HomeMy WebLinkAbout024-741-07-2402-LUP-2004-597 Application for Land Use Permit(*Non-shoreland*) o �o •,,
County of Sawyer �
PO Box 676 -Haywazd WI 54843 �
715/634-8288 �
*Property that is not located within 300'of a creek,river or stream or within 1000'of a �' �
flowage,lake or pond or does not have any of the above waterbodies located within �
the property's boundaries. � `
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. y,
PRINT-USE BLACK INK OR PENCIL Q n �
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pwner �—' /,YeO'7 Trqf�QB. Builder �;
kd�5{e��/�N �. �
I l5L9 �F1G�.-�. 1--�NE 559V3//R�D/l� /nDs�tti�n .�rcak ,C�G+� �
Mailing Address Mailing Address O�
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City,State,Zip r� City,State,Zip �,
5"07-89b- 309� 5�g9 3� �i�-t,�y-59c�2 �r 7r.5�49-�'9 "�
Daytime Phone Daytime Phone n
Additional Information: Zone District: �'Q-1 �o
Lot Dimensions: �S
Date lot was created: /`�� Acres: �3/(� o
Is there wetland near the proposed structure?If yes,how faz G �
Building Land Use Floodp}ain:� )Yes O No `;
�
(�New ( )Filling
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O Addition O Dredging Driveway access off of a(Check one): �.,
O Alteration O Grading O Private Rd O Town Rd. o
( )Moving On ( ) ( )County Hwy ( )State Hwy ti �
� ) � ) o S
r
Primary Structure Accessory Building Addition � °
( )Dwelling ( )Gazage-attached/detached ( )Deck "'
( )Year round ( )#of car stalls ( )Porch =
O Seasonal �Storage Building O Enclosed �
O Frame built on site O Screenhouse O Living room J rn
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen '
( )Mobile/manufactured ( )Other ( )Bedroom .�'� �
( )Other primazy structure ( ) ( )Relocate/enlarge � �
� � � � ( )#of new d
AdditionalInformation: � _
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Type of Construction: p �7
( )Frame ( )Log (�C}Pole/meta] ( )Block ( )Concrete �j I �
( )Other .d .-�
Construction Cost:Primary Structure$ � �
D. �
Accessory Building:$ �,�)n(� , C C� Addition:$ �
� 3 p �5� Certified Soil Test# QZ, - { "� �z
Deed:"v oi__� g
CSM:Vol Pg Lot# Sanitary Permit# qz-O 4S o, %b
Plat Envelope Or: n� �
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Condo Vol Pg Yeaz Installed: I�7`�l � �
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Aff of ex septic Vol Pg Owner When Installed:
Previous office approvals/actions:
Vaziance:# LUP:# �tZ-�,12. SP�# CUP:# i I
Inspection Report:# Change of Zone District: I`3I���
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�S o00 L�\
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 ,
p� 7 ft. long ft. long ft. long ft. long
Floor area � �v 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-- Rear Lot Line
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Fire Number and Name of Road ( I �;p � (� t t So 9 � A � E. LA�.E
1. Enter lot dimensions and indicate north by arrow. Sig atur of Owner or Authorized Agent:
2. Indicate the location and size of the requested construction —
Signature
activities. � Q � ��_
Print Name:.��, �
3. Also, indicate the location and distance to the well, The above certifies that the list info ation and intentions are
true and correct., that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines and to the 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. aot��9 as oW�er�s> a9e�t, has the permission of the owner(s) to
perform the work requested on this application. The above
persons/s hereby give permission for access to the property for
onsite inspection.
Permit fee: $
ac� �'r�� �' .�,� , ���% `� '
Issue Date Signature of Iss 'ng gent
�'� ,.�.�;��, � , ,� „�(�� �.�� _ 50% Rule: Average Road Setback: _
Expiration Date
Office Comments:
TOWN OF RO� N
SEC. 7 TWP 4 I N . F
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SHORELAND PRESERVATi01`7 AGREEMEI`1T �
(Shorcline Ve¢elation Protectioo A�ea)
Land Use Permit No.Dy" .�7�I rI (To be entered by the Zoning OCfice) Indei No. �- 5 Q�
WHEREAS,(list ali owners) Stanley and Wanda Pruka
owns rea] estate within Sawyer County ihat is subjeet to the Saveyec County Shoreland Regulations, and
� WHEREAS,in order to seci�re a Land Use Permit.
� NOW, TH�REFORE, the owner(s) hereby certifics thai, as a condiuon of issue of said Land Use Permit, that
� the SHORELINE VEGETATION PROTECTTON ARLA on said real eswtc is intact to a mi�timum depth of
-l�l. 35' landward from ihe ordinary Fugh-water roazk of the wate�body. _ _ _ _. .
� 'Ihe ownec(s) hereby egces to comply wilh the shoreland vegetative protection area requirementsn effect on
� q.410 SHORELAND VE(38TATION PROTECTION ARE/�> Sawyer County Zoning Ordinenee,
��j the date ilmt thc land use permit is issued by the zoning oP6ce. The owner(s) turther agrees to aliow authorized
—h- tepresentBHves of the Govemmental Unit w erter onW the ovmer's propetty at the following descrip[ion
� between the hours of 8:00 A.M. end 6:00 P.M. [Secbon 9.13(1) POWERS, Sawyer County Zoning Ordinance)
� to inspect the stxucture(s) or uses authortud by said l�nd Use Permit and to deurmine if the SHORELINF.
,� VEGETATION PR01'ECTION AREA exists and tliai it is being p�sen'ed• 7�his authorization shall tctminate
J on t1u date of expuation of the land use pe�mit. However,the ownar's obligation to maintain che SHORELINE
L VEGETAT[ON PROTECITON AItEA in accordance �+'�th Section 4.410 SHORELAND VEGETATION
Q. PROTECTION AREA, Sawyer County Zoning Ordinance remains in effeCt. Violation of ttiis Agreement will
suthoriu, in additiion to other pcnalties and relief required under thc Sawyer County Zoning Ocdinance,
� injunctive relief, restoretion of said real estete, the revocation of said Land Use Permit and the removal of all
b� sUucluros approved by the issue of said Land Use Pem�it and the revocation of any othec uses approved by the
� issoe of said Land Use Pccmit. AU puties agrec d�at this Agreement shall be filed with the Sawyer County
, Zoning Office.
� art of the SE � NW � Section 7 T41 N
Q I,egal Description of Property: p `
R 7 W. Town of Ro d L e _
. , T' „ ""^, . '024-741-07-2402
Aa1ed this 0� day of
' �
(Owner) (Owner)
(Owner) (Owner)
(Owner) (Owncr)
'It�is instrument was drnRed by:
� �Sawyer County Zoning O�ce