HomeMy WebLinkAbout010-118-00-2500-LUP-2004-661 _ �� '
Application for Land Use Permit(*Shoreland*) � o o -
County of Sawyer ,�� � �
PO Box 676 -Haywazd WI 54843
715/634-8288 °�-
*Property that is located within 300'of a creek,rivex oi stream or within 1000'of a W�. ��- �
flowage,lake or pond or has any of the above waterbodies located within � �'
-- the property's boundaries. <++ ' '
CONSTRUCTION SHALL NQT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. W �"
�RINT-USE BLACK[NK OR PENCIL �
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Owner —�- Builder a�c �
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Mailing Address ` Mailing Address � O
�/���Y/9�-�l � .Si�Yn2 l � `
City,State,Zip ,`: � City,State,Zip
Dayti�Phone Daytime Phone �
7�s 63Y-S`��'y
Additional Information: Zone District: ��
Lot Dimensions: o?.SO f I,�C� � i�
Date lot was created: / f�'.� �__ Acres: � �
Is there wetland near the proposed structure?If yes,how far o
Building Land Use Floodplain:O Yes (�'N�o �
(�"ew ( )Filling Chippewa Flowage:( )Yes ( ) No c�
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration (,�-Grading ( )Private Rd (�wn Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy "�
� ) � ) � `,�
Primary Structure Accessory Building Addition o �
( )Dwelling (!�'Uarage-attached/detached ( )Deck �
O Yeaz round �t of car stalls O Porch �;,
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Othex ( )Bedroom �
( )Other primary struchzre ( ) ( )Relocate/enlarge
O O O#ofnew ,>
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Additional Information: p
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Type o�Construction: �.� r�
rame ( )Log ( )Pole/metal ( )Block ( )Concrete � � ��;
�
( )Other � �� �s
o '3 �
Construction Cost:Rr•�ar�-Structure$ �� �J b �
ro
Accessory Building:$ /d'�0 oa Addition:$ �
o y
�
Deed:Vo1 3q% Pg 32� Certified Soil Test# � � �
c_, -
� z
CSM:Vol Pg Lot# Sanitary Permit# � �-j °O �
Plat Envelope Or. � ,
Condo Vol Pg Year Installed: �o� `� i;,
"Loads and Flows": Vol Pg Owner When Installed: � �
�o�� "
a �
Previous office approvals/actions: ,� �"`
Variance:# LUP:# � -� �l,� SP:# CUP:# � � �J�
w
Inspection Report:# Change of Zone District: �i �, \�
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Describe the construction using these columns. List the dimensions of each structure in a separate
c lumn. List each story, each addition, each alteration in a separate column.
#1. � #2. #3. #4.
Size 3Y � ft. wide ft. wide fr. wide ft. wide
�8 ft. long ft. long ft. long ft. long
Floor area �� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt from gcade � j to peak fr. hgt. ft. hgt. fr. hgt.
Stories � stories stories stories
# of bedrooms � n�� O ��
�'C �t
Lake/Pond lowa e/River/Stream Name /��
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— C„ � �. �� 3� �'
75 � ���� o �
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20
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Fire Number and Name of Road I oZ(i"7�W S• S�o� � .
1. Enter lot dimensions and indicate north by arrow. Signati Fe o r r or uthq[i�ed Agent:
2. Indicate the location and size of the requested construction s�7`
SignaWre
activities.
PrintName:J a�f�l/ nJ . �
3. Also, indicate the location and distance to the well, The above certifies that ihe �isted information and intentions are
true and conecL, that all work shall be pedortned in compliance
Septic tank and dralnfleld, wedand aTeas, �ot lines, with the requiremenis ot the Savryer County Zoning Ordinance
and Ne laws and regulations of the State of Wisconsin, and if
centerline of the rOad and waterbodies. acting as owner(s) agent, has the permission ot the owner(s) ro
peAorm the work �equested on ihis appliration. The a6ove
personsls hereby give pertnission for aceess ro the property for
onsite inspection.
Permit fee: $
I[�C, �`�
Total land area within 300' of the waterbody: (A) � °�i o��
Total impervious surface area [including this project] (B)_� QOo
(B) / (A) x 100 = % Used _� (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Re uired? O Yes (� No
November 17 , 2004
Issue Date nature of Issuing A en
November 17 , 2005 50% Rule: AverageRoadSetback:
Expiration Date
OfficeComments: (�1.� hp�J�jt{p��p�� LiUi� ��p iq..��D��� � �
� 1�15�04 C�
SHORELAND PRESERVATION AGREEMENT
(Shoreline Vegetation Protection Area)
Land Use Permit No. �5/- �p(p/ (To be entered by the Zoning Office) Index No. Q�- �p�o�
WHEREAS, (list all owners) Je J�`V �� �/(� l� Y�
,
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 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
�1 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 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
0 Zoning Office.
Legal Description of Property: � o TS .2 ,� ✓ q� � y /�iQ�4 / o � � 7
Fo��la�A--r�� �c.4�b� s� 73 L �-- �J-� 6 y
-26 - �/� - k � ar d6 t 60
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Dated this / � day of '1ZgY—, , 200 ,�
(Owne (Owner)
er) (Owner)
(Owner) (Owner)
This ins[rument was drafred by:
Sawyer County Zoning Office
EDGEWATER BEACH
SUBDIVISION
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GRAPHIC SCALE
TAX ASSESSMENT
wo o zoo �oo aoo ieoo Information contained
advisory. Map occura
quality of the public
was prepared. It is r
( IN FEET ) substitute for an acc
1 inch = 400 ft.