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Home My WebLink About024-741-19-5309-LUP-2004-498 Application for Land Use Permit(*Shoreland*) o �a ' , 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 y O the property's boundaries. � CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. PRINT-USE BLACK INK OR PENCIL � � �Or"3ERT �. AtJ'�ON.1� ETU,�I—I�lpEAwA�I �EMODELINC� c � Owner U N�� S -10 7 Builder a 5 oAK p,Rc�oK Cu�B DR . 7 Q-9 �.1. �IaH�.tsor� Lak� C�o.a� � Mailing Address Mailing Address � � �au F3aooK,��1 Gos2'3 l-�`l� a,gP WT arR�F3 " � City,State,Zip City,State,Zip (30 83� - IFS4-7 �\5 �34 -Co\�� -' � Daytime Phone Daytime Phone �, RR-I `� �' Additional Information: Zone District: � 'r �� Lot Dimensions: T F�E C-l)L A R� ��(S£� DR Aw�G� � Date lot was created: S EP 1 7 2- Acres: � .-I s ._ Is there wetland neaz the proposed structure?If yes,how faz ND o 5 Building Land LT Floodplain:( )Yes (�No �o n O New Chippewa Flowage:O Yes O No ^ m ,�Q,Addition ging Driveway access off of a(Check one): � � O Alteration ' g O Private Rd �Town Rd. � ( )Moving On ) ( )County Hwy ( )State Hwy � � � ) ) � � U t� Structure uilding Addition o 0 ling arage-attache detached ( )Deck � � eaz round stalls ( )Porch W easonal ( age Building ( )Enclosed ame built on site ( use O Living room co odulaz/manufactured O Greenho se O Kitchen � ( )Mobile/manufactured ( )Othe � )Bedroom , - ( ther primary structure ( ) ( )Relocate/enlazge � ` � � ( ) ( )#of new � �(�i�all�roo rr� � Additional Information: �o��s � p ea,lla.d 9�13�ov S:yU�`' �n � � Type of Construction: `r QQ Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � � � ( )Other y Construction Cost:Primary Structure$ ,Zy � Accessory Building:$ Addition:$ 2 5 3Q''J� � � S�iN/;a� '- � Deed:Vol -�� Pg 7.3- Certified Soil Test# �, z sa___ g�-_ � b0 7y CSM:Vol P Lot# Sanitary Permit# 75'OCa� � Plat Envelope Or: � � Condo Vol Pg Yeaz Installed: ��1�5 N � �,, "Loads and Flows": Vol Pg Owner When Installed: � � /k.iToN1C7 ,, Previous office approvals/actions . �' 99,`iP.l Vaziance:# �1 2 -ti TI LUP:# �I,U93 SP:# CUP:# ' Inspection Report:# Change of Zone District: � � 9��e��l �SS�t3 . Descri6e 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. ADD�TIv�I #2. #3. #4. Size�ft. wide ft. wide ft. wide ft. wide �ft. long ft. long fr. long ft. long a Floor azea I 3 O sq. ft. sq. ft. sq. ft. sq. ft. Hgt from gade I S to peak ft. hgt. fr. hgt. ft. hgt. • - Stories I stories stories stories # of bedrooms — Lake/Pond/Flowa e/River/Stream ame S�� AnAC�� Fire Number and Name of Road 1015 3 N /�PV nn lr�C �Inn 1. Enter lot dimensions and indicate north by arrow. Signature of Owner�A�uth�orized Agent: 2. Indicate the location and size of the requested construction '��.,.� r• 1�:...\e......-e SignaWre activities. /� � PrintName:��-�OB£e-? S Ft t�l CDIJ ID 3. Also, indicate the location and distance to the well, The above certifies that Me listed information and intenuons are irue and correcL,ihal all work shall be pertortned in compliance septic tank and drainfield, wetlancl areas, lot llnes, W�t� �e requirements oi ihe Savryer Counry Zoning oNmance and the laws and regulaHons of the State of Wisconsin, and if centerllne of the road and waterbodies. acting as owner(s)agen4 has me permission ot me owner(s)to peAorm the work 2quested on this application. The above personsls hereby give permission for access to the property for onsite inspection. �. C�% Permit fee: $ �-� + Ser J-'�,.-1�S�r2}�� Totai land area within 300' of the waterbody: (A) 32,73 9 �� Total impervious surface azea [including this project] (B) I586 (B)/(A)x 100 = % Used y. 8°7c (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? ( ) Yes (X)No �g�tomhPr 1L �nn� Issue Date Signature of I' ui Agent September 14, 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: 3� � 3 d � . � � � � ( - /.i� V ',l � �� V� .�, i` 1 ��Q' � t;;,l / ��O � m � � . � _ — �o • � � �� ,r,.H :, �. 00 t � , � �. tiv� � � � ��- `� _ _ N ��ti U� l L--' - �' .._----''"._ C ` - ; ' �\ Ci ' �p 9 'Oo C�'t- . _ � �S. � �G � ', � � N_�_' �9 '� , W�"�N O�.rC cp �'� �..: - �° Y��, `� 5� �' , , � -�� q 1�,�° F�.�D � T'� o tJ o` �� 1...�� 1 ,.- � �J AG� 1Oq • 13 � `-�o� � �� ,l � . � � � � � __ � _ . - .. , ��--..� - �t�C.�l '� `� ,� �- �,�'-Pt�� Gov =r �aT 3 L�`� � � � -- � \ --� �rr � � 1 L.I •I•� • � :�.8 :1.2 �1.6 � �1.5 f •r -' r �• ✓ �2.2 :2.5 � �Lt / :2.8 � '� :2.6 i � . � � � � �, ��.3 �� _��-_L�. �� _ __ ��.7 ' :�.9._ _ _ _ _ . _ _ ,� •,1�,�1��_ � '2.13 � � . 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I� E g�' '� �o, i�N N �, � �4y' ��;, , -� P i , �- N �� ,A� o,,� �y� s�, ,� � ��o � �, � \� � i o .' �\�` , //�\ / � � -�� Qt � 6�SE W ' ONp N\ I S� / � 1 ° p- �7 `� � � / � O �3 � m�/ ��QI o 1 w � W ,y 9�S C� �00 . P N ��° \ N p. lb Oo V �� ar 1��h� t (� N �\ ° ��\�-- W �,�<`° �'�o�� S ��'J' \`\ , \ . -��o - , � �y 6. 7S Ov `�,l-� �9%O:;F, S,�-y 6.9 , �52,9.5-, �-- �\ w �� '\ o\ OG,E9/ �� ' �� I �� V ! � � � � � V \ � ----� vq o �11 0, .�� -��Q9� b�o�_ � 6>3 �'i�e�Y�d gun,�r t�.:,,:,,�1 S ---- - _ � SHORELAND PRESERVATION AGREEMENT (Shoreline Vegetation Protection Area) Land Use Permit No. �-y9$ (To be entered by the Zoning Office) Index No. v -� WHEREAS, (list all owners) ��K32�C' � �tvTc�tJ r� �owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, d E.. 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' landward from the ordinary high-water mazk of the waterbody. � ,,�/ T'he owner(s) hereby agrees to comply with the shoreland vegetative protection azea requirements of Section ��' 4.410 SHORELAND VEGETATION PROTECTION AREA, 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 following description � between the hours of 8:00 A.M. and 6:00 P.M. [Section 9.13(1) POWERS, Sawyer County Zoning Ordinance] � 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. This authorization shall terminate on the date of expiration of the land use permit. However, the owner's obligation to maintain the SHORELINE � VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION O� PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. 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 Pernut 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 Permit. All parties agree that this Agreement shall be filed with the Sawyer County Zoning Office. c Legal Description of Property: _�-�6 V 'r LZ�"� 3 � q — �r-� --� �� of CSM vol 2 �g 165 Town of Round Lake, Sawyer County, WI Dated this g day of S�� , �� o�-�-� (Owner) (Owner) (Owner) (Owner) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office ----