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Home My WebLink About026-939-20-5112-LUP-2004-502 � 1 Application for Land Use Permit(*Shoreland*) � r � y 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 �J � � flowage lake or pond or has any of the above waterbodies located within � N�S j'�T the property's boundaries. � CONSTRUCTION SHALL NOT BEGIN UNTTL ALL REQUIRED PERMITS HAVE BEEN ISSUED. , PRINT-U E BLACK INK OR PENCIL �1 �-D��i� �E�iv�''� �.,: �'c�i�'r.s��; � I'� � Owner B ilder P: � ,l�o X 7� /ss� � �'9�-0/D� N: Mailing Address Mailing Address �_ O � �� GU� �/�'1G /��yk�,-�P`�'G�S"��r'� �� City,State,Zip ity, tate,Zip � ��- �t>S �593 7��" �1�/ '�.s':s"� � � Daytime Phone Daytime Phone d� � �•, � Additional Information: Zone District: �.�� i -t Lot Dimensions: ,/Q�l.c: i3 t,300 T>FF� '0� N Date lot was created: Acres: l�5 '� i Is there wetland near the proposed structure?If yes,how faz 7,s o e Building Land Use Floodplain:O Yes O No 5=�v3r�� bauu� b ` G (,)O New ( )Filling Chippewa Flowage:( )Yes ( ) No � O Addition O Dredging Driveway access off of a(Check one): x� O Alteration O Grading O Private Rd Qc�Town Rd. � O Moving On O O County Hwy O State Hwy Q0 � ) � ) � S Primazy Structure Accessory Buildin Addition o ,°r.. 6Q Dwelling ,(�Gazag -attache detached ( )Deck , � � (�Yeaz round (�#of c s �Porch I 2X �� ( )Seasonal ( )Storage Building ( )Enclosed = 6(j Frame built on site O Screenhouse O Living room c^o, V� ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen ,•`_', � ( )Mobile/manufactured ( )Other ( )Bedroom — ( )Other primazy structure ( ) ( )Relocate/enlazge ' � � ( ) ( )#of new � AdditionalInformation: "' � � � � � Type of Construction: ' � �Frame ( )Log ( )Pole/metal ( )Block �Concrete p ( )Other y Construction Cost:Primazy Structure$ 'yS��Q�'�'• �'�' ,.d � Addition:$ � °,�0 Accessory Building:$ �, W � � Deed:Vol 79,3 Pg 1�z Certified Soil Test# �J-!� �� ; z CSM:Vol Pg Lot# Sanitazy Permit# g]— ZZ-lo 0�/�35� � � Plat Envelope Or: � ' Condo Vol Pg Year Installed: N �, "Loads and Flows": Vol Pg Owner When Installed: � � ci Previous office approvals/actions: � Variance:# 03-Ut7 LUP:# C�3 ys�� SP:# CUP:# � �paY Inspection Report:# 0 3-6 3 3 Change of Zone District: as��s � i Describe the construction using these columns. List the dimensions of each structure in a separate column. List each st,ory, each addition, each alteration in a separate column. — -� #1.�Cnrf �ntti�" #2. �j�v #3. ��,r�'�' #4. ��"�-� Size ft. wide ��Ft�wide �" ft. wide ft. wide ft. long 30�( ?O ft�-la�g �� ft. long ft. long Fioor azea�3�l�sq. fr. �� sq. ft. 5?� sq. ft. sq. ft. Hgt from grade to peak z�, ft. hgt. ft. hgt. ft. hgt. Stories _�stories stories stories # of bedrooms_� � ��N L� 1� _ � Lake/Pe d/Flow e/Rived eam Name /�_.-! .', � � . �. �t � � C ' �� J ll. SP � ,:� "� �,�1, �,� p F � , , ;�- s8, � �� .� �, �,� .--- ,.,�,a„s,� .u�...� �� 5 p`"� ,;,-_(?— �" ' ,�� P� , �� ,� .y p -�, -t-so . , , i� `� ' �--- /�- � - - - - . a��y � � ��" - �----- ` � � ��a E _34� '.� 2 7- _q �_ ^ � N F-e ,�� _� �k' � yp'`�� -; �. , � , , , . t j ��f Fire Number and Name of Road vl/"� S J o �f .�� 1 /(� 1. Enter lot dimensions and indicate north by arrow. Sig�at of OwneP or Authorized Agent: 2. Indicate the location and size of the requested construction \� Signature q J g�a��- activities. �,/ f t PrintName:�fTUY-�A� � �—►�,yA�r,� 3. Also, 1ndlCate the IoCatlon and Q1StanCe to the Well, The above certifes that the listed information and intenuons are We and cortect.,ihal all work shall 6e peRortned in compliance septic tank and drainfield, wetland azeas, lot lines, with the requiremenGs of the Sawyer County Zoning Ordinance and the laws and regulations of ihe State of Wisconsin, and if centerline of the road and waterbodies. aa�o9 a5 owner�s� ayem,nas me Pe�,�ssion or me owoe�(5)�o pedortn Ne work requested on ihis applica6on. The above personsls he2by give pertnission for access to the property for onsite inspection. c� Permit fee: $ `��i�� Total land azea within 300' of the waterbody: (A) �� 390 Total impervious surface azea [including this project] (B) 59� (B) /(A)x 100 = % Used `T o-l0 (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? Yes O No September 15, 2004 - Issue Date Signature ofIssu nt Septemaber 15, 2005 50% Rule: AverageRoadSetback: Expiration Date Office Comments: �n TOW �� 0 F� S � �l � S EC . 2 0 TW P 39 � R - .- .,..�. - . : 1 . 2 : I . I � 1 . 3 : 1 . 4 � I . 5 : 1 . 6 : 1 . 16 Q�' : 1 .7 ' 1 . 8 � . :4 . 9 'k • ��lo � I � ' f , I� 1 Y • : 1 . 13 : 1 .14 : 1 . 15 : 2 .12 5 313 '2 � 11 4 : 2 . 1 20 ; 2 . 9 �2.17 : 2 .8 � :2 .7. : 3. 1 � 6 3 5.i7 2.oe � : 2 . 6 � 2 3 4 5 � 1 . 51 1.50 1.50 1.53 1.53 , 2 6 -( ; 2 . 5 • � '�. 2 � 1.58 5.26 �� : 2 , 4 • 3.5 :3.6 :3.4 :3.3 ioi :2. 15 , ; 2 . 3 :3.7 � 2.1 \ -r`'�`�'�--��-�'J�._"�^ : 2 . 2 � \ v��✓�� '+ � : z .�3 Z�Z � �� 2.�4 ��'Z � . � :7.10 ) � � � LITTLE �7a � SAND LAKE � c3 � l ` � 4. 1 2 :7.1 O •d9 . 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I�.� J) ,,:; II 11 � �.�: �� LJ I'I ;' ° �-- .:::•::,:•',' �� ° �� —.J�_ II // ..:� 0 II �� II �`— II ��::::. �.:. ��`' ll II � .�;:�� '� . �, ll II :':'.:::::'.''� � II o� ___ ° so � � . . . . . . . jj � 28 � II II II II II II II '�1 so ---__ � o ` � ZONE X g� 32 33 ��.F Sissabagama �-��..L :^ :::, SHORELAND PRESERVATION AGREEMENT (Non-Intact Shoreline Ve2etation Protection Area) Land Use Permit No. ��/-� (To be entered by the Zoning Office) Index No. �� -`r50� WI�EREAS,(list all owners)_�dyn �-- /�.��i �,,y'��✓ 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 Permit,that the SHORELINE VEGETATION PROTECT'ION AREA on said real estate shall 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 ail times in the future,the real estate subject to this Agreement shall comply a with all shoreland vegetadve buffer requirements of the Sawyer County Zoning Ordinance in effect on the date � that the Land Use Pernut 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 sttucture(s) or uses authorized by said Land Use Permit and to deternune if the SHORELINE �VEGETATION PROTECTION AREA e�cists and that it is being preserved.Violaflon 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 Pernut. All parties agree that ttus Agreement shall be filed with the Sawyer County Zoning Office. � � �A � Legal Description of Property: bU f ,SW /U� � ?� GLvv�,�/l! (..lJ � �s z Ye T wicmncin_ 026-939-20-5112 O Dated this �-9'D� day of �d0 y , �i�) � � (Owner) 1 (Owne (Owner) ��l,�i��G� U`�i (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office �