HomeMy WebLinkAbout012-740-04-5302-LUP-2004-679 / ,
Application for Land Use Permit(*Shoreland*) r `
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 REQUIItED PERMITS HAVE BEEN ISSUED. �
PRINT-USE BLACK INK OR PENCIL
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Owner' Builder o,�°�-
,.Z 3�1 N M�IZTn.� �vE' IOC;�t8w CouN�' 2e �
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Mailing Address Mailing Address � p
h�n�<_"�c��� ,�'LLINoIS �-1550 �-�,-�iYtc��,uh��� (,.v�. -5 �I�'�/_� � �
City,State,Zip� City,State,Zip � �
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Daytime Phone Daytime Phone _
Additional Information: Zone District: �I�./
, r�, � � �;� ��� � � �� Lot Dimensions:1 I y X 3oy�k�'7C X�17' �
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Date lot was created: �Q`)R Acres: �.�// `
Is there wetland near the proposed structure?If yes,how far �;G o _
Building Land Use Floodplain:O Yes (x)No G �
O New O Filling Chippewa Flowage:O Yes O No n
(�Addition O Dredging Driveway access off of a(Check one): ,t �
( )Alteration ( )Grading ( )Private Rd (�)Town Rd. � ��
( )Moving On ( ) ( )County Hwy ( )State Hwy tlQ �
� ) � ) � �
Primary Structure Accessory Building Addition o 0
QQ Dwelling ( )Garage-attached/detached ( )Deck �
(Xj Year round O#of caz stalls OC)Porch �„ "'
( )Seasonal ( )Storage Building ( )Enclosed �
(}C)Frame built on site O Screenhouse (�)Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge �' `~
O O O#ofnew
Additional Information: p
�
�
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Type of Construction:
( )Frame (�)Log ( )Pole/metal ( )Block ( )Concrete -L
( )Other � �
Construction Cost:Primary Structure$ _ „ti �
Accessory Building:$ Addition:$�GC[ � _
� '
Deed:Vol Pg " I:. Certified Soil Test# 7S-3 y� �; z
CSM:Vol - Pg �'1 I Lot# `� Sanitary Permit#('►�.��� r�'--�'�CI � � %h
Plat Envelope �'S�� Or. b, � ��
Condo Vol Pg Yeaz Installed: N
"Loads and Flows": Vol Pg Owner When Installed: �c �
�
Previous office approvals/actions:
Vaziance:# LUP:# 9'y� SP:# CUP:# �
Inspection Report:# 7 hange of Zone District:
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Describe the construction using these columns. List the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a separate column. � �;
,
#1. � ;� �� -- � � � #2. � , �� � �,, ��_ � � �� P��ti #3. 4 �. ,_ �; #4.
`, � r� , ;
Size 3ti ft. wide ! ;� ft. wide ft. wide ft. wide � ,�
�-�- ft. long i � � ft. long ft. long ft. long � �
Floor area �'.1� sq. ft. :� ;� 1 sq. ft. "�- `�1 �' sq. ft. sq. ft.
Hg� from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories i stories � stories stories :,
# of bedrooms .
° 9
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Fire Number and Name of Road ' ' ;' r 1 : . : - �
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l. Enter lot dimensions and indicate north by arrow. Signature of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction � `� �_ �l , '; � ;-?;
�'� � r Signature �
activities. .
3. Also, indicate the location and distance to the well, Thet bove.certifies that the list$d information and intentions are
true and correct:; that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines, with the requireme�lts of the Sawyer County zoning Ordinance
and the laws and regulakons of the State of Wisconsin, and if
centerline of the road and waterbodies. acting as owner(s) agent, h�as the permission of the owner(s) to
perform the work requested on this application. The above
personsls hereby give permissibn for access to the property for
onsite inspection.
Permit fee: $ �S �
Total land area witlu'�0' of the waterbody: (A) � `� SoC� - , �_
, ,
Total impervious surface area [including this project] (B Za/0
(B) / (A) x 100 = % Used �, ��� (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? ( ) Yes (�) No
December 14 , 2004 _
Issue Date Signature of Issuing ge t
December 14 , 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
SHORELAND PRESERVATION AGREEMENT
� (Shoreline Ye�etation Protection Area)
Land Use Permit No. �/ — � rJ 9 (To be enteied by the Zoning Office) Index No. �y - � 79
WHEREAS, (list all owners) �E i<� r- y �� . �ti�� = 1 �.,' � �; H i r.' z �-/ I� . M c:i«
,
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' landwazd from the ordinary high-water mark of the waterbody.
V
� The owner(s) hereby agrees to comply with the shoreland vegetative protection azea requirements of Section
� 4A10 SHORELAND VEGETATION PROT'ECTION 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
� 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 sha11 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
�q issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County
i Zoning Office.
�
Q Legal Description of Property: To u> >J < y i P o �' �n .� � /1, G pvT LaT �
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Dated this zo day of Oc� � , ,ZGY�`1
(Owner) (Owner)
0.. �ti'� -
(O er) (Owner)
� � . .s.
(Owner) Q (Owner)
This instrument was drafted by:
Sawyer County Zoning Office
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