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HomeMy WebLinkAbout026-185-01-1700-LUP-2004-631 �. Application for Land Use Permit (*Shoreland*) o o - ` County of Sawyer � � \ PO Box 676 - Hayward WI 54843 d 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 ' �/ ' AR�¢rson q�,,� �� c� `�� � • �r2C < S•E . y4� I-��..�5 �iYI'r� < ,-,�s r,���ric►,v� �; Owner Builder s� � � .�'f'.,s' � /� ..,�,7���^i d,� ��r-. c/b l�.J C-����D. -� o: Mailing Address ) Mailin Address � � ��- r � =s/�a / � S.�/�`�� � �� ' � ! � �, City, State, Zip City, State, Zip � . ��� � �a�� 'S � /5- �,E;.�Z -�i ��t� � ��i Daytime Phone Daytime Phone '.� ; 1 Additional Information: �Zone District: ��¢�'��'���� ,�� �' �� ` � ,: � � � Lot Dimensions: / � C=' � .� �.C�T� �S U�O C�Z. �i. ;� �1 '�` -: 3!c � Date lot was created: /�i � Acres: . ` _ Is there wetland near the proposed structure? If yes, how far �,,, o� � Building Land Use Floodplain: ( ) Yes (x)No � � ( )New ( ) Filling Chippewa Flowage: ( ) Yes ( ) No o� ( )Addition ( ) Dredging Driveway access off of a(Check one): � ( )Alteration ( ) Grading ( ) Private Rd � Town Rd. � ( ) Moving On ( ) ( ) County Hwy ( ) State Hwy � � l � \ � N � Primary Structure Accessory Building Addition � o 0 ( ) Dwelling ( ) Garage- detached � ( ) Deck � , � ( ) Year round (� # of car stalls ( ) Porch W ( ) Seasonal ( ) Storage Building ( ) Enclosed � O Frame built on site O Screenhouse O Living room �v ( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen � ( ) Mobile/manufactured ( ) Other , /� ( ) Bedroom � ( ) Other primary structure ( ) ,��x�(? Cf�-�'.�C��" ( ) Relocate/enlarge A � � ( ) ( ) # of new � � co AdditionalInformation: �;' A a � � � t � � Type of Construction: o �,' �Frame ( ) Log ( ) Pole/metal ( ) Block O��,Concrete p ( ) Other y Construction Cost: Primary Structure $ `�' ,.d � � Accessory Building: $ r '7 5 U �' Addition: $ � � � r. � � Deed: Vol (oZ 7 Pg 1 z�_ Certified Soil Test# ; z dq � CSM: Vol Pg Lot# Sanitary Permit# � � Plat Envelope Or: � �r�. �`��-�`�' � Condo Vol Pg Year Installed: J,f'� ���C� N � �, "Loads and Flows": Vol Pg Owner When Installe • � � ,T r j'_ �� � � ''.y•... � Previous office approvals/actions: � Variance: # LUP:# SP: # CUP: # . • � Inspection Report: # Chan e of Zone Dis�rict: ;,, g � ��/���;c/ ► �Z� l 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. `� ^— - � C7��,'rc #3. #4. . Size ft. wide ft. wide ft. wide ft. wide . ft. long � ft. long ft. long ft. long ` Floor area sq. ft. � sq. ft. sq. ft. sq. ft. Hgt. from grade to pealc %.3 ft. hgt. ft. hgt. ft. hgt. - Stories _� stories stories stories # of bedrooms � Lake/Pond/Flowa e/River/Stream Name � —� � / � �� c�'/�.�'� %€ ��C1 c- i �`� �'/� �' !,� <- /� . • �uss �txiit�� Construction � � 9032 W Cty Rd B Hayward. WI 5484? �� �_a��; : , �� Fire Number and Name of Road ���'/� ��� ����r�_ . ��i q �.� �-i 1'G�'� ` 1 . Enter lot dimensions and indicate north by anow. $�natu e of 0 ne u orize gent: 2. Indicate the location and size of the requested construction ' �' .� � Sign e / activities. �, � � f s Print Name: ��J.k:cLG � •��"� l � 3. Also, indicate the location and distance to the well, The above ceRifies that the listed information and intentions are true and correct., that ail work shall be perfortned in compliance septic tank and drainfield, wetland areas, lot lines, 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 and waterbodies. a�c��s as ow�er�s� a9e�t, 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: $ ��'� Total land area within 300' of the waterbody: (A) .Z,S d � G S�� �' i Total impervious surface area [including this project] (B) �� � �- (B) / (A) x 100 = % Used /�� (Shall not exceed 15%[or 25% with a conditional use permit].) Shoreline Vegetation Protection Area: Mitigation Required? ( ) Yes ( ) No November 4 , 2004 ' � _ Issue Date Signature of Issui g nt rlovember 4 , 2005 50% Rule: Average Road Setback: Expiration Date Office Comments: E ��, __ . __,�� 71546�a.E�--. �.0�4� RU� ?�'=TH CONSTRUCT P�aE r� . POWER 01'ATIOR�•IF.�� ' Knc,u°al!Men by thcs:presenls.?i,�;i,__�tE_.f� _�e7z5v'� property uwner,T�ov+n�.�i SAN� I�{7[E____,Su,�, ��u�tv,Part of Govem�z�ent Lot � ��c, ��._c �1� � ,$tate of Wiscoiisi�,have � _ . _ __. �i;�.cen�litutr;i a�,t:� �r��i�?e.� �S -5��/lN r of �45$_S� 11�__C�c,wsr2r�ei7osJ ��i tl��C�unt} oi S�W�j�72., �tate of��1�. �� �;,tny tn�e and Iawful a�er.t for >>ie arid i.�rzry���3zrze �ta.�.r aau _. to do an;r cui.. ans neccssary For thc als}�!i�ati�n Yor,iiegotiation of,or�c��runfn�c�;staie,coun�y am� � �:1 peralits with the Couniy of Saltyer,1Vtscorsin,gn;n�snd granttng hcreby unto ;:.;d agent ful!power and authorixe to Jo so aA�d perf'orvi ali and aver}ac*and tk�ings�;�,.ttnever required and necessary to be done in about said precc:;es,a,f�l'�.c ro all intents:�� s��i;rposes�u I mighc and could do if �ers:?naliv pre�ent,resc��=ingfu;l r����ar of substif�:,�. ��,r.�n��rcvoca�ion,hereb}�iatifying all tliat m:s.ud agent �'?i:s ii� ���<i,:�c shalf fay.�l',i` �..caas�to be done by viilua uier:cf. 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