HomeMy WebLinkAbout032-338-22-5713-LUP-2004-108 Application far Land Use Permit��'�-���� o o 'Xi
County of Sawyer � �
PO Box 676 -Haywazd WI 54843
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agees that all work _ �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin. �
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. � I
C�v�r C(SC�L P�NT—USE BLACK INK OR PENCIL �
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Owner Builder �
,�i'avo Gc7oo,0 /-,�,u�- rl%i.tso� c,vey /zi0 Gc% o�
Mailing Address Mailing Address � �
����- �� ` �535�os" �,��i�s � � s-Yss�— ,�
Ciiy,Staie,Z p City,State,Zip �
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Daytime Phone Daytime Phone � �
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Additiona]Information: ZoneDistrict /DcvN �� Gl/.`.IJIE� �
Lot Size ,�r�- AC.�'�S �
Date lot was created/�� Acres �.6�
Is the property in a Shoreland District?(within 1000'of a lake or pond,�vithin 300'of a river,
creek or stream) If yes,how faz from the shoreline&water name: ;�SS� CvNN�+^5 �X', �
Is there wetland near the proposed structure?If yes,how faz �j' � �
Building Land Use �° �`
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Qlf New O Filling Floodplain:O Yes .(.�'}'No # �
( )Addition ( )Dredging �
( )Alteration ( )Grading Chippewa Flowage: ( )Yes {�No �
( )Moving On ( ) � r"
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( ) ( ) Driveway:( )State �f County ( )Town Rd. �
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Primary Structure Accessory Building Addition �,, �
( )Dwelling (�Garage-attache et e ( )Deck �'
( )Year round ( )#of car stalls ( )Porch ��
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room � �
( )Modular/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom L�
( )Other primary structure ( ) (�Relocate/enlazge �J
( ) ( ) ( )#of new � <
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Additional Information: "
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Type of Co�struction �,
I�j Frame ' ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other
Construction Cost:Primary Structure S �OOt� 'p -�! '-'��-`
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Accessory Building:$ Addition:$ _ z
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Voi .S 3 � Pg ��of Deed Certified Soil Test# 9J`�/�1-3
CSM Vol Pg Lot# Sanitary Permit# 9�-- Q'�� `�
Plat Envelope Or: `�C
Condo Vol Pg Yeaz Installed
Aff of ex septic Vol Pg Owner When Installed:
Gazd Gazebo Vol Pg
Previous Variance: LUP: '�'G- c'�� Inspection Date: al�I l0�
3'�93�
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.
#l. #2. #3. #4.
Size_�_ft.wide ft.wide ft.wide fr.wide
�_ft.long ft.long ft.long ft.long
Floor area�sq.ft. sq.ft. sq.ft. Sq•�•
Hgt.from gade�6 to peak ft.hgt. ft.hgt. ft.hgt.
Stories�_ stories stories stories
#of bedrooms —
Lot Line or Lake/River name:
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Fire Number and Name of Road /(�`-��02� C.U%y ��� /'!
1.Fill in lot dimensions and indicate north by arrow. Signature of Own r Authorized Agent:
2.Indicate location and size of existing and new structures. �
3.Indicate location of well,septic tank,drainfield.
4.Indicate distance to existing structures,lot lines,septic system. IvF�� SI��CL�S
5.Indicate distance to the ordinary high-water mark of any lake,
pond,river,stream,creek,and name the body of water. P��t Name:
The above ceNfies ihat the listed information and intentions are
6.Indicate any grading or clearing in excess of the construction site. we a�d�orr��Tne a�o�e Persoos�5 nereby y�ve Perm�ss�o�ror
access to the property for onsite inspection.
7.Indicate distance to any wetland.
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�,� �o�o Permit Fee:
Apri1 28, 2004 �
Issue Date Signature of Iss �ng gent
April 28, 2005
Expiration Date
Office Comments: �cy��,,,� ,(Y���;,, �c�,,,,��
Inspection Date: 50%Rule Applies: Avg.Setback: Within Reservation boundaries:
Restrictions and other information:
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CO�NNORS �
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SCALE: I INCH= 4�.�0 FEET FOR ASSESSMENT USE ONLY NOT
DRAWN BY: C K DATE : I / I2/�2 INTENDEO TO SHOW CONCLUSIVE
COLON (:) 1NDICATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
B0�INDARY LOCATIONS
SHORELAND PR�SERVATION AGREEMENT - .
(Non-Intact Shoreline Veeetation Protection Area)
Land Use Permit No. n y �U 8 (To be entered by the Zoning Office) Index No. �y - /08
WHEREAS, (listallowners) Ronald J . Guarascio SR
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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 PROTECTION 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 all times in the future, the real estate subject to this Agreement shall comply
with all shoreland vegetative buffer requirements of the 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
representatives of the Govemmental Unit to enter onto the owner's property at the following description 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. 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
strttctures 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.
Lega1 Description of Property: O�a — 5�,,� — �"� _ s��f '�,
Part of Gov ' t Lot 7 Sec 22 , T38N , R3W '�
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(Owner) / (Owner)
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(Owner) (Owner)
(Owner) (Ow:ier)
This instrument was dralled by:
Sawyer County Zoni�g Office
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