HomeMy WebLinkAbout026-760-00-6000-LUP-2004-026 Application for Land Use Permit(*Shoreland*) � o -
County of Sawyer �
PO Box 676 -Haywazd 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.
q_ , � PRINT-USE BLACK INK OR PENCIL
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Owner / Builder � O
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Mailing Address Mailing Address � �
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City,State,Zip City,State,Zip
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Daytime Phone Daytime Phone
Additional Information: Zone District: /�'I�'�
Lot Dimensions:
Date lot was created: l�i��'�(� Acres: . �
Is there wetland near the proposed structure?If yes,how far o
Building Land Use Floodplain:O Yes O No �
( )New ( )Filling Chippewa Flowage:( )Yes ( ) No �
(� )Addition O Dredging Driveway access off of a(Check one): �
(�Alteration ( )Grading ( )Private Rd ( )Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy o �
� � � � N ;�+
v, r
Primary Structure Accessory Building Addition o 0
( )Dwelling ( )Garage-attached/detached ( )Deck N �
�o
( )Year round ( )#of car stalls ( )Porch �:,
(�Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room �;
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlarge `�
� � � � ( )#of new �
���i a�-hP�ow• oWu
AdditionalInformation: � P
� �
0
Type of Construction: `� �
(xl Frame ( )Log ( )Poie/metal ( )Block ( )Concrete
( )Other_ �
Construction Cost:Primary Structure$ �oi O E� v .ti �
Accessory Building:$ Addition:$ � (�,�
�
Deed:Vol (oa7 a Pg /%5'� Certified Soil Test# r7(o ;�q� �, z
CSM:Vol_�Pg�(�__Lot#_�__ Sanitary Permit# %(�-��� � ri�n�4arx:r�� �
U�
Plat Envelope_ �8�� Or: �` �
Condo Vol Pg Year Installed: ��i o� d'O lgl9� N �
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"Loads and Flows": Vol Pg__ Owner When Installed: �
Shc�.QaMD P•na�ns�r v«�.u�. -�SL--��--
.
Previous office approvals/actions:
Vari�nce:# LUP:# SP:# CUP:# �
Chan e of Zone I�istrict: \��
Inspection Report:� � � �\�
\
3a�,s3
Describe the construction using these columns. List the dimensions of each structure in a separate
columa List each story, each addition, each alteration in a separate column. .
#1.� #2. #3. #4.
Size ft. wide fi. wide ft. wide ft. wide
�_ft. long ft. long fr. long fr. long
Floor azea �n sq. ft. sq. fr. sq. ft. sq. ft. �
Hgt from giade to peak fr. hgt. fr. hgt. ft. hgt. ,
Stories � stories stories stories
# of bedrooms C
Lake/Pond/Flowa e/River/Stream Name
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Fire Number and Name of Road (.���-/� N .5 ¢, S S a b � ..� �
1. Enter lot dimensions and indicate north by arrow. Sjq�ature f Owne��rized Agent:
2. Indicate the location and size of the requested construction �
SignaWre
activities.
PrintName:
3. Also, indicate the location and distance to the well, The above certifes ihat the listed intortna6on and imentions are
we and wrrect.,mat all work shall 6e performed in compliance
Se tic tank and drainfield, wetland areas, lot lines, wim me requirements ot me Sawyer Counry Zoning ordinance
P and the laws and regulations of the State of Wisconsin, and H
centerline of the road and waterbodies. a�ro�s ag ow�er�5�ayem, nag me���5�00 0�me owr�e�SJ io
peAorm tl�e work requested on ihis application. The above
persons/s hereby give permission for access to the properry for
onsile inspedion.
Permit fee: $ ��
Total land azea within 300' of the waterbody: (A)
Total impervious surface area [including this project] (B)
(B)/ (A) x 100 = % Used (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection A�ea: Mitigation Required? O Yes O No
February 18, 2004 (/�/ ���1//��y���
Issue Date Signature of Issuing Agent
February 18, 2005 0
50% Rule: Average Road Setback:
Expiration Date
Office Comments:
BLACK MALLARD CONDO
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11�a3��e �.-ner on /✓or�h �ine
ofGov•�'�o< i.s - s-3e—y /✓o.-�� /neGov-�Lo�/s
Du� r 900.00
bue WEST 440.00
/'i�on Eioll�a'Inc� r.n� e,.
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qll of'Iter conc�rs StaKed o N
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W �fh I�"X 30' u^oh ���pes V� /g o
� �.is �65./ft. � m°
penrinqs are re�erred '� 3'e'''"�"L — �
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,��0�0 SUR���•F7+�d Aliesch, reE�istercd land survr;ror, hereS,y ce-�ti£y: mhat in
M117 comp.. nncr v�3t'�� tho pro��i.sion� of Chaptrr 2�8 .�£ t}:e F�isconaln
Statutes, r.nd the aubdiuiaion reo�_tlat�ons of th^ Town o: Sand Lake�,
end und.er the dircetioa oP Jack &of-ren , or�ner oP sr.id le.nd,
I heve su:���e�efl, dicided an mspc p._ certl�!ed s�i^v��y; that auch c�rtified
survcy cm�r�ctl� repre,aente all exterlor bound2rloe and the subdivialon
oP the lar�d survcy�d; nnd thnt t����.is land is loc�ted Sn Governe�ent
� Lot Pourtoen (14), Section Fivc (5), ionr. Tl�irty-eight (38) Pforth�
Fangs '.Iinc� (9) F�r.�t, Tovm o" Sand Lake , S^.n�yrr Cn�,mty, to c,5t:
Co:i ^ncing r.t t'_e intereecY.ion o£ the l"cet one-e�ghth 19ne of
5^ctlon 5 nnd the ??orth 1'.nr, of GovernTFnt Lot 14, s,� desc^she�7 in
C.S.i'. 12]"92 Volume 1� nages 119-120� Fr.�later o£ Teeds, Sr�sger
County� tYonce dar Ea,yt� 900.00 fect� to the �oint of beginning� thence
South 02�-OG� Eaet� P54.20 foet to ct point 20 £eet� more or lc.�,� fror.t
thc c�nter� s r�3mc of 8lssnba}-ama Loke� thcnce along the mer.neer line
a'ong the Lakc� Idort2: 870-5^� Exst� 110.00 Peet, thoncs
South 81�-10� East� 'u27.G5 Peat to a noint 44 Seet� morc or l�:�s., fr-•m
the c�at�^�s e�?r�e of S'.ssabu�ann Lake und the ond of the mecndrr '_ine,
t'-er��-c i;o.*th 02o-Of� Sk�st� 900.22 f�dt� thence due "r'estry 440.00 Se_t
to the p�lnt oF 3e:;'nring, Sncl�.�d7.n�-, all the land lyin,r, be*a•��cr, the
mccr,der lire an�l the �-:at��.r�e c?ze of S: saaba�;ama Lake. .N
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Received tov record tAe ��iG., day o[
�A D 19�a{/J'3a o cloct
ecorded in vol. �{-
of n,�w�vaoe 2 L"7
C4tlNed3�t904p4_L �'na...,:, �i. 7sia�'..:.i
o�v�n
SHORELAND PRESERVATION AGREEMENT
(Non-Intact Shoreline Veeetation Protection Area) .
�� Land Use PermiYNo. O�I-Dc�lo (To be entered by the Zoning Office) Index No. Q�- Q��
-o
CWHEREAS, (list all owners) f ra q f�e h I�P �o y1 e n C� // n �d Cn nr/r� � _
v I/�e n ��, �1a l/
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� owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
p WHEREAS, in order to secure a Land Use Permit.
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� NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Permit, that
Q the SHORELINE VEGETATION PROTECTION [1REA on said real estate shall be restored in accordance
with the MiGgation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
The owner(s) hereby agrees that at all tnnes 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 Perxnit 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 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 penalties and relief required under the Sawyer County Zoning Ordinance,
injunctive re(ief, 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.
Legal Description of Property: �tr} (n�v{ /�� /`/ , Se e �,pn 5"r]"38ti� � �/ L.� , � vf l.� �
�' SYY� Uol 4 � �`lo7r lc�t�n o-� �'� nd 1s.kw� � i ���e��' (��vu1�y l,(/7
� �
Dated this �_��_day of �� , � �6 cf
!�4 �n� L����`y' 2''� '� � (
(Ownex)� (Owner)
/� ,
(O er) (Owner)
L��/ /���._.�/�l�
(Owner) (Owner)
Tliis instrument was drafted by:
Sawyer County Zoning Of(ice