HomeMy WebLinkAbout026-839-07-5205-LUP-2004-254 Application for Land Use Permit(*Shoreland*) ,.�
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County of Sawyer � � ��
POBox676 -Haywazd WI54843St:F. l.)��iC;s: f..;�.:}t`.�"',ni.:NT
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. i
PRINT-USE BLACK INK OR PENCIL �
�Jr,,��c� tf a��d �✓�n�� P1 /<z�1 Ken Sh�e-� c
Owner Builder a �
`J2 �lN 5� r�n� If411��( �� �k L - ���� b2o'3V
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Maili�ess Mailing Address � O
���U L C M u Y1 i t' �J� 5 3 S?�� �1-�:/�o ti r� W� 'i`-��'��l3 �� �
City,State,Zip City,State,Zip f
uo� 7ti�' ��'�� �7is �;� 3�i 3�3� �
Daytime Phone Daytime Phone �._
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Additional Information: Zone District: ��-�
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Lot Dimensions: ;�5 -
Date lot was created: Acres: . ��3
Is there wetland near the proposed structure?If yes,how faz %:i 5" `f' o
Building Land Use Floodplain:O Yes (;.�)No � _
(k)New O Filling Chippewa Flowage:O Yes kx} No �c
O Addition O Dredging Driveway access off of a(Check one): � n.
( )Alteration ( )Grading ( )Private Rd (�Town Rd. � =
( )Moving On ( ) ( )County Hwy ( )State Hwy °0
� ) � ) � `�
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Primary Structure Accessory Building Addition o 0
( )Dwelling (Y�Gazage-attachedL ta ( )Deck � �
O Yeaz round (2�#of caz stalls O Porch W
( )Seasonal ( )Storage Building ( )Enclosed �
O Frame built on site O Screenhouse O Living room c�
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen v
( )Mobile/manufactured ( )Other ( )Bedroom Q
O Other prunary structure O O Relocate/enlazge y
( ) ( ) ( )#of new �
AdditionalInformation: "' ;
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Type of Construction: J
(�Q Frame ( )Log ( )Pole/metal ( )Block ( )Concrete ' �
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( )Other v �
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Conshuction Cost:Primary Structure$ a �
Accessory Building:$ ,� :>> -i� = Addition:$ � �
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Deed:Vol 5z�_Pg u7$ Certified Soil Test# q� - .3(cy � z
CSM:Vol Pg Lot# Sanitazy Permit# �5-C,��> °O �
Plat Envelope Or: o� �
Condo Vol Pg Yeaz Installed: �;,
"Loads and Flows": Vol Pg Owner When Installed: rn �
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Previous office approvals/actions: g5_v ^�
Vaziance:# q5 bt S LUP:# R3`3�� SP:# CUP:# }�
Inspection Report:# Change of Zone District: "�j G/�0 y
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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. 7 > �- u = #2. #3. #4.
Size � � ft. wide ft. wide ft. wide ft. wide
v. L ft. long fr. long ft. long ft. long �
Floor area �l</�' sq. ft. sq. ft. sq. ft. sq. ft.
Hgt from gade !y' ;�' to peak ft. hgt. ft. hgt. fr. hgt.
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Stories � stories stories stories
# of bedrooms Cj
Lake/Pond/Flowa e/River/Stream ame
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Fire Number and Name of Road G>�'�l /� ��'A b c��t c. r L�,n e_
1. Enter lot dimensions and indicate north by azrow. Signa ure of Owner r A thorized Agent:
2. Indicate the location and size of the requested conshuction � ��-�---:°f�.���
Signature
activities. Q '� ,/K�`/
PnnWame: R O i f/.
3. Also, 1ndlCate �'le loCahon and dls�ilce to i.ile Well, The above ceNfies that Ne listed intormatlon and intentions are
true and conect.,that all work shaii be peAortned in compliance
septic tank and drainfield, wCtland aieas, lot lines, with the requirements of the Sawyer Counry Zoning Ordinance
and ihe laws and regulations of the Siate of Wisconsin, and if
CenteLline of�'le road aIld wateTbodles. acting as ownef(s)agent,has the pertnission ot the owner�s)to
perfortn Me work requestetl on ihis applicatlon. The ahove
persons/s hereby give permission for aceess to the property(or
oD onsiteinspection.
Permit fee: $ ��
Total land azea witlun 300' of the waterbody: (A) ��F� �c��
Total impervious surface azea [including this project] (B) Z Z� �
(B) /(A) x 100= % Used /�,J``OJo (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? Yes O No
June 10, 2004 � - �
Issue Date Signature of s ui gent
June 10, 2005 50°/a Rule: Average Road Setback:
Expiration Date
Office Comments: mu,�- �(��(1',U,�. O� �-�-01 �jt.��ppK�{� �p�yl �,QC�_Wb C.�/�`�
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SHORELAND PRESERVATION AGR�EM�NT '
(Non-Intact Shoreline Ve2etation Protection Area)
Land Use Permit No.�y-25y (To be entered by the Zoning Office) Index No. �-�5'�
� WHEREAS,(list all owners) !7cL�,J I-{- „� jj/,�n c/ /`7 �2 r� _
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-p 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 Pernut,that
-� the SHORELINE VEGETATION PROTECTION AREA on said real estate shall be restored in accordance
Ywith the Mitigation Plan and Implementafion 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
�r representatives of the Governmental Unit to enter onto the owner's property at the following description to
V inspect the structure(s) or uses authorized by said Land Use Permit and to detemune if the SHORELINE
j. VEGETATION PROTECTION AREA exists and that it is being preserved.Violation of this Agreement will
Oauthorize, in addition to other penalties and relief requued under the Sawyer County Zoning Ordinance,
injunctive relief,restoration of said real estate,the revocation of said Land Use Permit and the removal of a11
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: S c r j-��J�OPlU
� �'3�-0�-07-0 :� S�
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Dated this '� day of � _3� a
� ��-�-��/./�� �` _
(Owner) (Owner)
_�l�c'�,�c,�,�j �7. �ait�
(Owner) (Owner)
(Owner) (Owner) —
This instrument was drafted by:
Sawyer County Zoning Office