HomeMy WebLinkAbout020-639-11-5218-LUP-2004-585 Application for Land Use Permit(*Shoreland*) o o �
County of Sawyer �
PO Box 676 -Hayward WI 54843 n'
715/634-8288 C �
*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. �J �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMTTS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL
P I
YRctL� E1�.�L'nl G�J A�D W��K �Iuss SM� �e�iR. � �
Owner Builder a
qo��ccl � �
$'�i a s, Kvsrn�E�, a3o1 �AST ro�re��r. �'!�4 0:
Mailing Address Mailing Address � O
C��e�h� t� . �0(-�5 Z mA�sNnE��.cJ+ s�/�ry MAzu1�Rv�.�i � �' t
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City,State,Zip� City,State,Z p .�
�7 3- 58 i - ��-� a 7i5����-zs�� ����da�{�» A
Daytime Phone Daytime Phone �
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Additional Information: Zone District: �/2 Z ��
1.o�a� PNonIG q7,9aoSF �
,..'��_ ;.�,��t,f Lot Dimensions: R
L
Date lot was created: �1,t�i= ly 9 q Acres: �• �/
Is there wetland near the proposed structure?If yes,how far �� o �
B ilding Land Use Floodplain:( )Yes ( )No 5 503 fi az ro(�� �
.�New O Filling Chippewa Flowage:O Yes (x) No c� �j
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration ( )Grading (kl Private Rd ( )Town Rd. �
(�Moving On ( ) ( )County Hwy ( )State Hwy °Q
� ) ( ) ���Jr�:'si�c`►Ra/L � 5
v� r
Primary Structure Accessory Building Addition o 0
�Dwelling (?(1 Gazage-attached/detached (Xf Deck � �
O Yeaz round O#of car stalls (}�Porch f�'`,a�'"FD�`� �,
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room co
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen �
�Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlarge �
� � ( ) ( )#ofnew C
c
AdditionalInformation: -�"o >
i �
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0
Type of Construction: � �.
(�'Frame ( )Log ( )Pole/metal ( )Block ( )Concrete T; �
G
( )Other '° ,�
Construction Cost:Primazy Structure$ �����{1 ,.d �
Accessory Building:$ /� ��'� Addition:$ � �
� �Deed:Vol Rz� Pg z Certified Soil Test# - - �,
CSM:Vol�z�Pg_�$_Lot#�_ Sanitary Permit# O����ZP � '�
Plat Envelope 59y� Or: � �
Condo Vol Pg Yeaz Installed: N
"Loads and Flows": Vol Pg Owner When Installed: � �
�
Previous office approvals/actions: N
Vaziance:# LUP:# SP:# CUP:# ���
Inspection Report:# Change of Zone District: I�I��,�
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l�°�
2-I IIS
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. I�o�t s 6 #2. C-aIE�2Af-, C DEnkAE+� #3. l��c°k '=wcxosc� #4. 1�kc� F�'"'
Size�ft. wide �' ft. wide � � ft. wide _;2�Q_ _ft. wide
S�c� ft. long �� ft. long �4� ft. long iC; . ft. long
Floor azea /S j / sq. ft. ��T sq. ft. I`{ L sq. ft. ��� sq. ft.
Hgt from gade � y to peak I 7 ft. hgt. � � ft. hgt. `� ft. hgt.
Stories I � stories I stories I stories
# of bedrooms_�
Lake/Pond/Flowa e/River/Stream Name L��P�E��1 �'�E�-
�°H i�3°Ea�A �� JE�.
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FireNumberandNameofRoad �l�i�'SIDE �q/�
1. Enter lot dimensions and indicate north by arrow. Signa re of Ouyne�r�_or�rized Agent:
2. Indicate the location and size of the requested construction �I,.�.L� c�J'
Signature
activities. n
PrintName: Y�l�� S � �C)A�J'�
3. Also, lndicate tile lOCatlon and dlStanCe to the well, The above cerGfes that Ne listed information and intentions are
We and correct.,tl�at all wo�C shall be perfortned in compliance
septic tank and drainfield, wetland azeas, lot lines, wiN ihe requiremenls of the Sawyer County Zoning Ord nance
and the laws and regulatlons of the State o(Wisconsin, antl if
centerline of the road and waterbodies. aa�o9 as ow�er�s>ayem,nas me Pe�m�Ss�on or me ow�eq5�to
pedortn the work requested on this applicatioa The above
personsls hereby give permission for axess to the pmperty for
onsile inspection.
Permit fee: $ ����5
Tntal land area within 300' of the warerhody: (Al � U 8�
Total impervious surface area [including this project] (B) � ��� � �
(c%
(B)/ (A) x 100 =%Used ,,,(o�, (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No
October 14 2004 —
Issue Date Signature ofIssui g t
Oetober 14. 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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SHORELAND PRESERVATION AGREEMENT
(Non-Intact Shoreline Veeetation Protection Area)
Land Use Permit No.��(To be entered by the Zoning Office) Index No. ?�-_5��
f
WHEREAS,(list all owners) A I.t S� ��`��'-D � L���t� �(/�, �j{�
owns real estate within Sawyet 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 PROT'ECTION AREA on said real estate shall be restored in accordance
� with the Mirigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
a
-�. The owner(s)hereby agrees that at all times 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
/� 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 to
,.� inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE
� VEGETAT'ION PROT'ECTION AREA exists and that it is being preserved.Violation of this Agreement will
3 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
ln 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: E:�o U ,Ce� � S�G l� T�+:ti� 0�9� /�4�-�C� � Lt�
Q d��iJA leJrS� T� n o-� i �
C"snt #.59��, V�c a/� Py P_f�9 ��za-lo 9- l�-5z �9
Dated this /Ui'`� day of O�tjklor , zGby
Owner �
( �J�c'�—,/J�Ct.2.��___- �OwnerC_Lf'I1.P�'t / '/.(.C/�'�
(Owner) (Owner)
�ku�. S L()�,2�i �'iG�E,� /lf, �/�,P�
(Owner) (Owner)
This instrument was drafred by:
Sawyer County Zonntg Office
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