HomeMy WebLinkAbout032-539-10-4206-LUP-2004-123 Application for Land Use Permit(*Shoreland*) o 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 ar 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 `�
� �1 9�- P r � �N S�j � U f�P C-� � � �
Owner Builder a
� ��?70 � St�ti se7� `.b�L f�.� �5 3� St�uw. �,J� o�
Mailing Address Mailing Address —�,� � O
�� c�����' �,��7;� s3/s� %r"�,�,��� lC%s ��/k%6 � �t
City,State,Zip —' City,State,Zip �
;7/�-z6b-6'-���
Daytime Phone Daytime Phone
Additional Information: Zone District: ��l
Lot Dimensions:
Date lot was created: //-o�`I-9�/ Acres: / .D a
Is there wetland near the proposed structure?If yes,how far o �r+
Building Land Use Floodplain:O Yes O No G �
�ewr ( )Filling Chippewa Flowage:( )Yes ( ) No �
O Addition O Dredging Driveway access off of a(Check one): x� �
�
( )Alteration ( )Grading ( )Private Rd ( )Town Rd. � '
( )Moving On ( ) ( )County Hwy ( )State Hwy �'
� ) � ) � S
Pr ary Structure Accessory Building Addition o �
(�Dwelling ( )Garage-attached/detached ( )Deck �
( )Year round ( )#of caz stalls ( )Porch W �
�Seasonal O Storage Building O Enclosed � J
(�'rame built on site O Screenhouse O Living room co J
( )Modular/manufactured ( )Greenhouse ( )Kitchen �
( )Mobile/manufactured ( )Other ( )Bedroom
( )Other primary structure ( ) ( )Relocate/enlazge ` � �
( ) ( ) ( )#of new ��� ��'
Ui
AdditionalInformation: (.0 a
� �
0
Type of Construction: r �
(?�Frame ( )Log ( )Pole/metal ( )Block ( )Concrete
, �
( )Other y
Construction Cost:Primary Structure$ ,�5'.,,'? /-L! "� ,ti �
Accessory Building:$ Addition:$ � �`�{
4'/-a'>3 99-cv`5� ,� I v�
Deed:Vol (0 7/ Pg [a a Certified Soil Test# }�,►�{,��T� � z
CSM:Vol�Pg�=Lot#� Sanitary Permit# �3-'�Qa' 9 9-/0� 00 �
yla 1 ��
Plat Envelope � Or: b,
Condo Vol Pg Yeaz Installed: i,
"Loads and Flows": Vol Pg Owner When Installed: �c �
�
Previous office approvals/actions: '�
Vaziance:# LUP:# SP:# CUP:#
Inspection Report:# 97-,�31 7� Change of Zone District: �
���N G
3u��5
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1
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. widc� �?bSs ft. wide ft. wide ft. wide"
�x�ft. long 36 ft. long ft. long fr. long
Floor azea j�sq. ft. , O/ O�sq. ft. sq. ft. sq. ft.
Hgt from giade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms
���6 �`p`-f' Lake/Pond/Flowa e/River/Stream Name
- ���'�`"C .
��
Fire Number and Name of Road � � � '�� � �
1. Enter lot dimensions and indicate north by arrow. Signatu�of rl�r�r/9,uthorized Agent:
2. Indicate the location and size of the requested construction / � ,�' ,��
Signa re
activities. , � ( �/ � /
PrintName: ��4b' �( l�!
3. Also, indlCate tlle loCatlon and d1St3nCe to the Well, The above ceRifies that the listed information and intentions are
We and wvect,ihat all work shall be peAortned in compliance
septic tank and drainfield, wetland areas, lot lines, wan cne �eq���emencs or me sawye� co��ry zoo�ny om��a�ce
and the laws and regulations of the State of Wisconsin, and if
centerline of ttie road and waterbodies. acno9 as ow�er�s� a9eo�,nas me Pe�m�Ssion or me owoe��s�io
perform the work requestetl on this application. The a6ove
personsls here6y give permission for access to the property for
onsite inspection.
Permitfee: $ ,��`�jC� -f S�(� � ��G�
Total land area within 300' of the waterbody: (A) �f�� �/3/
Total impervious surface area [including this project] (B) /J�/G'
(B) / (A) x 100 =%Used c�'�S`7, (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes �No
May 4, 2004 -
Issue Date Signature of Is in gent
May 4, 2005 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
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RE �RAWN BY: CK DATE: 9/30/82 INTENDED TO SHOW CONCLUSIVE
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SHORELAND PRESERVATION AGREEMENT
(Shoreline Vegetation Protection Area)
Land Use Permit No. Q — / (To be entered by the Zoning Office) Index No. �y - �
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WHEREAS, (list all owners) �- �.L�=rl� �' Q(�=�� C� Ll� �<�(/S�'�
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 is intact to a minimum depth of
35' landward from the ordinary high-w,ater mark of the waterbody.
The owner(s) hereby agrees to comply with the shoreland vegetative protection area 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
representatives of the Governmental 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
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 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 ��ill
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 Pertnit 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: 'T j �p / � � �� �,
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Dated this � '�� day of n ,' � �pd y(
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(Owner) (Owner)
(Owner) (Owner) " `��-:;� r�r-`-� ;� --�~;r,
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(Owner) ��V�ller) � i �� �r ij� � t} L�1n� � �
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This instrument was drafted by: N . �. tr;#
Sawyer County Zoning Office ��''