HomeMy WebLinkAbout012-640-17-3304-LUP-1997-531 ' �` 75Aa
Application for Land Use Permit y �._
County of Sawyer R �
PO Box 668 -Haywazd WI 54843 �
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 � �,
and the laws and regulations of the State of Wisconsin. r` ' 1 ,
PRINT—USE BLACK INK OR PENCIL .�� �
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Owner � Builder y �
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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 ��
Building Land Use J/ J
( )New ( )Filling Zone District /�./`�. /
( )Addition ( )Dredging o
( )Alteration ( )Grading Lot Size �
( )Moving On ) - ��v� ��
� �
( ) ) Acres �?�% �
K
Primary Structure Accessory Building Addition � �
( )Dwelling ( )Gazage-attached/detached ( )Deck S
O Yeaz round O#of caz stalls O Porch o
( )Seasonal ( )Storage Building ( )Enclosed
O Frame built on site O Screenhouse O Living room
( )Modulaz/manufactured ( )Greenhouse ( )Kitchen
( )Mobile/manufactured ( )Other ( )Bedroom rf�
( )Other primary structure ( ) ( )Relocate/enlazge �
( ) ( ) ( )#of new �
Type of Construction
I,�`��
( )Frame k( )Log ( )Pole/metal �d( )Block ( )Concrete �
( )Other - "
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R' �
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Construction Cost$ �
Vol S r r�. Pg �� of Deed Certified Soil Test# ��-� � �����
CSM Vol ��, Pg ; ,'�'- Sanitary Permit# `_ ►�'�
��_„
Plat Envelope Or: � �r z
Condo Vol Pg Yeaz Installed �
Aff of ex septic V P Owner When Installed: �\
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Application for Land Use Permit— Page 2
Describe Conshvction: List dimensions of each struchue, story, addition, or alteration.
#1. #2. #3. #4.
Size ft. wide ft. wide ft. wide ft. wide
= �;� � ft. long ft. long ft. long fr. long
Floor azea sq. ft. sq. ft. sq. ft. sq. ft.
Hgt from grade to peak ft. hgt. ft. hgt. ft. hgt.
Stories stories stories stories
#of bedrooms
reaz lot line or waterline of lake/river
In the box sketch in:
Location and size of all
existing and proposed structures.
Location of septic system.
Indicate distance to: �
Waterline `� �
Road �
Lot lines
Septic system
Distance between structures.
Indicate North.
Fire Number:
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Signatur Owner
------- centerline of road-------
Issue Date 30 Sept. 1997 Expire Date 30 Sept. 1998
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Office Comments: " �
�C�,�.nS. c�.p,w�oS 9�39�91
Pe.< C��
DRAWINGS OF PROPOSED� � . . . . ', �. 4��.� �
ACI7VITY SHOULD SE PREPARED � . ��
IN ACCORDANCE VVITH SAMPLE N � CO �N W � � }-
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SITE DiAGRA1Y1 Scale: 1 inch = feet
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�� APPL,ICA � .
770N/PERMIY FOR �p �O �S
► uired u�der Sx[ioa 30.12(3). Wis. Shts. �rs�0t to sxtion �
�r'Pers�mlly ideatifiable iafo 30.12(3)(A)3, Wis. Stati. Fo�
/ mo.��,.r•,N.me rmatioa on this R��1 to provide this info rm 3506
^ fi'Om will be used for no otherraution maY rrsult in the dis¢v
�O �%al Lpe�lion P �5e• SV� Of yOUf
5��,o�Ao�� ,�oaGE�� ��
!1 T, ,00 �
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Home T4cphoa No. ��• s?r�y3 � )Ciry / T� � ) Vi14ye of / •T N�R�
� ) ��T;elepdom No. Fi+e Number u � . �
1 heee6 J, � Tax Pucel No. � .
Y cettifY that�8e' �. Coum
�bore meotioned a behal��i6e oa•�K�o f�d�io ia Wa�ad accunla. f am 16e o r N'me a f Wamrway .
conp�d Lertia nuLL�+ad���luae vi14�11 a����tioos.���wdr�dW tha oP�nan p`°P�rty or�m Ne dui a�� � .
� 6 �°'�Y h+uk ic�5y��yor' �����°rob eomply wLLW oy o�a���d�We���,I e and liva aod yy�
Rintedh or TYP�d Fu�jJ• " '/$- � D wio�u of..30.]2(S).Wu. ➢mvi,iom of Ne p�.i,,;i �'iL eomWq Um
R DF/ (� �j �° 4ei Z — 7�e I�� s'a4.or forfei RAdm the o
��/ "' . ����/G SiYdo�n y,�� �G ] o+re unAer a.30.15,1Yu.S��nr'tio
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A 7�r'� ;��s o o.�,�P,�a
TT��O� YOU 14ILTST C011IpLY
�n�cs � � corm � �— 9
OF FACT ITTONS ON
' �1e�pplieau�ya cou�plied viN w � BACK OF T$� p�,r
��P�O'�Vroject wi]I na R P�ocedural+ad leyil leyuuemee[�oC Wuomin Lw.
"��'il7 nw u all ip��4�
The IkP �mew 6aa det� conroomey�y�llution u d�finad ia�N q.q. ��w�oot�dvenely�fiect a.��er qwli .
�
7Le j� n� �d�t the jr�yy�of Ipy P«mit�vpWd 4tt.• it ihe Projec[u eo`ut�uciedJin�co �ae wa[er pollulion w a
�xonain Ad�m�yauative Code�nd 1Yuc�o¢�i'ucs�hy�jy�Wuy"���Q+�au��e jta'e actioo iiYniLcanUY aRcc�inY�he qwLiyoC[he y�P`�4 r4e�
�IVQ[J c Pro,«`���ac�veWnds. P�o�ec�u pe�,�aill eompiy vi�8 W�PPIi461e���nhr°�x.
SIONS OF I,q�y ;
2Le Dep���has unhorib uader s.
70.72(�.Wis.StwNA 1Q3,�y b1A�.�� uae�P�'mit for ilw Pro a�
TI� OF P�°��++comylied oi�h a. 1.11� 1i'u.St+q.am �Op�Adminittnuve Cada b •
APPEqi, RIGg� �
�beL'eve tlu[rou h.v�.ri
�R9UC#f f0 RVICM� Yht W ehallen�e���
r.rtmea[a«idcw mu,be wao4, r«�.ew��a t„w•thu�y,�
nu f o r h u�oo the Sart ry o f��pro�Rmau of wu•Sha..Yw hava 30 y �ia Ad�yn+a�ve Codea�W u c o m i n S'aww ewblisy p��rioda oi�6in
N�Wy Re+w+cu. 'ly� Y'atter th�deeuion u maiied, W b �
ootice iu P�widsd y or ahew�K aery
P +w+nt W a.227.{8(1).�Yu.Shta.y tLe p�rtmea�.to ssrvs�
��R�SCONSIN _ DEPq�.�EM K N�'�TMENT OF Nq'��_ ���CE USE ONL,y
TU�.RESOUR�
d By;
Date Siga�
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PERI�ITT CONDITIONS: RIPRAP PERM�,r �
PAGE 2
LEAVE BLANK - FOR DEPARTMENT OF NATURAL RESOUP.CE USE ONLY
1• 1' r ce in hi ertnl an b Innin ont h r 'e mean ha �
��n�itlona of this oertnh ou have read understand and a ree o fol� w
Z• A photopraph ot the completed project shall be submitted to the Department within 10 days of project completion.
3• You are hereby authorized to place clean Tieldstone or qu rry stone 6 to 24 inches in diameter alonp ��i � linea�
teet of the shoreline. The stone may extend up to � feet waterward as measured from the exist�a�k. The
stone shall follow the natural contour of the shoreline and shall not be placed hipher than
ordinary hiBh Watertnark The final riprap slope shall not exceed 2 feet horizontal to 7 foot verti— c�a� �nches above the
<• AI� greding and excavation must be confined to the minimum area necessary for construction and shall not exceed the
maximum area allowed by the local shoreland zoning ordinance or 10,000 square feet, whichever i< le�s.
5� The use af filter cloth, or a filter layer, under the riprap is recommended to extend the life of the structure and to improve
effectiveness.
6. The project shall be constructed in a manner that prevents upland soil losses and sedimentation of the waterway.
Temporary erosion control measures such as mulch, silt fence, and/or strew bales shall be used as needed and shall be put
in Place prior to any precipitation or N work ceases for ionger than 24 consecutive hours. Any upland areas distur6ed
durinp construction shall be properly stabiiized immediately following project completion by seeding and mulching.
�• The removal of trees, shrubs, and othe�shoreline vepetation shall be kept to a minimum and any vepetation removal above
the ordinary hiph watermark af the waterway must comply with the shore cover removal reQuirements of the local county
zoning ordinance.
$• No waterwa�d extension o{ the uDland property is permitted other than what is reasonably necessary for ihe placement
of riprap to stabilize and protect the exislinp bank. No fill material may be placed in a wetland or below the ordinary hiph
watermark of any suAace water.
9. This permit is not valid unless you have obtained all reduired approvals from other LOCAL, STATE and FEpER.4L
jurisdictiOns.
7 0. This nermh exolres on November 7 oi the eelendar vear followino the dery ot isauance No constr�ction may take place -
after t1Wt date unless you obta�n a wrttten extens�on of this permit from the Department before the date the permit expires.
1 7. You must keep a copy of this permit at the project site at all times until the project is completed.
12• You must allow Department employees access to the project site to make inspections at any time to determine whether
the work is in compliance with this permit and any other lepal requirements.
7 3. If necessary, the Department may:
a. Amend this partnit by thanpinp or addinq conditions to ensure that the project is in compliance with all app�icable
lepal requirements.
b. Revoke this pertnit to proteet the public interest or prevent material impairment of navipation.
�4. You must maintain the riprap in pood condition.
i5. Other conditions: (�_f��� /� ,,_ � _ � .
'� � Qn a� �a e�e'f'
,a t�p��: 9-2�-7� -�, �� e 9� �I< <
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>ertNt aent to: Conaervation Wmd�n '� � ' p � / l
c —�jCouncy 2oniny AdmiM�tratw 2',� l S �ol , /Z �`O��ya.'('ci.Q / ( �ipo'f v'�r�•,,Q�
�c�s�at-Ciu, U.S. Artny Corps of Enyinsen /� (�
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