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Home My WebLink About024-741-17-3206-LUP-2004-405 Application for Land Use Permit (*Shoreland*) ` r `� ': 1 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 boundaries. � � CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �. � PRINT-USE BLACK INK OR PENCIL � �'��;��{�� t .�� f�'��{�i�;:� -.� d ,�.�D ��► � Owner Builder � ��f Q�-. � �- �c J, ;r _t j,., �- , �) ( (��p � ~ �' -� � �� t �4Par �• Mailing Address Mailing Address � p �«._r ,��'� ��i;��; �.c� Y� �ll J�" � � ��Xt/ r S`fg� 3 � � � � City, State, Zip� ity, St te, Zip �` �� -/.�.� - ��/�r� 7��- y6Z -37� I �� Daytime Phone Daytime Phone Z . ^n Additional Information: Zone District: � R � � Lot Dimensions: �- � Date lot was created: Acres: �,t �� Is there wetland near the proposed structure? If yes, how far ,� ;% � � � o Building Land Use Floodplain: ( ) Yes (�No � O N w O Filling Chippewa Flowage: O Yes �J No � (�dition O Dredging Driveway access off of a(Check one): � ( ) Alteration ( ) Grading � Private Rd ( ) Town Rd. � ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy °C \ � � � N � Primary Structure Accessory Building Add' 'on o � ( ) Dwelling ( ) Garage-attached/detached (�Deck � � ( ) Year round ( ) # of car stalls ( ) Porch W ,`. ( ) Seasonal ( ) Storage Building ( ) Enclosed � � ( ) Frame built on site ( ) Screenhouse ( ) Living room c� ��, ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � r, ( ) Mobile/manufactured ( ) Other ( ) Bedroom �� ( ) Other primary structure ( ) ( ) Relocate/enlarge �' � � ( ) ( ) ( )# of new ,.i AdditionalInformation: j „ �)�1 � r n f�. Typ f Construction: " �- (� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � ( ) Other �� n� �� Construction Cost: Primary Structure $� � b Accessory Building: $ Addition: $ . � c� 800 � Deed: Vol�Pg rJ f 2, Certified Soil Test# � z CSM: Vol Pg Lot# Saliitary Permit# � � � Plat Envelope Or: o� Condo Vol Pg Year Installed: �`c�� IC(�r. � N "Loads and Flows": Vol Pg Owner When Installed: � � � .� Previous office approvals/actions: `" Variance: # LUP:# SP: # CUP: # ��.a ��t�� Inspection Report: # Change of Zone District: �J �`� � � ��'`. . 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.�.c�� #2. #3. #4. � Size fr. wide ft. wide ft. wide ft. wide ,x� ft. long ft. long ft. long ft. long Floor azea_�sq. ft. sq. ft. sq. ft. sq. ft. Hgk from grade to pealc ft. hgt. ft. hgt. ft. hgt. Stories stories stories stories # of bedrooms . - � � , Lake/Pond/Flowa e/River/Stream ame '` ;— ,��k�A �� F ,-� 5 � . - � .- � G^� �' , ' �� ,�` __ � - r za ,� . �'4 ^ � ,� v' 20� . J f �...� � � � � � � � �� 5�� 2� -� ay - 3� z lo�c,�: � � t$ ' � r� �f� £ � ' 2V � • , ---_ ,'� , � , _ ,�� r � � � o � �. � c� �OD l� � I(B S�Ff� . Lp� 6� � /(� � 6�.�k �'� _ , .-� . _��-__ 3�"� Fire Number and Name of Road / % O �5`� ti� l �1� ��;�,�� _ �!'} 1. Enter lot dimensions and indicate north by arrow. Si r of Owne r A horized A ent: 2. Indicate the location and size of the requested construction 9 t� :�.7 g SignaNre activities. L /, 1� (� / Print Neme: �• ��T� l_F 6' ��1�n/ 3. Also, 1ndlCate tlle IoCatlon and d1StanCe to the Well, The above certifes that ihe listed information and intentions are • We and cortecL,that all work shall be peAormed in compliance septic tank and drainfield, wetland azeas, lot lines, wtth Ne requiremenLs of Ne Sawyer County Zoning Ordinance and ihe laws and regulations of the Sfate of Wiswnsin, and if centeriine of the road and waterbodies. a��e as ow�er�s�aqe��, na5 me Pe��55�on or me owne��s�to perform the work 2quested on Ihis application. The above personsls hereby give permission for aceess to the property for pp onsite inspeIXion. Permit fee: $ 7 � � Total land area within 300' of the waterbody: (A) �/ 7, 9/� Total impervious surface azea [including this project] (B) _3 � 1`_� (B) / (A) x 100 =%Used '�� (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? ,Yes O No August 4, 2004 - Issue Date Signature oFIssu g nt August 4, 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: �� N . �KES , . � . / .5. � L o.t. � � �L ` � LJC .6. 1 R � ` _''� • �i29 .5.2 /.// �_ ` 4 / " ' .5.5 /./9 .5.3 - ' y _,L" .5.4 -`L" , -,�,- ,�, .7. 1 .8.3 J s .,i_ .8.2 _�L" 3 `�' _�L" .8. 1 ,�. . 10. 12 . 10. 11 _,L• -,�- � _,L" � 10. � 70. , 10.1 .,0.3 nceR �r .10.13 .10.10 �S .10.9 .9. 1 .�o.s . �i�, . 1 pLA CI.D 7 .10.6 n I yo i o.� .9.4 � :1.6 3.� PO . 12. 1 .,1,2 LAx :,., � , ., : �' a �° L �`'1 �� : �.+! � 3.y� z . 12.2 ;�; . 12.5 .rs.a . 12. .�yV : 1 .3 . 12.3 . 12.7 .15.6 BURNS ' LAKE : 1 .5 • 12.y . 15.2 .12.6 L �,. _ .. - - SHORELAND PRESERVATION AGR�EMENT (Non-Iutact Shoreline Ve2etation Protection Area) � Land Use Permit No. �- y(�j (To'be entered by the Zoning Office) Index No. ��/ - '�� WHEREAS, (list all owners) Robert and Elaine Carlson � s _, downs real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and � WHEREAS, in order to secure a Land Use Permit. 4 �. 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 o with the Mirigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department. � The owner(s)hereby agrees that at all times in the future, the real estate subject to this Agreement shall comply G with all shoreland vegetative buffer requirements of the Sawyer County Zoning Ordinance in ef�ect on the date � that the Land Use Permit is issued by the Zoning Office. The owner(s) fur[her 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 VEGETATION PROTECTION AREA exists and that it is being preserved. Violation of this Agreement will authorize, in addition to other penal6es and relief required under the Sawyer County Zoning Ordinance, � injunctive relief, restoration of said real estate, the revocation of said Land Use Pemut and the removal of all o 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 Pernut. All parties agree that this Agreement shall be filed with the Sawyer County ? Zoning Office. � Legal Description of Property: Part of the N � of the SW 4 Section 17, T 41 N, R 7 W. Town of Round Lake, Sa er County, WI Dated is Z� da o� July 2004 `'1�' , �� — � c�-��- (Owner) (Owner) (Owner) (Owner) (Owner) (Owner) This insuument was drafted by: Sawyer County Zoning O�ce �. � � � .'"�"� ;� � �. . � , � .� =� , -� � - s, � � ,�-�` ., :�•: _ ` �- - ""�' � . �y . t �' � ;1�'� � � . �: �` � � ,-;r � �. ��-��`�•r��e., �`� ��,,,�: '�� , : � ;' �,-, �� ,�� , ��, ,i A F�" ;� ( �,�`4� ` �*.,-�" �' - .- . _ t »_, '.._;�.� � . c�`. _ - . s�- ,.' �",7�. i� . . ' � , 4_.i. . - �,c3� j ��T L A��P iyk�.FfMf.}�,:h`y��•', �� .. �� =6 • _ . `,� r� 3; s. �' �' �`,� �R..,-y�.,��,,,� - i. �a,^ . �y � ��a,��... ,�: . . usN'a.'' . ,�. . - -. . ��".'U�t _ b '' ^-� � �� ' �\� "J *�� .� =`a �, ,t �'-. �i . .�?� , �� IIY�� ','�!.�I 5 i � � � - �� I��r� ` .�� *. .y �'> � tik` . + .�.� � .�, ;" `� ... .� � � .� `�►��-� � �� a;4• \ P� ��,. � , � �4 . . �,� ;� � - - -- �i <;& ,x :� f�� "° -� rf , � �^- k �.r. . � ��,, ,, ; '� � � � .� �� .�� + '�d �, , _. 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