes,how far o
Building Land Use Floodplain:O Yes O No � ..
( )New ( )Filling Chippewa Flowage:( )Yes ( ) No �o �=
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy °�
G�
�) � ) � �
� r
Primary Structure Accessory Building Addition o 0
( )Dwelling ( )Garage-attached/detached ( )Deck �
( )Yeaz round ( )#of caz stalls ( )Porch �„ —�-
( )Seasonal �Storage Building ( )Enclosed �
O Frame built on site OScreenhouse O Living room co
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen V
( )Mobile/manufactured ( )Other ( )Bedroom _
( )Other primary structure ( ) ( )Relocate/enlarge .� �
� � ( ) ( )#of new `�
�
AdditionalInformation: �- p
��, 1�. �1:��lScti� �:�T L��'� L,��C �a�2� r r�
W �
Type of Construction: U
( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete G. �
�l'
( )Other O y
�
Construction Cost:Primary Structure$ ro �
w
Accessory Building:$ �L�� Addition:$ �
� �
Deed:Vol (s`i 7 Pg�_ Certified Soil Test# �)�-1; r��5 � z
CSM:Vol Pg Lot# Sanitary Permit# ��c�-,Z y� tlQ 7�
Plat Envelope Or: o, Irp
Condo Vol Pg Yeaz Installed: N I�
"Loads and Flows": Vol Pg Owner When Installed: o
0
4' -u�3 a.
Previous office approvals/actions ���, ��� �
Variance:# LUP:# �j',z -U�/ SP:# CUP:# ,�
Inspection Report:# Change of Zone District:
8/5�6y
l t g 2-0 �
Describe the construction using these columns. List the dimensions of each structure in � separate
column. List each story, each addition, each alteration in a separate column.
#1. #2. #3. #4.
Size ft. wide _L�ft. wide ft. wide ft. wide
ft. long ��' fr. long ft. long ft. long
Floor azea sq. fr. 3(r0 sq. ft. sq. ft. sq. ft.
Hgt.from gade to peak ft. hgt. ft. hgt. ft. hgt.
SYories stories stories stories
#of bedrooms
Lake/Pond/P'lowa e/River/Stream ame � � ��`� l`� `-�'�� ��`���
1�����
�—,�i����'; .z ��
��' a �
$3
- �
,�,���pw, .�a,u�a�2.
U
� 932
��� Sh� 34O
`��t �,°o
S{�,d, `T h
i >�"'
�i
-!z�' �
Fire Numbe d Name of Road `�?�8 /il /�FSk�'r._� 'i2,�c, �-
1. Enter lot dimensions and indicate north by arrow. Sig�ure of Owne�r qr�/juthoriz�� ed A9ent:
2. Indicate the location and size of the requested construction �( a��7,�, �,, % I xJ
8CY1V1t1eS. � Signatur6
Print Name:
3. Also, indlCBte the IoCdtlon 2Sld diStBriCe YO the well, The above ceRifies ihat the listed inFortnation and intentions are
tme and wrrect,that all work shall be pedormed in cnmoliance
septic tank and drainfield, wetland azeas, lot lines, with the requlrements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin, and if
Centerllne of the road and WateIbOdles. acting as owner(s) agent has the permission of the owner(s)�o
pedorm Ne work 2quested on this application. The above
personsls hereby give permission for access to the property for
onsite inspedion.
Permit fee: $ 75pO
Total land area within 300' ofthe waterbody: (A) 3o�p5�v
Total impervious surface area [including this project] (B) /$8J3
(B)/(A) x 100 = % Used (o°Jc (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes (�No
August 9, 2004
Issue Date Signature ofIssu g ent
August 9, 2005 50% Rule: AverageRoadSetback:
Expiration Date
Office Comments:
.--- \
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GRAPHIC SCALE TAX ASSESSMENT PURPOSES ONLY
o zoa ♦oo eoo ieoo Information contained on this map is
advisory. Map accuracy is limited by the
quality of the public records from which it
wos prepared. It is not intended as a
( IN FEET ) substitute for an accurate field survey.
1 inch = 400 ft.
.
SHORELAND PRESERVATION AGREEMENT
01 (Shoreline Vegetation Protection Area)
c
i� Land Use Permit No. � y � y l f] (To be entered by the Zoning Office) Index No. �- y� 7
q WHEREAS, (list all owners) ' � d �I /�p.LSo�'1 ,
f ��P So�.,, � ���� Tv n `�cc_�I-�i� �' _
� �e.�Son , I/E r n o n n n d v�� S �cx, I ,�i �� E� �ec.�e .
1
� 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.
tJ
� 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 mark of the waterbody.
J 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 authorized
-a 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 struciure(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
j structures approved by the issue of said Land Use Permit and the revocation of any other uses approved by the
T issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
� Zoning Office. .
LegalDescriptionofProperty: Part of Gov' t Lot 4 in Section 35 , T41N , R8W
Being im the ' Town of Hayward, Sawyer County , WI
Date this � �— 0 day of ,
� � �
�
(Owner (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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