HomeMy WebLinkAbout024-841-13-5320-LUP-2004-497 _ �
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Application for Land Use Permit(*Shoreland*) � .� -
County of Sawyer y �
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 l�as any of the above waterbodies located wiUun
the property's boundazies.
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. '
n PRINT—USE BLACK INK OR PENCIL
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�le,n «��, kP�y,. LaC�,o � �
Owner Builder
�-/�a(� p�cfu rP rP,`�1�� K�(� ,�ox 7P/ �:
Mailing Address Mailing Address • , p p �
�-fn /�A� SS/G�] ��avi.�a.�ol(�S .5"S'8 5%� _ �
City,State,Zip Cit ,State,Zip ~
� � �,Si��y-���� �
Dayt' e Phone Dayti e Phone
Additional Information: Zone District: c,�G.�c �e iP
Lot Dimensions:
�
Date lot was created: Acres: � /;3
�
Is there wetland near the proposed structure7 If yes,how far o
Building - Land Use Floodplain:O Yes �No v�
�f New ( )Filling Chippewa Flowage:( )Yes �'No � �'
O Addition O Dredging Driveway access off of a(Check one): �
( )Alteration Q�Grading �Private Rd ( )Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy °Q
O � ) � �
N ,.CL
Primary 3tructure Accessory Building. Addition o �
�(Dwelling �Garage-attached/detached ( )Deck � I/
�Year round (3)#of car stalls O Porch W �
( )Seasonal ( )Storage Building ( )Enclosed �
( )Frame built on site ( )Screent�ouse ( )Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ;�
( )Mobile/manufactured ( )Other ( )Bedroom �
( )Other primary structure ( ) ( )Relocate/enlazge � a
� � ( ) ( )#of new
Additional Information: ,:
� �
�
0
� �
Type of Construction: �
�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete
( )Other y
Construction Cost:Primary Structure$ �,�EC�CC� ,b I�
Accessory Building:$ Addition:$ � I,c�
� ��
3R3 d6$ x� �
Deed:Vol Pg Certified Soil Test#_�y_`�'% ; z
CSM:Vol „1 �/ Pg�_Lot# 07 Sanitary Permit# f�(=J�.`�z °4 �
�GS/�/ �yNal.r.,� � �
Plat Envelope ��� � °`
Condo Vol Pg Year Installed: N
"Loads and Flows": Vol Pg Owner When Installed: � �
0
`�'e
�
Previous office approvals/actions: �
Variance:# LUP:# SP:# CUP:#
Inspection Reporl:# Chaz�ge of Zone District `)II`p�
�
�-f�310 I �
,Pescribe the construction using these columns. List the dimensions of each structure in a sepa ate
�um List each story, each addi 'on, eaFh alteration in a sep ate co mn.�� ri n e S� �as e�x�
( # U. � #2. ci u`ci1� (�r�-' #3. o rci �f,��Y_ �q
�e ft. wi de ft. wi de ft. wi de 7� ft. w i d e
ft. long �� ft. long ��ft. long J=; ft. long
�laor azea G sq. ft. �(�sq. ft. Z 2- sq. fl. ��!� 13 � sq. ft.
�'igt from grade�_to peak��ft. hgt. �, ft. hgt. ft. hgt.
�ones�_ �_stories �_stories stories
bedrooms�_
33cb Lake ond/Flowa e/River/Stream ame
G ��`� - `
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Fire Number and Name of Road � �;,� ���e,s �oa�
1. Enter lot dimensions and indicate north by azrow. Signature of QY�qer A boFized Agent:
2. Indicate the location and size of the requested construction ��
Ponl Nartre: l�� nBL-G��.O ((
activities.
3. Also, indicate the location and distance to the well, n�aeove��n e�mee nre ns�ea mrormedon nd IntenUone are
true aM coned.,B�at e�wak aheA be perfoimed M compAence
septic tank and drainfield, wetland areas, lot lines, wllh tl�e iequlremenb ol Ihe Sawyer County Zonhg Oidinenoe
and O�e lews end regutetlone of Ihe State ot Wixonsk�, end H
centerline of the road and waterbodies. e�nr�es o�r(�)�ye^t nes nb�em�eston or me owrrede)ro
perlorm tlie wak requested on Mb applN�ibn. The ebove
persons/s he2by gNe permisabn (or eocess M Ihe property(a
�onskelnspectlon. �
Permit fee: $ ,� 00. �n ' /q �,j
Total land azea within 300' of the waterbody: (A) "7 / �� l
,` �
Total impervious surface azea [including this project] (B) ,� t��e `T ����/ �
(B)/(A)x 100 =% Used __�_�(Shall not exceed 15°/a[or 25%with a conditional use permit].)
S;toreline Vegetation Protection Area: Mitigation RequiredT O Yes �No
� Y n
September 13, 2004 � � M ��),� (1 � � � -_� 7�-
Issue Date Signature o s i g Agent
September 13, 2005 50% Rule: Average Road Setback:
Expiration Date
O�ce Comments:
POWER OF ATTORNEY
Know all Men by these presents,that I, �j/p,;,, �U ��
, property owner, Town of�s,,./ �o,�� , Sawyer County, Part of Government Lot
y�, • 1/4, 1/4, S �_, T y�N , R gw , State of Wisconsin, have
made, constituted and appointed - of , - ' � 'a u�jiov�
in the County of ,,� , State of iswnsin, my true and la agent for
me and in my name, pla e and stead to do any and all things necessazy for the application
for, negotiation of, or obtaining of state, county and local permits with the County of
Sawyer, Wisconsin, giving and granting hereby unto said agent full power and authorize
to do so and perform all and every act and things whatsoever required and necessary to be
done in about said premises, as fully to all intents and purposes as I might and could do if
personally present, reserving full power of substitution and revocation, hereby ratifying
all that my said agent of his substitute shall lawfully do or cause to be done by virtue
thereof,
In witness whereof, I have hereunto set my hand and seal this �,�,o( Day
of ���_ , 2004.
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Owner AII�a-n I�ud � �
Notazy: � -` vi U�i G. e,m �'�
State of: (J , s e o ✓� c,�n
County of: S �e r
Personally came before me this � { day of , , 2004,
The above named �Q� �,�� , to e to be the person who
executed the foregoing instrument and acknowledged the same.
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�ONpV K tE�y��� �i�� L�� �/i�-c,r�iL/ .�t�d�,G.
� i�otary� tc Count, State
t NOTARy �
��M --. —� �� My Commission expires: � o �;7 ,,��
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[ RETREAT
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5 DLEHUSftT CONDO.
I HEIGH75
SUBDIVISON.
LOTS 1
THRU 7.
CERTIFIED SURVEY MAP
PART OF GOVERNMENT LOTS '3 AND �4 OF SECTION
13, r0{yNSHIP 41 NORTH, RANGE 8 WEST,
TOWN OF ROUND LAKE, SAWYER COUNTY
WISCONSIN. (ALL OF CSM N0. 6966 AND 6162)
THIS SURVEY CANCELS AND SUPERCEDES CSM
N0. 6162, AS RECORDED IN VOLUME 22 AT PAGES
114 AND 115.
SCALE
1" = 100'
N�/. crn
sEc i3
0 100 S90 '00'00"E 2650. 13' �ss c�.n
s�`c���— 1241.35' 1408.78'
BPA9 LIP
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LEGEND � o
m
Q = GOVERMENT CORNER FOUND SS�'dj m o
■ = FOUND 1 1/4" IRON PIPE d•�a I �t "
o = FOUND 1 1/4" IRON ,t� �,� �9°i � � o
PIPE FROM CSM 5955 1 fi7.33' E S :
0 sei•oo'is•M g S-._I f
• = FOUND 3/4" REBAR �6�`Lp � �lg fi�• c'
FROM CSM 6162 '�' o �
� = SET 3/4"X24" AEBAR ��'^��' .� EpSENENT N87'0]'fifi'ry
WT 1.50 LBS/FT �"� 2,0 /�5y I � �
( J = REC�RDED ���9"�'p4�
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ROUND LAK a '4 �'
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SHORELAND PR�SERVATION AGREEMENT '
� �-Intact Shoreline Ve�etation Protection Area)
Land Use Permit No. �'�- y9 rf (To be entered by the Zoning Office) Index No. Q�- �/q. �
WHEREAS, (list all owners) �/��:�, � ,J� ,� ,,,, .� ���/�/
,
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 shall be restored in accordance
with the Mitigation 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
� 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
a 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
Q VEGETATION PROTECTION AREA exists and that it is being preserved. Violation of this Agreement will
-p authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance,
7 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 Permit. All parties agree that this Agreement shall be filed with the Sawyer County
Zoning Office.
N
� Legal Description of Property: T��,1,,, � �a;,�„�� �,,�p , ,�.�c ; /��
,
� _� �/lt� �kt� La�'�
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Dated this. day of_�i� . , o7U oy
�.
( (Owner)
(O �ner) � (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office