HomeMy WebLinkAbout032-338-20-5203-LUP-2004-228 Application far Land Use Permit(*Shareland*) "•'
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County of Sawyer ° �
PO Box 676 -Hayward WI 54843 i
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. � �
�b� �� ��_ PRINT-USE BLACK INK OR PENCIL � ��.
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Owner —� Builder a t �
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Mailing Address Mailing Address �
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City,State,Zip + City,State,Zip � �
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Daytime Phone Daytime Phone � �
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Additional Information: Zone District: �1��—/
Lot Dimensions: �
Date lot was created: Acres: �o� 9 '�
Is there wetland near the proposed structure?If yes,how faz o �
Building Land Use Floodplain:O Yes (j�No5`��5`'i o��s-a G �
f�J New O Filling Chippewa Flowage:O Yes (j{l No �o �
O Addition O Dredging Driveway access off of a(Check one): � �
( )Altcration ( )Grading ( )Private Rd �Town Rd. � %
( )Moving On ( ) ( )County Hwy ( )State Hwy °Q
( ) ( ) t�n G�
0 0`
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Primary Structure Accessory Building Addition o 0
�Dwelling ( )Garage-attached/detached ( )Deck � �
O Ycar round O#of car stalls O Porch W
( )Seasonal ��'�Storage Building�� ( )Enclosed
�(}Frame built on site O Screenhouse O Living room �
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen V
( )Mobile/manufactured ( )Other ( )Bedroom p \
( )Other primary structure ( ) ( )Relocate/enlarge ��"'
� ) ( ) ( )#of new , I
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AdditionalInformation: °;i a
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Type of Construction: L� �
( )Prame �Log ( )Pole/metal ( )Block ( )Concrete p �,
( )Other ��
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Construction Cost:Primary Structure$ '�'�r?�b ,.d �
Accessory Building:$ Addition:$ ^
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Deed:Vol 'J Pg �'I Certified Soil Test# �, z
CSM:Vol Pg Lot# Sanitary Permit# z:c rs/.�s /'��vy `"� �
Plat Envelope �r� � �
� V
Condo Vol Pg Year Installed: /Y �`t7 (�cttc�� i:.�
"Loads and Flows": Vol Pg Owner When Installed: � �
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Previous office approvals/actions: �.
'^nce:# LUP:# SP:# CUP:# �
.Report:# Change of Zone District: �
3ad��t (�i���y���
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Describc the construction using these columns. List the dimensions of each structurc in a separatc
column. List each story, each addition, each alteration in a separate column.
#l. r�?a, .; F/�,: .. #2. �c�r #3. �-��'f' #4.
Size e2 6 ft. wide 7-� fr. wide / ,3 ft. wide ft. wide ��'
�ft. long ��ft. long G ft. long ft. long �
Floor area ��Y sq. ft. L//�; sq. ft. � �� sq. ft. sq. ft.
Hgt from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
# of bedrooms �
/.3� Lake/Pond/Flowa e/River/Stream ame
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Fire Number and Name of Road N� -(7 a2 ('�%e,1� (.�ct t
1. Enter lot dimensions and indicate north by arrow. Slgnatu�e of Owne�o��luthorized Agent:
2. Indicate the location and size of the requested construction ��� Lti eS;�
Sgnatu2'
activities. /- . -+ t,7
Print Name: (Y.�{/C Y � V"�y rf n �
3. Also, indicate the location and distance to the well, The above cerofies mat ihe listed intormation and intentions ara
We and correct., that all work shall be perfortned in complianca
septic tank and drainfield, wetland areas, lot lines, with Ne requirements ol ihe Sawyer Counry Zonin9 Obinance
and Ne laws and reguWtions of the State of Wisconsin, and il
centerline of the road and waterbodies. aca�y as owr�er�s�a9eo�,na5 me�r,��5io�oi me o�,e��9�io
peAorm the work �equested on this appliotion. The above �
personsls hereby give permission lor aceess to the properry lor
onsfteinspedion.
Permit fee: $ ��
Total land area within 300' of the waterbody: (A) yt?,00�
Total impervious surface area [including this project] (B) /loa9
(B) / (A) x 100 = % Used �°l„ (Shall not exceed 15%[or 25% with a conditional use permit].)
Shoreline Vegetation Protection Area: Mitigation Required? O Yes O No
May 28 , 2004 - �
Issue Date Signature ofIs ui A ent •
May 28 , 2005 50%Rule: AverageRoadSetback:
Expiration Date
Office Comments:
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SCALE: I INCH= 400 FEE
DRAWN BY: CK D
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� SHORELAND PRESERVATION AGREEMENT
� (Shoreline Vegetation Protection Area)
�
v�i Land Use Permit No. (To be entered by the Zoning Office) Index No. - �
7
� WHEREAS,(list all owners) %J��-"� � ��j'�="� —/v�eCJ�.�
� �'��Y `� We�r�v.� _
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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 is intact to a minimum depth of
� 35'landwazd from the ordinary high-water mazk of the waterbody.
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3 The owner(s)hereby agrees to comply with the shoreland vegetative protection azea 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 Govemmenta] 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
9 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
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: /i/� /���✓� /E 0 �'�T"� •� �C .Se u YT-r �30�� �c�`'
4� �xact�.���'�.� �i� j"�c �.2� f�c,�c�� Ywce�aC"ti �do ) �vr�.�y.���e2
�fLc%��ytit .�3b') /ikyrl,f ft'u�rye %� Hee. <%) %�✓�'sl"
Dated this ��� day of !?/liti 3cr c�j�
� G�it.�ru.� 2 t,Je��_/11.P�e..�a�v _
(Owner) t` (Owner)
(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sa�ryer County Zoning Office �
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