HomeMy WebLinkAbout012-739-06-4210-LUP-2004-168 /�-
Application for Land Use Permit(*Shoreland*) o 0
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 r
the property's boundaries. �J �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL /
�u2�nne�f'rl�cht�et L2r,c �c��� � �
Owner Builder o��-
�(J�-�fl.� �.k�J� �-C� N �
Mailing Address Mailing Address � p
C�x��r2� W1 ��cY.�� � �
City,State,p City,State,Zip �`
G�� ��� i�i��3 �
Daytime Phone Daytime Phone
Additional Information: Zone District: ��—�
Lot Dimensions: �
Date lot was created: Acres: U.$-10 A
�
Is there wetland neaz the proposed structure?If yes,how far ° N
Building Land Use Floodplain:( )Yes (�No � A
O New O Filling Chippewa Flowage:�Yes O No n 3
3
(�Addition O Dredging Driveway access off of a(Check one): � �
( )Alterarion ( )Grading ( )Private Rd �C)Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy °Q
� ) � ) � �
Primary Structure Accessory Building Addition o �
( )Dwelling ( )Garage-attached/detached (�eck �
O Yeaz round O#of car stalls O Porch L,
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room c� I'
( )Modular/manufactured ( )Greenhouse ( )Kitchen v �
( )Mobile/manufactured ( )Other ( )Bedroom C3 ��
( )Other primary structure ( ) ( )Relocate/enlarge �;, �
( ) ( ) ( )#of new �
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AdditionalInformation: ^� p
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Q �
¢� �
Type of Construction: ,�,� �
(�rame ( )Log� ( )Pole/metal ( )Block ( )Concrete N
( )Other �
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Construction Cost:Primazy Structure$ /K L� �
ro W
Accessory Building:$ �j�. Addition:$,���D ' � �
$�-3/S�i7 fo �
Deed:Vol Pg Certified Soil Test#�6-l`b� � z
CSM:Vol Pg Lot# Sanitary Permit# �j(p'Ic"i7 °4 '7y
Plat Envelope Or: o, ,�j
Condo Vol Pg Yeaz Installed: �,
"Loads and Flows": Vol Pg Owner When Installed: o �
ci
Previous office approvals/actions: q�(-a� �
Vaziance:# LUP:# �Q-ab$ SP:# CUP:# G
Inspection Report:# Change of Zone District:
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Describe the construction using these columns. List the dimensions of each structure in a separate
column. List eac story, each addition, each alteration in a separate column.
#1. #2.�GlC. #3. #4.
Size . wide /�ft. wide ft. wide ft. wide
ft. long �ft. long ft. long ft. long
Floor ar sq. ft. ��sq. ft. sq. ft. sq. ft.
Hgt from e to pealc ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
#of b drooms
Lake/Pond/Flowa e/River/Stream Name
SP� l��i4��i�A6/[�tl�
Fire Number and Name of Road ��SJ�/ ��lCk'i-ODfZA7 ��
1. Enter lot dimensions and indicate north by arrow. Sign ure of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction �C y� i - �,rl'�i��•
Signalur
3CtiV1tleS. PrintName: S�«a'�n4= ��`���J
3. Also, indicate the location and distance to the well, The above certifies that the listed information and intentions are
We and cortect.,that alI work shall 6e pedortned in compliance
septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning ONinance
and lhe laws and regulations of the Sfate of Wisconsiq and if
centerllne of the road and waterbodles. acting as ownef(s)agenC has tne pertnission of the owner(s)to
peAortn the work requested on ihis application. The above
personsls here6y give permission for access to the property for
onsiteinspeclion.
Permit fee: $ `j��
Total land area within 300' of the watexbody: (A)3o,Gbo
Total impervious surface azea [including this project] (B) a yg0
(B) / (A) x 100=% Used g.3�o (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? �j Yes O No
� � 1 �
May 11 , 2004 � �v"�� � _
Issue Date Signature of Issuing Agent
Mafy 11 , 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments: 3�«��'�/ �. �/79/Z� �Q,�/Q� ����� " n'J � �S ���U�-t
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SHORELAND PR�SERVATION AGREEMENT
(Non-Intact Shoreline Veeetation Protection Area)
� Land Use Permit No. —� l� (To be entered by the Zoning Office) Index No. (�Z - /�
a WHEREAS, (list all owners) rC�j�¢p� �(f � �fzQif�� �,�
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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
c� with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Deparfinent.
� The owner(s) hereby agrees that at all tunes 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
t�p that the Land Use Pemrit 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 to
� inspect the struchue(s) or uses authorized by said Land Use Permit and to detemune if the SHORELINE
� VEGETATION PROTECTION AREA eitists and that it is being preserved. Viola6on of this Agreement will
Q 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 Pernut. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
Legal Description of Property: �� ?3S- 06 — 'ti�o�l�
s� S �O 7-3s,u �Gc�
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Dated this�_day of A� � , �'� p l�
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(Owner) (Owner)
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(Owner) (Owner)
(Owner) (Owner)
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�i�e Ga,�.�-1 r,u�d s��� n�' �P i,�/�e�-
This inshvment was drafted by:
Sawycr County 7oning Office
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