HomeMy WebLinkAbout024-741-30-1404-LUP-2004-084 y J \
Application for Land Use Permit(*Shoreland*) ,1\
County of Sawyer ° � - .
PO Box 676 -Hayward WI 54843
715/634-8288 O
*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 PERMTTS HAVE BEEN ISSUED.
H R.5 PK% PRINT-USE BLACK INK OR PENCIL
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�Owner Builder a �
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Mailing Address Mailing Address � p
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City,State,Zip � City,State,Zip �` �`
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Daytime Phone Daytime Phone � �
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Additional Information: Zone District: �i�-j U�
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Lot Dimensions:l,�,j�j(J'-�L��.J`.J`�� �- �
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Date lot was created: /'7�i Acres: � �>C� y
Is there wetiand near the proposed structure?If yes,how far /F�ii9 0 �
Building Land Use Floodplain:O Yes �No � ^
�Q New O Filling Chippewa Flowage:O Yes (� No c� R�
O Addition O Dredging Driveway access off of a(Check one): x�
( )Alteration ( )Grading ( )Private Rd (1Q Town Rd. �
O Moving On O O County Hwy O State Hwy b0
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(�'S�J�iTi0iUX1 L N �
�r iA�'tf[-� E�t1�'Alyc � o
Pnmary Structure Accessory Building Addition o
( )Dwelling ,�JGarage-attache detached ( )Deck �
O Yeaz round f�)#of caz stalls O Porch W
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room �o, l/�
( )Modulaz/manufacYured ( )Greenhouse ( )Kitchen � R1
( )Mobile/manufactured ( )Other ( )Bedroom �,
( )Other primazy structure ( ) ( )Relocate/enlarge � '
�i E +� .�E ( ) ( )#of new ` � �
� � /D a'�7" � R1
AdditionalInformation: � p
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Type of Construction: � �
�Frame ( )Log ( )Po1e/metal ( )Block ( )Concrete
( )Other
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Construction Cost:Primazy Structure$ �
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Accessory Building:$ ��L'C>L�,C'c'� Addition:$ �
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Deed:Vol��,,Q Pg /�� Certified Soi]Test# `�%-/y,� '�
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CSM:Vol ��Pg '�Lot# r i _ Sanitary Yermit# �,j -O/� °4 %h
Plat Envelope Or: o, �
Condo Vol Pg Year Installed: �;,
"Loads and Flows": Vol Pg Owner When Installed: � �
�//-.�C/I7i95 G�f lLCL y '
Previous office approvals/actions: 00-0(c( .�
Variance:# LUP:# `t3�633 SP:# CUP:# `P.
Inspection Report:# Change of Zone District: 1�
a�sie �
�59y�
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. �
#i. e #2. #3. #4. �
Size � ft. wide ft. wide ft. wide ft. wide ,
�fr. long ft. long ft. long fr. long �
Floor area 6�� sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade�to peak ft. hgt. fr. hgt. fr. hgt.
Stories � stories stories stories
# of bedrooms �
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road �G����y/v ��' �iL i1//i�L-� CfJ�
1. Enter lot dimensions and indicate north by arrow. Sirga�tu of Ownej'or Authorized Agent:
2. Indicate the location and size of the requested construction �' ' %/�,(/�(�i� �
'Lo. e 6fZ SignaNre �
activities. �f���S �ALL�L�
PnntName:
3. Also, indlCate tlle locatlon and diStanCe to the Well, The above cerEfes ihat the listed informalion and intentions are
We and cortect.,ihat all work shall be performed in compliance
septic tank and drainfield, wetland azeas, lot lines, wNi Ne requiremenGs of lhe Sawyer County Zoning Ordinance
and Me laws and regulations of the State of Wisconsin, and if
centerllne of tlle road and waterbodles. acting as ownef(s)agent,has tne permission ot tne owner(s)to
perform the work 2quested on this application. The above
personsls hereby give pertnission for aaess to the property for
onsite inspedion.
Permit fee: $ /�"C ��C
,
Total land area within 300' of the waterbody: (A) ?'� � :
Total impervious surface area [including this project] (B) �3 9� - —
(B) / (A) x 100 = % Used ��_(Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes No
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April 26 , 2004 _
Issue Date Signature of Iss i g nt
Apr i 1 2 6, 2 0 0 5 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
�F ROUND LAKE
TW P. 41 N. R . 7 W.
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Page 1 of 2 pages
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( . �;:,.:..; Ueputy
SHORELAND PRESERVATION AGREEMENT
(Intact Shoreline Veeetation Protection Area) ' '
Land Use Permit No. �y_08 � (To be entered by the Zoning Office) Index No. �- ��
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WHEREAS, (list all owners) �/�Or7{s � �%LL-�=L�r' °d /T/� G, /�/,�LLCC�_
��.��9 �c/ /yl� C'L/�//dC ,��/��
!��/�y�i/�,P�, ��i.� ,5-����3
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 ordinazy high-water mazk of the waterbody.
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 fg�owing description 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. 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 Pemut. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
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Legal Description of Property: �C7lz/,Z/ � � �4/y�/� �l3rk'L-'
�q� v� ��T SE' / ��' %� ,5�e . .�o �i'��%� s�i ti 7 ai
CGrr?t��ii�i° :z� G%� � _ 75�i - .30 - iS�o;L .�9�c�=� �1 , �, �
a th' � v�� day of �<' ��U 5�
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(Owne ) �' � (Owner)
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(Owner) (Owner)
(Owner) (Owner)
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�:; ,4 �r S�T ��' y ���_� i��� �,�<�,�«� ,;���c� . �
This instrument was drafted by: ��t �����G��
Sawyer County Zoning OCfice
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