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Home My WebLink About024-741-19-5201-LUP-2004-435 � ' r� Application for Land Use Permit (*Shoreland*) o o �� 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 wrthm 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 � � � �l y��vEr�i � �1A+�-► ��v'A �C�u,�� lil,t�lv��Z o Owner Builder ¢: `� �12�j (�{�CA �v� � -�� o: Mailing Address Mailing Address � � ��► . Lc��S��. �1� S5�}� (� -� �, City, Siate, Zip City, State, Lip � n(`�2-5i 2-U,S�Z- � R Daytime Phone �'iq�' q5Z-g!z-G�zZ Daytime Phone � � Additional Information: Zone District: �2_J �~ � r Lot Dimensions: � � z Date lot was created: __ Acres: , 5?�_ � Is there wetland near the proposed structure? If yes, how far ^]O o v, Building Land Use Floodplain: O Yes (,�No � r' ( )New ( ) Filling Chippewa Flowage: ( ) Yes �( No � ^: Addition Dred m Drivewa access off of a Check one � r' � ) � ) g� g Y � )� �Alteration ( ) Grading ( ) Private Rd �(Town Rd. � ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy �" � ) � ) � � v, r Primary Structure Accessory Building Addition o 0 i � LWC1iIi1� ( i Garage-attachedldetached � ) Decic � � ( ) Year round ( )# of car stalls ( ) Porch �;, �`' ( ) Seasonal ( ) Storage Building ( ) Enclosed � �. O Frame built on site O Screenhouse O Living room c� ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � <� ( ) Mobile/manufactured ( ) Other ( ) Bedroom ( ) Other primary structure ( ) ( ) Relocate/enlarge �' A ( ) ( ) ( ) # of new -�-- - . r,, � Additional Information: �z��,_,Y,,�� ,�,,�,�-,,,,,� ��->:��r. w�� ..�- � C�_LCC'�v�w�uclC>� cti vc\cs-r� w.,�c-�c��:�� y�J�'�x�i.Q.-L N�tti .�,.v.�c w� �v:7 - � N 5�:.>��1c� � (� Type of Construction: � _ (�Frame ( ) Log ( ) Pole/metal Q�Block ( ) Concrete �; �� ( ) Other `,. y Construction Cost: Primary Structure $ `��' � � �. Accessory Building: $ Addition: $ � � ; � V �. ?�ev�: �Jol !o ! Pa Y�S CP,-r.f1A� �c;� TP�r#—, oy- �q5 � ^ z ^_ � � CSM: Vol Pg Lot# Sanitary Permit# c�`C-_Z 2� � 7� � Plat Envelope Or: o, � Condo Vol Pg Year Installed: �,�;�,.J ,4, ti�S �; "Loads and Flows": Vol Pg Owner When Installed: c� � � ..� .,� Previous office approvals/actions: Variance: # LUP:# �j 9- y3c� SP: # CUP: # 'r Inspection Report: # Change of Zone District: �//ay assl� ( 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. #3. #4. Size�_ft.wide ft.wide ft.wide ft.wide ��' ft.long fr.long ft.long ft.long Floor area 2'�10 sq.ft. sq.ft. sq.ft. sq.fr. Hgt.from gcade 10� to peak fr.hgt. fr.hgt. ft.hgt. Stories 1 stories stories stories #of bedrooms 1 Lake/Pond/Flowa e/River/Stream Name �,�� --��:�� a�` � ►��- n�� i��,�5 �` \,� SP„�c .� b��y ��.�1� � �pd�.l �ly w.�i�w I �li�"uN \'�L'j / ct✓v� s,c��noJ wH�� c��,�r ne� r� w M, m ,. 1� YI\ � � "EO M��l It: � � . � �� ` Ir��,�r . z � � � s f�/ i c� :� ► n�;,, � �i � � C �� ,c � I � ��V i �� ,ic� / � � Fire Number and Name of Road ^ '� ' c c�,a,N 1. Enter lot dimensions and indicate north by arrow. Signa Own or Authorized Agent: 2. Indicate the location and size of the requested construction i��l % �u'� —� S�'ign�ure activities. Print Name: �f��t�,� � � �'„�,c•. 3. Also,indlCate tlle loCatlon and d1StanCe to the well, The above certifes that the listed intormatio and intenticns are true and correct.,Ihat all work shall be peAormed in compliance Sept1C t3T11C and d2alnf eld,wetland azeas,lot Ilnes, with the requiremenGs ot the Sawyer County zoning oMinance and the laws and regulations of the State of Wisconsin,and if centexllne of the road and waterbodies. acting as ownet(s)agem,has tne permission oi me owner(s)to peAorm Ne work requested on this application. The above personsls hereby give permission for access to the prope�iy for onsite inspection. Permit fee:$ �S�C'� Total land azea within 300'of the waterbody:(A) /�°i,�UC� Total imper�ions st�rface area[including this projectl(Bl �-�.'i Z S (B)/(A)x 100=%Used {�5°7a (Shall not exceed 15%[or 25%with a conditional use permit].) Shoreline Vegetation Protection Axea:Mitigarion Required?O Yes �No �� 1lE ��`� - - Issue Date Signature of Iss i g nt i _��in„�� 1�. 1.,06S 50%Rule: Average Road Setback:� Expiration Dat Office Comments: _""'� 1 V v��l ��'" �. . SE�. !� .'T. � . Of `— -- ��s; � V � z�s. - � ��s: � �� s' �' � ��5; , � s�s: \ L'S: -�--� lU e.�; _ Y . Q � � st � � ' ��--�� o � ` �i ll) 1 �M^ a \ --� M — �1 � M � _ \ l ` N q N • L N � � _ � � � — �----��\( � �s � „ � _ J � � ��I � N � _ � — — t+� — - , �. �N � o � P� I"� � � .. ll') � 'n��" ..; — N _ C�I ,;: '.'"' � _ - . � , — i F — �. I M • � � . � ` / , �� ,n �' , } N N � � � M � � N . �� ti t� �� f�� N d . N \ M �� / QI N N � � � � "1 — Q � � � � cp �. �cV cv � � K? N (V ��/�i' , � N, �j ` � � �� N � � i � _ N ` < , �' �c? ' , � ��,�.� � — c�,t.� � � , �c' / M ' N � . � ( • N l'n N M/ i t � � + � � � � V � � SIiOREI,AN PRESERVATION AGRF,EMENT 3horejipe uc etallon Protection Area Land Uae Permit No. �� -�-��..a?�(To be entered by the Zoning p�ce) Indez No. � _ �'I�EREAS,(list all owners) c�--i-e„e�� ` � �� A2ri,'1�, rj u�2(- � ��s real esffite "'i� Sawyer County that is subject to the Sa er Coun Shoreland Re � V�'F�REAS,in order to secure a Land Use Permit. � ty B��ns, and -�- � NOW,THEREgpj� �e o��S�hereby certiges that,a�g�ndition of issue of said Land Use Pemiit,that the SHORELINE VBGETATION PROI'ECTION qREA on said real estate is intact to a minimum depth of 35'lendward from ihe ordinary}u�_a,ater mark of the waterbody. ?J � �e��e�s�h�by g�s tO�mP�Y�+'ith the shoteland vegetative protectioa area requirements of Section � 4.410 SHORELpNp V��}ETATION PItOTF,CT[pN ARFp�SaW,y��t Zo ' Vli tepresenfatives of the Go�v�t is issued by the zoning office.The uwner(s){urth�a�e�o authotized emmental Unit to enter onto tt�e ov,,ner•9 p�pperty � �e following desotiphan i belween the hours oF 8:00 A.M.and 6:00 P.M.[Section 9.13(I)POWERS,Sawyer County Zoning prdinance] � to inspect the stru�t�($�or u4es anthoriud by said Land Use pe[mit and to determine if the SHO1tELINB �VEGETAT70N PROTEC7TON,t�,REA exists a�d�it is being presen•e�..[t�is suthorization shall temunate on the date of expication of the land use pemut� go�,e�,�o�er's obligation to maintain the SHORELIN� (� VEdETATiON PROTECITON AREq in �p�� S�tion 4.410 SHORELANp VEGETATION PR01ECTipN q��gaµ,3,ei��,�n�g p��Ce��eff��v'o�on of this Agreement will � sufhorize, in additioa to other per�alfles and reiief required under the Sa i�junctive relief,reatoiation of said ieal q'Yer County 7.oning prdinance, y��e ��b estate,the revocation of said Laad Use Permit aad�pmoval�all � PP1O Y the issue of said Land Use P�t�d the revocarion of any other tues roved b the Q� issue of said Land Use pe�mit. All patties agrce�t�Agr�ement sha11 be filed with the Sawyer County Zoning Office. �B�D�riptionofProperty: Part of Gov't lot 2, NW4 NW 4 Section 19, T 40 N, R7W wn of Round Lake, Sawyer County, Dated this�_�y of (� UC�``�.T- �C�t�� (Owncr �--- �,� . (Owner) (Owner) � (Ownar) ` L (OwnOr) (Owner) This instrumc�[was drafted by: Sawyer County Zoni�q p�� 4