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Home My WebLink About026-939-26-5204-LUP-2004-581 Application for Land Use Permit(*Shoreland*) ,� 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 �� 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. PRINT-USE BLACK INK OR PENCIL r' ! i �]� �]�� , I��M A� �awl:� I-t�=%x+.i �i�hlc"(�� '[�A� �:G i t�n�n;�1--('0� c f�'y �'"' Owner Builder a, �I� S 31�� I��c��c.l;�`� i�rZ;,� I��%�3c� �J �i'ar� ��,�Y� '7c� o: �' Mailing A�ress Mailing Address � O � � �c��; m�. ��,za.— ��;-�� ,�� l��,�� ,1�� City,State,Zip City,State,Zip Cr�► - '�I�i� - 3! �� G��_9 -�-f-�i�� T� Daytime Phone Daytime Phone Z, � Additional Information: one District: I?IZ— ! � C� �C��.� ��-�.c, �'-�-`-'�.� ��S Lot Dimensions: ,l Date lot was created: Acres: ; � � Is there wetland near the proposed structwe?If yes,how far o �.� Building Land Use Floodplain:O Yes ('ji�)No c . ( )New ( )Filling Chippewa Flowage:( )Yes (� No � O Addition O Dredging Driveway access off of a(Check one): � F ( )Alteration ( )Grading (*)Private Rd ( )Town Rd. � �� ( )Moving On ( ) ( )County Hwy ( )State Hwy � ) � ) � � Primazy Structure Accessory Building Ad ition o � ( )Dwelling ( )Garage-attached/detached Deck � O Year round O#of car stalls Porch w �r ( )Seasonal ( )Storage Building ( )Enclosed � O Frame built on site O Screenhouse O Living room co �'� ( )Modular/manufactured ( )Greenhouse ( )Kitchen ", ( )Mobile/manufactured ( )Other ( )Bedroom O Other primary structure O O Relocate/enlazge C� ( ) ( ) ( )#of new � ; AdditionalInformation: ''�' p J� �� m � o Type of Construction: � N ( )Frame ( )Log ( )Pole/metal ( )Block ( )Concrete � . �' ( )Other � �` � �. � Construction Cost:Primary Structure$ �v ❑ ro Accessory Building:$ Addition:$ z,(JD � I� �, �_..� Deed:Vol C�7�� Pg 2�2- Certified Soil Test# �'�' �� '� � �z CSM:Vol I� Pg�Lot#_� Sanitary Permit# �7(n - 1�,�1 tl0 7y Plat Envelope ��' ( �Z��' Or. i_,�� r�t�_ �,�� Condo Vol Pg Year Installed: �;, "Loads and Flows": Vol Pg Owner When Installed: o � � Previous office approvals/actions: �'�' �`�` Variance:# LUP:# � I ' � SP:# CUP:# �`� `�. Inspection Report:# Change of Zone District_ �\` \Q 389`'9�( 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. #2. #3. #4. Size ft. wide ft. wide ft. wide ft. wide ft. long 17 r rar� sq. ft. Hgt. from grade to peak Stories # of bedrooms ft. long ft. long; ft. long sq. ft. sc)- f't. sq. ft. rear lot line or waterline of H4 M LnKE lake/river 12 3' ilr 'pi H DccK- _ jot li n CAM � qe® 53, 10 1 N ' -p � ' u,► wc<< 36, oc, 36 NEW �yJARR�E Fire Number and Name of Roa ------- centerline of 1. Enter lot dimensions and indicate north by arrow. 2. Indicate the location and size of the requested construction activities. 3. Also, indicate the location and distance to the well, septic tank and drainfield, wetland areas, lot lines, centerline of the road and waterbodies. Loi; LiaN E road ------- Si9p e of Ovyne� "uthor�ed Agent: Signature �. Print Name; The above certifies that the listed information and intentions are true and correct., that all work shall be performed in compliance with the requirements of the Sawyer County Zoning Ordinance and the laws and regulations of the State of Wisconsin, and if acting as owner(s) agent, 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: $ 7 J- , 00 Total land area within 300' of the waterbody: (A) -36: 900 TOWN �F SAI� D SEC . 26 TWP 39 N�: F � � . � � HAM I .5. I ( SE E SHEET 2 • s 4 3.8 ��s� ��. s �3.10 6si =39 i.�r 3.4 i.a '� /.Jt 3.E /.ff •3.�i /.r[ °3. � � .�� 3, � LAKE :3,u 3 ;4,10 7 i � '�1.9 \� �,4 �4.6 2 �4. :4. .9. I � � ;4.4 ;4.3 �4.t ., v �- ,. :4•2 � � .I I. I .12.1 ( .� :� - SAWYER COUNTY CERTiFIED SURVEY MAP �arx o� �o�cvhNu,xk lok 2, h��Yiovt 2G•'(sq nl. 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(Shoreline Veeetation Protection Area) � � Land Use Permit No._QL/-5$/ (To be entered by the Zoning Office) Index No. ��-�� WHEREAS,(list all owners)_�.�y m R S A nSn ��1-��..j K��Y _ � owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and q WHEREAS,in order to secure a Land Use Permit. d � NOVJ,THEREFORE,the owner(s)hereby certifies that,as a condition of issue of said Land Use Peanit,that V' the SHORELINE VEGETATION PROTECTION AREA on said real estate is intact to a minimum depth of � 35'landwud from the ordinary high-water mazk of the waterbody. 0 The owner(s)hereby agrees to comply with the shoreland vegetative protecrion azea requirements of Sec;tion t 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)fiu�ther agrees to allow authorized - cepresentatives of the Governmental Unit to enter onto the owner's property at the following description ..n 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 � VEGETATION PROTECTION AREA exists and that it is being preserved.This authorization shall terminate d on the date of expiration of the land use permit. However,the owner's obligation to maintain the SHORELINE � VEGETATION PROTECTION AREA in accordance with Section 4.410 SHORELAND VEGETATION 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, � 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 I issue of said Land Use Permit. All parties agree that this Agreement shall be filed with the Sawyer County �- Zoning Office. O Legal Description of Property: _ Datedt �s � �iayof � , ��0� (Ownex) (Owner) (Owner) (Owner) (Owner) (Owner) This instrument was drafted by: Sawyer County Zoning Office