HomeMy WebLinkAbout032-540-32-5201-LUP-2004-287 �e.e: -�7�eo � . .
Application for Land Use Permit r ,� -
County of Sawyer ° ,°��
PO Box 676 -Hayward WI 54843 .r�,,_
715/634-8288
The undersigned hereby makes application for a Land Use Permit and agrees that all work �
shall be done in compliance with the requirements of the Sawyer County Zoning Ordinance 5�
and the laws and regulations of the State of Wisconsin. .{�
NO CONSTRUCTION MAY BEGIN UNTIL ALL PERMITS HAVE BEEN ISSUED. � I
t`���;Q�� Gt.✓l�- PRINT-USE BLACK INK OR PENCIL *`
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Owner Builder �•
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ity,Stat :p City,State,Zip ��
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Additional Information: Zone District we�� 4
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Lot Size fl
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Date lot was created Acres p
Is the property in a Shoreland District?(within 1000'of a lake or pond,within 300'of a river, !
creek or stream) If yes,how far from the shoreline&water name: ,gac ke r Lq k� Z
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Is there wetland near the proposed structure?If yes,how far o
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Building Land Use � �
(�New ( )Filling Floodplain:( )Yes ( )No # ;;
( )Addition ( )Dredging � G�
( )Alteration ( )Grading Chippewa Flowage: ( )Yes (�No � ,��,
( )Moving On ( 1 r"
9.� °
( )_ __ ( ) _ Driveway:( )State ( )County (>O Town Rd. Ia
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Primary Structure Accessory Building Addition a y�
( )Dwelling ( )Gazage-attached/detached (�Deck
O Year round O#of car stalls (�Porch �
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site Q�Screenhouse O Living room �
Kitchen � ��
( )Modular/manufactured ( )Greenhouse ( ) p
( )Mobile/manufactured ( )Other ( )Bedroom —
( )Other primary structure ( ) ( )Relocate/enlazge
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Additional Information:
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Type of Construction �
04 Frame ( )Log ( )Pole/metal ( )Block ( )Concrete �
( )Other — � .L
Construction Cost:Primary Structure$ 8�fi ' °� — O
Accessory Building:$ Addition:$
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Vol�6`� Pg �13 of Deed Certified Soil Test# O 3- ��� �
CSM Vol Pg Lot# Sanitary Permit# p 3 � 3 S �
Plat Envelope Or: �
Condo Vol Pg Year Installed o200 3
Aff of ex septic Vol Pg Owner When Installed:
Gard GazeboVol Pg W"z"���
Previous Variance: LUP: Inspection Date:
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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
�ft. long ft. long ft. long ft. long
Floor area �0�sq. ft. sq. ft. sq. ft. sq. ft.
Hgt.from grade C�.� to peak ft. hgt. ft. hgt. ft. hgt.
Stories / �— stories stories stories
# of bedrooms �
Lot Line or Lake/River name: ga�1Ce �-ak2-
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Fire Number and Name of Road -763 3 Qa�ke.c' �G ke. (�d .
1. Fill in lot dimensions and indicate north by arrow. Si nature of Owner or Authorized Agent:
2. Indicate location and size of existing and new structures. �„��w.1/��^�^-
3. Indicate location of well, septic tank, drainfield. � � � �
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4. Indicate distance to existing structures, lot lines, septic system.
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 certifies that the listed information and intentions are
6. Indicate any grading or clearing in excess of the construction site. t�ue a�a coRea.rne abo�e pe�sonsis nereby 9��e Perm�ss�on ro�
access to the property for onsite inspection.
7. Indicate distance to any wetland.
Permit Fee:
T �ne 22i 2004 '
Issue Date Signature of Issui g nt
June 22, 2005
Expiration Date
Office Comments:
Inspection Date: 50%Rule Applies: Avg. Setback: Within Reservation boundaries:
Restrictions and other information:
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SHORELAND PRESERVATION AGREEMENT
(Shoreline Vegetation Protection Area) -
Land Use Permit No. (To be entered by the Zoning Office) Index No. - _
WHEREAS, (list all owners) � � � ' � C�
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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
�S' landwazd from the ordinary high-water 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 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:
Dated this / �' day of ,) �,_,� , ��D �
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(p (Owner)
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(Owner) (Owner)
(Owner) (Owner)
This instrument was drafted by:
Sawyer County Zoning Office