HomeMy WebLinkAbout026-938-06-5908-LUP-2004-404 • � � -- _ .: .
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Application for Land Use Permit *Shareland* s/
� ) r y
County of Sawyer � �
PO Box 676 -Hayward WI 54843 i
71S/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 boundazies.
CONS JRUCTIQN IALL NOT BEG7N UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
y/� �� PRINT-USE BLACK INK OR PENCIL
r����rs f�<< y T��r cr � .���`��Cs�n����i:cm� �
Owner �C j,$ � . �p��'�j Bw der � �
ti.�yy��'z�`��`£2iv,�-r� � T�asr�� l�j`l�� C�_ CL� � �:
Mailing Address Mailing Address � 0 �
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City State,Zip City,Stat ip '"
''�:�y�;C / �IS— (o��� �4'���.
Daytime Phone Daytime Phone Y qa-7� a
Additional Information: Zone District:��_ �
C7G�.�ry AIt ISO�
� I C�tS NvrS��'y IZvai LotDimensions:�,�j����Zic.y�?„�t�.ZF:�
}�uzr,�-�, wt s�Ig v3 i ,�� i�S.��1
Date lot wa created: Acres: �
Is there wetland near the proposed structure?If yes,how far u� o
T
Building Land Use Floodplain:( )Yes (�No �n
( New �
7� O Filling Chippewa Flowage:O Yes (yQ� No � —�
(: )Addition �( )Dredging Driveway access off of a(Check one): �
j�.Alteration �0 �tJ Grading O Private Rd OA Town Rd. �
( )Moving On ( ) ( )County Hwy ( )State Hwy � �,
� � � � N O
� ["'
Primary Structure Accessory�� Addition o 0
� �welling (�}�Garage attache detached ( )Deck �
(XJ Yeaz round (�#of caz sta s O Porch W
( )Seasonal ( )Storage Building ( )Enclosed
( )Frame built on site ( )Screenhouse ( )Living room co �
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlarge \
� � ( ) ( )#of new �
� �1
AddltlOnal T+,F.�--•=--� �
(�.�r�.e� �I-G w�.c.S� rc�e� �
elza/o`� , ,�
�T e of Construction: �
Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � ,,�
( )Other o
Construction Cost:Primary Structure$ ^ ,� �'
Accessory Building:$ � (]U,�_ Addition:$ �
# 3z33�y �
Deed:Vol Pg Certified Soil Test# � z
CSM:Vol�Pg��Lot#�_ Sanitary Permit# °Q x
Plat Envelope Or: �,
Condo Vol Pg Year Installed: �R-/. ) �;,
"Loads and Flows": Vol Pg Owner When Installed: � o �
�2>�c�� ����n r� "
._��.
Previous office approvals/actions: �I�
Variance:# LUP:# SP:# CUP:# —p0
Inspection Report:# Change of Zone District: _
7�z���`l
a�►���
. 1 _-
Describe the construction using these columns. List the dimensions of each structure in a separate .
colu n. List each story, each addition, each alteration in a separate column.
#1. #2. #3. #q.
Size ft. wide ft. wide ft. wide ft. wide
o�� ft. long ft. ]ong ft. long ft. long
Floor area_�sq. ft. sq. ft. sq. ft. Sq, g.
Hgt.fmm giade��to peak ft. hgt. ft. hgt, ft, hgt.
Stories � stories stories stories "
# of bedrooms � �
Lake/PondlFlowa elRiver/Stream ame
�� C�c`���
,
�
�
Fire Number and Name of Road �
1. Enter lot dimensions and indicate north by arrow. Signatu e Of Owt�bor �th� O�t'�'ze�d��A ent:
2. Indieate the location and size of the requested construction .x_��� G> - /�,�'-�s�-'z.i`"�
Signatwe
activities. �p�5 C, �L�s�3 f'iQ 7,S
Print Narrie:
3. Also, indicate the location and distance to the well, The ebove certlfies that the iisted intormation and inlenUons are
We and cortect, that all work shall be per(ortned in compliance
septic tank and drainfield, wetland azeas, lOt 11Iles, with the requirements of lhe Sawyer Counry zcnirg Ordinance
end tha daws end reguletions of ihe Stete of Wisconsin, and it
centeriine of the road and waterbodies. ac� as�ner�s� e9e�t nas me aem,asa� or tne o�e��s� ro
pertorm the work requested on this applica6on. The above
persons/s hereby give permissron for access to the properry for
onsite inspection.
Pernut fee: $
Total land area within 300' of the waterbody: (A) �773 9 Y / S.�
Total impervious surface azea [including this project] (B) � �1C?� `�.1-_
(B) / (A) x 100 = % Used �Q�D (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required� Yes ( ) No
August 4 , 2004 7�"
Issue Date Signature of Issui A e
A11gtiS t 4 , 2��5 50% Rule: Average Road Setback:
Expi tion Date
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DRAWN BY:�(. DATE : 7/6/87 INTENDEO TO SHOW CONCLUSI
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SHORELAND PRESERVATION AGREEMENT
(Non-Intact Shoreline VeQetation Protection Area)
� Land Use Permit No. �— Q (To be entered by the Zoning Office) Index No. �_- y�
� WHEREAS, (list all owners) _� �j�� ��,T(17� ;}'
k —
�
0 owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
� WHER�AS, 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, t6at
j the SHORELINE VEGETATION PROTECTION AREA on said real estate shall be restored in accordance
� with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
3- The owner(s) hereby agrees that at all times in the future, the real estate subject to tkris Agreement shall comply
with all shoreland vegetative buffer requirements of the Sawyer County Zoning Ordinance in effect on the date
� tUat 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 properly at the following description to
insPect the shuctnre(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 ttus Agreement will
` authorize, in addition to other penal6es and relief required under the Sawyer County Zoning Ordinance,
y injunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all
9 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 agrce that tiris Agreement shall be filed with the Sawyer County
Zoning Office.
pLe al Descri tion of Pro ert y� �, � � ��
g P P Y� 1 \_J��.V y�a — \��5� JI�XI �� ��W
� — ` ,� � Town of Sand Lake , Sawyer Count_�WI
OOa6'9'3B —O6 �5908
bated:this____�_ day of .�') �l�-n , 2 c���
���,er� s��r��y �.e�rs�7-
��wn�r} �/5 '�.�£/�� s ,7/�'/�s��fs �owner>
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(Owner) (Owner)
(Owner) (Owner)
This instnunent was draftedby:
Sawycr County Zoning Office