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Home My WebLink About026-939-02-5202-LUP-2004-550 � Application for Land Use Permit(*Shoreland*) �o County of Sawyer �, � PO Box 676 -Hayward 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 _ r the property's boundazies. � CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. � � PRINT-USE BLACK INK OR PENCIL c.�o�d(�.,d j�l. C��p. � ��! �s m� �.'�.,� z ��.h�U,d b d er La�p e-r��U � Owner Builder p- '7 0 3(� � �. �-��Si,.c �..C��'f.. I.� OCo�/ /tl ��. rW, L,�Y �{nr� �. 0 Mailing Address Mai/ling Address � O ��CIV �- !C�v'� , �l� � S 1 � � 3 �T0. 7[�r� �,�� c� Cly3 � City,S te,Zip City, [e,Zip � �� - v c�s- �r�a� 'r i s-- �c��. - q� S� o Daytime Phone Daytime Phone ° � Additional Information: Zone District: ,/2�-/ P S Lot Dimensions: � � Date lot was created: Acres: /p �c� �`.�� Is there wetland near the proposed structure?If yes,how far o o� Building Land Use Floodplain:O Yes (�o � � O l�w O Filling Chippewa Flowage:O Yes O No ti (��Addition O Dredging Driveway access off of a(Check one): x� ( )Alteration ( )Grading ( )Private Rd ( )Town Rd. � ( )Moving On ( ) ( )County Hwy ( )State Hwy °R � ) � ) � 0 0 N � vi r Primazy Structure Accessory Building Addition o ° ( )Dwelling ( )Gazage-attached/detached ( )Deck � I;;� O Year round ( j#of car stalls O Porch �, �'� ( )Seasonal ( )Storage Building ( )Enclosed � (�ame built on site O Screenhouse O Living room cro, ( )Modulaz/manufactured ( )Greenhouse ( )Kitchen � ( )Mobile/manufactured ( )Other ( )Bedroom p - ( )Other primazy structure ( ) ( )Relocate/enlazge � ` ( ) �i�% i,n 1-��J ti ( ) ( )#o£new �' AdditionalInformation: :1� � �� O " Type of Construction: �-' � (�rame ( )Log ( )Pole/metal ( )Block ( )Concrete � ( )Other � ,� Construction Cost:Primary Structure$ �J r' C o o � Accessory Building:$ Addition:$ � �,', � r-�� Deed:Voi 2yl Pg Cn�y , Certified Soil Test# �, z CSM:Vol Pg Lot# Sanitary Permit# � � Plat Envelope Or: � � CondoVol Pg YearInstalled: '�1��uV- �e� ��1�� N �� "Loads and Flows": Vol Pg Owner When Installed: � ci Y„ Previous office approvals/actions: ` Vaziance:# LUP:# SP:# CUP:# N Inspection Report:# Change of Zone District: 9��'�°`� � �s� ��. 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. (�a�1�1 #2. #3. #4. Size �o ft.wide ft.wide ft.wide ft.wide �,,�ft.long ft.long fr.long ft.long Floor area a o sq.ft. sq.fr. sq.ft. sq.ft. Hgt from grade�,��to peak ft.hgt. ft.hgt. fr.hgt. Stories / stories stories stories #of bedrooms D Lake/Pond/Flowa e/River/Stream ame e �r 1'e�)�E- �oo' �e� � � is�' o C y � � <? �x;s�:f � ta..;��'I h_. --� � d ��'� o ' o - ` � b L � � P' � � t (�a � �i, CS � P . �DU � D/ _._. .. .a.— _—_ __._._.______ _ __.� . p r b � ��Q.+� Fire Number and Name of Road l��a w,o �a.�� 7 O 4 4 %C� 1. Enter lot dimensions and indicate north by arrow. Sig ur o� or Autho�ized Agent: 2. Indicate the location and size of the requested construction Signalure activities. j� ' ^� Print Name: lJ�V��—1•Z H 3. Also,indicate the location and distance to the well, The above ce'fi s t a i a ion and inten6ons are We and co ,that all work shall be performed in compliance septic tank and drainfield,wetland azeas,lot lines, wiM the requiremenls of the Sawyer County Zonirg Ordinance and Ne laws and regulations of ihe State of Wisconsin,and if centerline of the road and waterbodles. acting as owner�s)agent nas ihe permission of ihe ovmer(s)to perform ihe work requested on this application. The above personsls hereby give permission for access lo the property for onsite inspection. e Permit fee:$ /(;0£ Total land azea within 300'of the waterbody:(A) a 2� So 0 Total impervious surface azea fincluding this proiect](B) 3ao0 _ (B)/(A)x 100=%Used 1 y. �a. (Shall not exceed 15%[or 25%with a conditional use permit].) Shoreline Vegetation Protection Area:Mitigation Required?O Yes O No September 30, 2004 �M.tO,c1--��('l�.ILI''eU '�Q.P�� U�' Issue Date Signature ofIss 'ng ent September 30, 2005 50%Rule: AverageRoadSetback: Expiration Date Office Comments: �---•---- � TOWN OF BASS LAKE �I .I �� _ � COURT OREILLES LAKE � � � 1 �2.2 � 5z3 �2.1 SCALE: I INGH=400 F � _ DRAWN BY:MK _ �_COLON (:) INDICATES SHORELAND PRESERVATION AGREEMENT � (Shoreline Viceetation Protection Area) y Land Use Permit No. ��Jr� (To be entered by the Zoning Office) Index No. Q 7 d � WHEREAS, (list all owners) Wnodl�--o��1�[ �0 l�'1 � CO r DOt'0.'F'l6'W �_r 1 — 0 � £ 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. \ A � NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Permit, that �� the SHORELINE VEGETATION PROTECTION t1REA on said real estate is intact to a minimum depth of � 35' landwazd from the ordinary high=.�ater mark cf:he�vzYerbody. � S R The owner(s) hereby agrees to comply with the shoreland vegetative protection azea requirements of Section "' ��` 4.410 SHORELAND VEGETATION PROTECTION AREA, 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 eS representatives of the Govemmental Unit to enter onto the owner's property at the following description � between the hours of 8:00 A.M. and 6:00 P.M. [Section 9.13(1) POWERS, Sawyer County Zoning Ordinance] to inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE 3 VEGETATION PROTECTION AREA exists and that it is being preserved. This authorization shall terminate � on the date of expiration of the land use permit. However, the owner's obligation to maintain the SHOREL,INE � VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION 1f� PROTECTION AREA, Sawyer County Zoning Ordinance remains in effect. Violation of this Agreement will � authorize, in addition to other penalties and relief required under the Sawyer County Zoning Ordinance, 7�injunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all Q 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: — Date this day of �� ` Tre�+ un� _ (Owner) (Owner) (Owner) (Owner) (Ownex) (Owner) This instrument was drafted by: Sa�ryer County Zoning Office