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HomeMy WebLinkAbout024-741-30-1408-LUP-2004-204 Application for Land Use Permit(*Shoreland*) o 0 County of Sawyer � � O PO Box 676 -Haywazd WI 54843 v 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 withiu Z ' the properry's boundaries. ° CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �_. PRINT-USE BLACK INK OR PENCIL r. � �- r�Nz��eQdo,,y%.L�c�LFk��l��:r Q�✓�lo��r:a.�}- Scl,�:��au. to,,s�iu�{��,) � � Owner '�- �y�✓-^'� C Builder a �/ �./ )�� / � ,� / �� o 0/IG W VV-^=)Q�//N /�U DY: /y-�/�I'`'���J �!L l�✓Yf�� �. Mailing Address Mailing Address � p f��,�cuo✓d 61/, .S�`iG`l3 E7K ltilc-*^��. G/t/% �473�i � � City, tate,Zip City,State,Zip � 7rs- 9`s�l- i/6i 7�r ���i-s�i7� � Daytime Phone Daytime Phone � � �. Additional Information: Zone District: 2�`-� S A � Lot Dimensions: /�6�,•r�X 5����a�� � � l'i"l� - �Y,s�8 sX ;��. � Date lot was created: f�`�' � Acres: ��S � Is there wefland neaz ttte proposed stiructure?If yes,how faz /',r� o �' � B 'lding Land Use Floodpiain:( )Yes (✓SNo � � (�New ( )Filling Chippewa Flowage:( )Yes � No � � ( )Addition ( ) redging Driveway access off of a(Check one): x� ry ( )Alteration (�Grading ( )Private Rd (:�Town Rd. � � ( )Moving On ( } ( )County Hwy ( )State Hwy � �ti � � � � N �y �._ P' ary Structure Accessory Building Addition o ,�r. (J�Dwelling ( )Garage-attached/detached ( )Deck � (Jf Yeaz round ( )#of caz stalls ( )Porch W ( )Seasonal ( )Storage Building ( )Enclosed (��JFrame built on site ( )Screenhouse ( )Living room � I� ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ( )Mobile/manufactured ( )Other ( )Bedroom .� p- O Other primary structure O O Relocate/enlazge S� � � ( ) ( )#of new �,`� �J � AdditionalInformadon: ',� > u� � � � T of Construction: � �ti (�rame ( )Log ( )Pole/metal ( )Block ( )Concrete ? rJ v ( )Other y Construction Cost:Primary Structure$ /S C���`� ,ty � Accessory Building:$ — Addition:$ � � � �13a1�yy � � Deed:Vol Pg Certified Soil Test# Q���Jr 9 �; z CSM:Vol�_Pg/a9�/.3G Lot#�_ Sanitary Permit# Uy- I �_`i �' � Plat Envelope �'� °` � Condo Vol Pg Yeaz Installed: n� � "Loads and Flows": Vol Pg_ Owner When Installed: ,�.�, 0 Previous office approvals/actions: Variance:# LUP:# SP:# CUP:# Inspection Report:# Change of Zone District: ,5�)���6`1 - as��lc� lV�' 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. /S� .j-io� ; #2. #3. #4. �: Size�ft. wide ft. wide ft. wide R. wide � t `t� ft. long ft. long R. long 8. long Floor area «`�� sq. ft. sq. ft. sq. ft. sq. ft. � , Agt.fmm gade !`/� to peak ft. hgt. ft. hgt. ft. hgt. � . , Siories � stories stories stories ' � #of bedrooms as Lake/Pond/Flowa e/RivedStream ame �`'✓tJ °• �`k� •, o , k;,,icl , �.z /�`-��" � �rt�n � � �J P�,✓ �` � w� � /' ��� Z. � � ��V � ,u'��i�.r/� �}�Z„W / �1�� ��, ���C I 3 ,�..�� i IA � � 3c' ' �.o''� — _/���s�.,�-�, �Jz,. ,�` Qp(' �9c.fst � yB� �d:dri �L � � ✓�n�' �� d � ' � S �l } O � � � t � W c , , � '�n � : �vr�I = �'e6�,� � r�' rn,� �,,.:�� i/ �J(a� � 5���,-���iG�„r�ir�G� ' 6C;T� �G ' �� i 1 (� ��J�� / 1 _.N.� ��t.ISC . C iT � �i � � I I� I ��C. ��i /•��C (Ci�� .�iz.� i7 : Fire Number and Name of Road 1`rf c � ����� ��� 1. Enter lot dimensions and indicate north by arrow. Signat � f er or Authorized Agent: 2. Indicate the Iceation and size of the requested construcrion R — , , .SignaNre , � activities. -!, PM�r�ame: . �,i.� -I-�i-l<���o 3. Also, indicate the location and distance to the well, rna anove�ma�me usmd a�eo�and imemq�s are true aM conect..that a9 work shatl be Perfortned in comPllance septic tank and drainfield,wetland areas, lot lines, `�'�'�a°'�"e"�s ot me sawy�ca„'ty Za� °'d"'a"ce ar�d the lews and regWetlans of the Slate M Wiscons'ei, aM it centerline of the road and waterbodies. a�'°a$°"'"er�s>aye"c�es m�ae"'�s"°"of ine°W"eK')m perfam the wak requested on this applica6on. 71ie above peisonsls herebY 9ive pmnission for access lo the P�We+h for o�ile in�ection. Permit fee: � eoo, c,� Total land area within 300' of the waterbody: (A) y/ ,f'��� '< r Total impervious surface area [including this project] (B) /s ,S' (B)/(A) x 100=%Used °%c (Shall not exceed 15%[or 25%with a conditional use pernut].) Shoreline Vegetarion Protection Area: Mitigation Required? ( ) Yes (�j No � —7 May 21 2004 - Issue Date Signature of Iss ' e t May 21 , 2005 50%Rule: Average Road Setback: Expiration Date Office Comments: .�r K � u �uu LH nC TWP. 41 N. � • 7 W• . / 9 �� :�.� 2' � ' � 2.5 2. 1 .1.1 � 5 3 3 4 y 1.6 ,�.a 2 5 \ .7 6 r'�r1._����. .1.8 1.7 2 3 2.3 ( ' � s.pz �l � '1 I.'F :1.8 � i � ` I 1.3 �1.9 1 � 1.2 _ 2.2 � .z.4 " ` � �,-��\ � °`� :2.1y �4 t�— ��, i ,.� � .3.T � � .4.1 2.9 ig �y r � ) 2 .2.18: .3.3 1` Y l , .4.2 :2.ia .3.8 2 a I .4.3 3 :2.i2 �3�6 3�\ -J '� � z .3.5 1) � j� 4.4 :z.i .3.y , W j 4.7 � .3.w �-- W . � .3. 1 Z � 0 4•8 :2.4 �� �Z�S\ 3.q � � � v � --- --4.5 _ _..:1 32 � W � � i,�v � .II � / .l4 � ' __ .:.�o � - , � a.b ;z.ic ' .a.i� 29 .� --r t .�. — — — �3.e ' :2.5 � I3.1 ' � ' \, 13.T � 13.6 ' s 13•3 13.4 � , �3•5 � �� .13.10 —`— ^— �� > ' �_r � � ia.2 \ , � i � �- t Is.q i 1�111 r� � 2.83 � � yL � �/ � � ! i � / /�` ' ' . � ��� , F � �/ � � � � � � tS' � � � i''`f � �'� � � � � -. � - , � ��-, '� ' ' � � � --- .-. �. � � � N. 88'2/' E 333.92 ,�� '�. 3S�o �. $$ o �11 N Z ry n 1� •�y � ry [ovEJoy SzZ� '� ' 5. 8 'zi• w sos.so' a�'. �OfER� , I p 89 ro^ ,��h a I rv�� �' 3 0 � �II� .Ly �2T \, 8k.Q• �s s N. 87'o8.s'E o.9/' og�_ W�. 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