HomeMy WebLinkAbout026-265-00-0300-LUP-2004-305 � .
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. Application for Land -Jse Permit (*ShorEland*) � r y
County of Sawyer � ° �
PO Box 676 - Hayward WI 54843 fi " �
715/634-8288 � ��
*Property that is located within 300' of a creek, river or stream or within 1000' of a D
flowage, lake or pond or has any of the above waterbodies located within � �
the property's bound�ries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. r
PRINT-USE BLACK INK OR PENCIL �
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Owner Builder ' �.. (T�
7��� ����tir�z�- � "33� �i t�t-{w��� S � l� �: .
Mailing Address Mailing Address � p
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City, State, Zip City, State, Zip � _l
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Daytime Phone Daytime Phone � z V ,
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Additional Information: �12,� m�..�- Zone District: ��- , 1
G��r� 5 c�I � N uflNS L+'�►�'" �
Lot Dimensions: � ��
ST��;� �-Akt t.�� r -
Date lot was created: Acres: _ v� ,� � ��i I ,�,
Is there wetland near the proposed structure? If yes, how far �,�� ��.�'!S� L_��� o l�
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Building Land Use Floodplain: ( ) Yes ( )No �
�New ( ) Filling Chippewa Flowage: ( ) Yes Q� No �
( ) Addition ( ) Dredging Driveway access off of a(Check one): �
( ) Alteration ( ) Grading ( ) Private Rd � Town Rd. � ''
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy °Q
� ) ( ) � o
N S
Primary Structure Accessory Building Addition
O �
�� Dwelling ( ) Garage-attached/detached ( ) Deck �
( ) Year round ( ) # of car stalls ( ) Porch �„
( ) Seasonal ( ) Storage Building ( ) Enclosed �'
( ) Frame built on site ( ) Screenhouse ( ) Living room �
�Modulaz/manufactured ( ) Greenhouse ( ) Kitchen �
( ) Mobile/manufactured ( ) Other ( ) Bedroom �
O Other primary structure O O Relocate/enlarge A
� ) ( ) ( ) # ofnew �
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Additional Information: (���`,�1� }.��`f�,� �\' ��i�l �� �
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Type of Construction: r
�Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete 0
( ) Other � �
Construction Cost: Primary Structure $ � � �Sc,�(c,,(���
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Accessory Building: $ Addition: $ � '
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Deed: Vo1�5n$ Pg� Certified Soill�est#_ �__ . � Z
CSM: Vol Pg Lot# Sanitary Permit# •�� ` �� �i� - °G 7�
Plat Envelope Or: �
Condo Vol Pg Year Installed: �� �,
"Loads and Flows": Vol Pg Owner When Installed: h �
T��yc��� �('I���;,� ;
Previous office approvals/actions: �
Variance: # LUP:# SP: # CUP: # �
, �,
Inspection Report: # Change of Zone District: : � �
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Describe the construction using these columns. List the dimensions of each structure in a sep�rate
column. List each story, each addition, each alteration in a separate column.
#1 . #2. #3. #4.
Size�_ ft. wide ft. wide ft. wide ft. wide
.�� ft. long ft. long ft. long ft. long
Floor area "! ° sq. ft. sq. ft. sq. ft. sq. ft.
Hgt from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories � stories stories stories
# of bedrooms �
L�-�Ay<C��l.�I ��St7�Y� Lake/Pond/Flowa e/River/Stream Name �� t-� ► � � S
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S�� ��� ►��K��
Fire Number and Name of Road J�� � � (,�; �� � I�(S L- !�
1 . Enter lot dimensions and indicate north by arrow. Sign�ture �0 r er or Authorized Agent:
2. Indicate the location and size of the requested construction
Signature
activities. -�U�� ����� ���
Print Name: `�
3. Also, indicate the location and distance to the well, The above certifies that the listed information and intentions are
true and correct., that all work shall be performed in comoliance
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. act��9 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.
Permit fee: $ �� 5� uL
Total land area 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 Area: Mitigation Required? ( ) Yes ( ) No
, )
June 28 , 2004 ��,,, ��
Issue Date Signature of Issuing Agent
June 28 , 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
WHITEFISH �AKE � : .
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� � S89° 37'w �z-r.oz' z�,9 " g Pa-'rt o£ �TGE�ND pSRE S�DIVISIOPI i:.
- -- - - - - - - -- Too29W Section 23, Township 39 North, Bange 9
-�3..� �� � West, Towr. oi Saz:d Laka, Cou^.ty of
un�t � o Sawyer, State o£ Wiaconsin, aad more
� i , pa._^tic��tarly described as follows:
I ti�° a
p i -13 t� -/?- 1
� x ,' � � / � - 30'--� BeSi"*"� at the Scuthwest coraer o` Lo:
�' 1:` �� c'. �� ' z6, ?��and Park Subdivision, thence .?
� -I . �� Z 4° � 1���� � 22$000 feet to a^, iron nipz;
� \ � �� � o ^yJ .�),}' �3 � thence N 0 00 � 50" E 200.00 ±'eet t
� Q o aa iron pipe;
��w J'� Q � f ' N � iheace N 15� 59� 10" W 260. 72 feet
���, � o- iron pipe on the ehore o£ Whitefish
I p• s �'9 / o, £ thence S 70� 29' W or. a meander lia�
�i�P �o o` , x said L�e 27.69 feet to an iro: p�p,
i '�,o °D�, '`P � g o thence S 89° 37 � W on said ¢ea-�der :
D � °sP � �27 •02 feet to an iron pipe;
� N thence S 0° 00 � 50° W L�ly1 .22 Seet �
' imn i e be' the f ;
m I said pa.Pel con�ain^, 2�09 ��c_esemo?
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o ! i N. meander line to the waters e�;z,
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m � a'� - subject to any e2sese�t o= reco_
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SHORELAND PRESERVATION AGREEMENT �
on-Intact Shoreline Ve�etation Protection Area) •
Land Use PermitNo. - 'j
�� Da (To be entered by the Zoning O�ce) Index No. C3_�-��Ik��
VV�-IEREAS, (list all owners) a- �� �� '
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owns real esta.te within Sawyer County that is subject to the Sawyer County Shoreland Regulations and , ``
VV�IEREAS, 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 sha11 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 a11 shoreland vegetative buffer requirements of the Sawyer County Zorung 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 to
inspect the structure(s) or uses authorized by said Land Use Pernut 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 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.
Legal Description of Property: �P�, a 3 —�,�,h 30 � � � �� a
S�,�,�O�V�� �J,� : - S��.,;—� � � �
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Dated this day of (�"�- J
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(O er)
(O er)
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(Owner)
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(Owner)
(Owner)
This instrument was drafred by:
Sawyer County Zoning Office
TOWN OF SA�IL
SEC.23 TWP 39N. R. 9 VI
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