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HomeMy WebLinkAbout024-741-34-1314-LUP-2004-655 .;�� Applicatian for Land Use Permit (*Shoreland*) o o �� - County of Sawyer � � PO Bo� 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 porid or has any of the above waterbodies located within _ the property's boundaries. �- CONST SU�T�ON SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. ��� � }�-/�1 1-�y PRINT-USE BLACK INK OR PENCIL � :� � � � , � D�� �C��K�.1,�OI�C�S I-� bMe� � � � ��: Owner� Builder °� r ; I ����uc.9 cl-�-� �{- � t� L�o x 35 �: _ ,� , o. Mailing Address Mailing Address � O �� � J � r I�u r �i'V l ���?��r � � Cit , State, i � City, Sta , Zip Y P �;�� - �:3►� - i�`�.�� •� I�� _ y �� � ��L�w I -.�.' � Daytime Phone Daytime Phone Additional Information: Zone District: �� '`� � Lot Dimensions: �D � '�"', � ��a) •�'� Date lot was created: Acres: � • ��' � Is there wetland near the propased structure? If yes, how far — o � � � Building Land Use Floodplain: O Yes O No�S4/ D/154 � � _ (�New ( ) Filling Chippewa Flowage: ( ) Yes ( ) No � :� O Addition O Dredging Driveway access off of a (Check one): � ( ) Alteration ( ) Grading ( ) Private Rd Q() Town Rd. � O Moving On O O County Hwy O State Hwy o 0 l � � � N � � r� Primary Structure Accessory Building Addition o 0 (� Dwelling (� Garage-attache detached (� Deck � O Year round O # of car stalls ( j Porch W I (x) Seasonal ( ) Storage Building ( ) Enclosed � O Frame built on site O Screenhouse O Living room c� � �� ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � � ( ) Mobile/manufactured ( ) Other ( ) Bedroom _ � O Other primary structure O O Relocate/enlarge 1� A ( ) # of new � ���-_ O O _ � , AdditionalInformation: J � L � � � � Type of Construction: �'' ( ) Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete `�- � � (�,) Other �11�U�,� 1[�!c-' F(�(-�mE - �� � Construction Cost: Primary Structure $ /�G% G�C C% �._ Accessory Building: $ Z� v c�f� Addition: $ � � .- � �r- �- DPed: Vo? �.:.c`�% Pg / `��� Certified Soil Test# ��)-�, � � � z CSM: Vol �j Gp� Pg�3.� Lot# � Sanitary Pernlit# t�7�% f���:�:'`-� � � � Plat Envelope Or: � Condo Vol Pg Year Installed: N "Loads and Flows": Vol Pg Owner When Installed: �. � � � Previous office approvals/actions: � Variance: # LUP:# SP: # CUP: # � Inspection Report: # Change of Zone District: �� ��s ��\� Describe the construction using these columns. List the dimensions of c:�._ .re in a separate column. List each story, each addition, each alteration in � separate colu::- #i . �-om E #2. �-1Sr(� � #3. t .. , #4. Size �y �� ft. wide �_ . wide ft. wide ft. wide � , , � � ft. long Z� ft. long � ft. long ft. lon�; Floor area ; � � � sq. ft. �$� sq. ft. � sq. ft. sq. ft. Hgt. from gracle to peak ft. hgt. ft. hgt. ft. hgt. Stories � 1 stories stories stories # of bedrooms "�_ Lake/Pond/Flowa e/River/Stream Name 7 � �� I,� � � Gr ' � �� �L ��� . ��J � c��`" Fire Number and Name of Road �' A� LL� !4 �'} f� L ���� ��?�� l . Enter lot dimensions and indicate north by arrow. Signature of Owner or Au orize Agent: 2. Indicate the location and size of the requested construction �v Signature activities. Print Name: r' � 4�+� � � � 5- K�'�- 3. Also, indicate the location and distance to the well, The above ceRifies that the listed information and intentions�are true and correct., that all work shall be performed in compliance septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if centerline of the road and waterbodies. a�t�n9 as oW�er�s� a9e�t, has the permission of the owner(s) to perform the work requested on this application. The above personsls hereby give permission for access to the property for � � onsite inspection. ;; a. Permit fee: $ � � �� �����%"����� Total land area within 300' of the waterbody: (A) .30F 30d Total impervious surface area [including this project] (I3) �O� (E} / (A) x 100 = % Used 7. �v '10 (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? O Yes � No November 10 , 2004 ^ Issue Date Signature of Iss 'n gent November 10 , 2005 50% Rule: Average Road Setback: _ Expiration Date Office Comments: � � ' � ' � . 1 ! �' � � �.p� � � � , � � t � .�s'� �8' w ( � -�� `� �� `-- --- -- .�- �6� ��% v� Q , C'����� �6� r0' -�i° �"� v (�.��R ��� � j � �� ,9= , �C �o , ,� �,�---� a� w@�- 46' -3�_, � --_.__._� 1_ F i�;:K �s �, h���� 26. � �c� ,n� � / � r ., .o��� 1�' / �� � � �• �- , � . � � � � .� ,�5 .�' �G � K � ��� � � ��� � � � ��'� . �� � � ��� � ;; , � � ! - - -- � ,: POWER OF ATTORNEY Know all Men by these presents, that I, Roger A. Amundson � , property owner, Town of Round Lake � Sawyer County, Part oi� , S� 1/4, NE 1/4, S 3 4 , T 41 , R 7 , State of Wisconsin, have made, constituted and appointed B r i a n B—r i s�y o f M i n o n g in the County of washburn , State of Wisconsin, my true and lawful agent for me and in my name, place and stead to do any and all things necessary 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 15 th Day of october 2004. , Lot # 3 CSM# 956 Parcel# ,:'� � n " ✓ ��Y)G�'��'_. �� Owner� Notary: Gary A. Brisky State of: Wisconsin � County of: Washburn Personally came before me this 1 5 t h day of 0 c t ob e r , 2004, The above named Roaer A. Amundson to me to be the person who executed the foregoing instrument and acknowledged the same. ��,��.�����,.►,,,�,� ,���P�.� p, gR��, - ashburn wisconsin �y,` •�����`���'����.y`�i�� �Notar UbI1C COUIlty State r•'►�OTARy� "�� _�= My Commission expi es: 0 4/0 2/2 0 0 6 e ' �' E . s `= �. �ue��c .• ; I'P�`�l`o�'��•...��►���r� ����, ,�'�� �f WIS�������� ''R�'��'�J19l1�1��,, 31d71aNl �;, No,o� TOWN OF ROUND LAK� �o • e Nnneaa SEC. 34 TWP 41 N. 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' � W- e' �i% > p' 1.67 Acres± 1.58 Acres +' ! l.10 Acres3 0 0.89 Acxes'� W i''• ��i n N �5 °y � . ., � .r. w o. 60 i a Y; ���, N_ i�0 5,E i ;C � �- --•i + / "N69 ��o j � �� + % L� ���o� SCAL.E 1��=100 , ' N� �� � < � a� _ l .:, � SET Ifla�� X 30��10.D.) IRON PIPE :, �ry� _`[' � MONUMENTS �� '%" � �' � FOUND 3/4 IRON ROD ''° � � '^"'ry _O�-' ' ^ � v BEARINGS BASED ON SOLAR OBSERVATIONS. , � �g ,j o� rl`��5 �q0�E. 240. _ CQ� � JULY 29, 1977 0 � . t1S S!\ �. N8 � � � w- ,,� � r`' �i�1d c� �/�-^� � N / ' N N � � � , : � ,Zo. P � L P� � � P� � ��� G � �. �'9 �.�� PA�E I OF 2 ��S V �� SUR`�4' �s:::.:— — D ;E>:=. — ----- — �ZON E �`�`�.�. -- A �� . . ZONE X �����> CLAKE , �:.?:��':��.� � � y�' / �" `�?���'��� -ZONE A lIJI ::'��..1` 21 � // 22 // � 23 //�;"� �� lJ .. .. 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'I .�:;:^�� . �� ,.... �� �.�.. ::� :� �: ,. ::: ::: ::::: �: . ���� :�.... ,; _�:::�.: �:::::�:,:::�::::::.:.:.:.::. .:. ��JNE X .. . �.:::::>:�: �::.:.�::=:::':::'' �.�.�.�.�.... .::��:�:�:�. .�: _---- � :.f:::���r�:� ::�:: :_:� : .��.. . . . .. ... . .. . , .. . .... : .:..,; : .:.:..:.: . .. ... . . —. ---- _—; ;:., � c ovEH : ��,-�. � :::��; ��: : :;�:�.::::::.::.:: ----_ _ - ; - -- _j . .. , .:. :: .:.:``<:�:'���� � ah�a�H -� : _., i _. _ AKE; � . j � -- -----—_ Y �'. �KA\� � ���o- . t . c- - ,.:� ,f-�..... >.. i �•:.: �.••u... �r �`:>�... • BAY-:�:':::�:�:::�:'.>:;i,`, J' '. •:..•. ._`�.�: II i �,t, ..•.�. • � ' •.•.�.�.�.�,.�. �: .. : . : . .: �=��:.::»�........:.::�;;::r>:. , � � �� zoivE , .......... �. .. �........�. :. . : � � �� ... ; :. _ � ` � ,� ::�-� .. - � �-_ . .. �S �. ...:......: ..-�'"`' _ _.- -—�;, .... � �::�:�.:. , .. . _,.,...,.., .. ..: . . .. . � � � ... . � � . J� . ... .. �. '.'. ' , .y.. ; � � . �� ,� ... I ��....':::'' .. � ..... . .� ._ '�"' _ ... " .... . ... .. .. -. • • . ` \ \ �::�:;.:��`?:�><:�;�i=-n�:. _:���:��. h�.:: ?��:�� ... �� .�.. .�>:��: ._,.;. � i�� 1 � �nni� v �`_-� SHORELAND PRESERVATION AGREEMENT (Shoreline Ve�etation Protection Area) Land Use Permit No. {To be entered by the Zoning Office) Index No. Qy - (�� WHEREAS, (list all owners) _ 126 q� �- � m U r� d 50(�I �- �1 +'� ►'1 t � Y►'1 V (1 � SZ�� � owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and �,,, WHEREAS, in arder 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 mark of the waterbody. � The owner(s) hereby agrees to comply with the shoreland vegetative protection area 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 SHOREL,INE VEGETATION PROTECTION AIZEA 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 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 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 QZoning Office. Legal Description of Property: �O� �� � s�'1 gJ`� �o , �. �' W '" !YL'- ._. ,J -�{... 7L/�i� 3 �f 7'— �/ N. / �. ' n I Gt/ . Town of Round Lake , Sawyer CountyLWl � 024- 741 - 34 - 1314 — _ --s Dated this .5" !1. day of -�'d � r , ZOD Lf � (Owner) b•.,qk.s�,aoe,�,gr��c l � Owner . s p�.;'�`� /��� �a� ,`;��~`M gewgsOO�a�Q 4+�:v o�0 .aa �� a�i `¢ � — (Owner) ..,� �g � �' " ` °�d' F� (Owner) . . ,�F� � � � � � 3 � F � � — n s� ,..� a�" � ' �oem �y& r / �'�x ACL'J E-�O •�� ��✓ (Owner) cy, {�1§Qp9 . t4�`�' a��' (Owner) . /�� �, �,lr ��, �, y�,s � ���i'� �� � This instrument was drafted by: �'"`� . . .�e �;;> Sawyer County Zoning Office