030-178-00-1100-LUP-2021-078 SUBMIT COMFLETED AV7UU710N AND �^�+•-��--�. - - � � '�"" 1 v
vee ro: #1P LqGA;C3ff FOR LAND USE PERMIT� �
SawyerCounty V �E�.COUfYfY,WISCONSIN �2,,,, �
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Zoning&Conservation Depart. � - - �� -�-
n,ce swme lae�e��el �...
10610Main5t5uite49 ��� O � ���� �� v n � ,
Hayward,W154843 �I�LiL��L
(715)634-8288 -� I IRfr s�. ^
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�... �, � No permits will6e iswed uMil atl fees are paitl. ��a`��:�� `',� . f�.�� �y���—_� /
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Checb are made payable to�Sawyer[ouMy Zo��ng DeparlmenL
novn- .. .. �. . .. . � .� -. �_:_..,..r F�LLOUTININK (Ni : � �
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Ownehs)Name: ' Co�tnctor(s)Name •
' I,b�.1 � Scc�tfi �`'I I�'U.,t,�se C�ns-h�,+.�t cm �
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MailiogAddr s: �� : MaiF Addtess: --�---� . ....-J
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Phone���. b b O• � 1�� . ����V � �1' I Phone: .�G:Ly,cw Z. �����
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Email:._��.�.��� JC'�/ l� •�W'��'r "/� ��,' Email: �h ��1 v��'1t'� /�`r•-���LLli�1 �
l t V�'�-�-(� I.� T o u 9,u��'�►-- , r ��, �
Site addrcss: � � � '�""���Or Date a p p lied(or.
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L�PIN k I��'��1..'O '�O� I TOwn OF: ! ��i ?l�1 V� ? .. �
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I Permi[delivery MtMod i _�.Call Owner �Owner -�Cali ContrMor �Mail Ca actor I � �
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., I1(,Is Property/Land within 300 feet of River.Stream..,�,d. ... .�.._.�..— . `. -T--�
�� lmr•m.•�e�th Distance Strutture a fiom Shoreline: .. :.- :
� � ��._f� ...: ! �
Creek or Landward side of floodplain? ��,-�.�� � �..
��Shoreland -
' �� Pond or Flowage Distance SVuctvre is from Shoreline: ��� � -.� /"r� ��
I Is Property/Land within 1000 teet of take,
I r yr.. �.; teet V' ���/
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�, Non-Shorelaod I �
Destribe Project �'�
Value at Time of Total M of
Project type Foundatio� What Type 8 Capacity is the ..�
Completion Number bed�ooms �
(House,garage,shed,deck ��O� (SaSement, ' Sewer/Sanitary System(s) ��
Addkion,etc...� CrawLsPace. � W �
Ust separateiy Slabj � i �
5 � S-- �
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�m6 , Y
s
���,,,�g
$�+��oo� �r�Po�� � �
ndQtion/AI[ention
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Height:
TotalSquare lowest
Proposed Use �/ proppud Swcture a�s� � Footage Grade to
I (mukiP�Y Ve� M�hest
story) Peak
Residence i X )
ft
with 2nd rtory or loft ( x �
Ft
with Basement ( X �
Ft.
{ X )
Attached Garage
Residential Use Ft.
Aaessory SVucture����) � x �
:� Agricukur3l ..-�':"`aa"sa":,�''�.'x""°'.�"` - Ft.
Use Temporary Guest Quarters or Bunkhouse{o�c�e ttipe; ( X �
ft.
�_ Commercial/ veck/Porch/vatio i x )
Ft.
Industriai Use ( � X I ?
(2"a)Oeck/Porch/Patio ' I G Ft. �3 1�
C_ Municipal Use �
Other iea�a:�; � x • �
Ft.
J Other ( x �
Prineipal Strudure(ngdn,nura�,comcse.oa+,m•cnt�ea!,ftc.t ft.
Addition/AReration�e�cpta;,� � ( x !
Ft.
Total habitable square feet: Total Non-habitable square feet: I/f�
� (deck=_,patws,gar�ges,sheds.storage area&otber structures) V�
i �
Original Applicatio „
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Att�:: cr yaur Property on 8S'x 11"or 8.5"x 14"paper.'Must'Incfude location and setback of proposed and existi�structures,roads,
' dmeway,sanitary componeMs,vveq,lake,river,stream,a�weWn�.
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� I Setba�k Secbadc �
i DewipNon I MeawremerKs � Measureme�ets I.
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Setback from the Centerline of Platted Road and/or � �db.f feet Setback from the take(o�d ry ngn.,,,,t«ma�e} �/ Feet
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Setback from the Established Right-of-Way i • UQ�'Feet Setback from the River,Stream,Geek �� Feet :�
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i--- � , ' Setback from the Bluff�t:cWx.bk n (J� Peet I
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- i Setback from the Nortb Lot Line �. Feet i
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- � Setback from the South Lot Line � � �. feet Setback from Wetland � Feet�
F--------� --.�_ - .._. . _ _�- - - ----
; Setback from the West Lot Line . � Feet Slope within area oi construc[ion/disturbance (,�i %Slope
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Setback from the East Lot Line ' 2. � + Feet . Elevation of Floodplain --�s � - JY �feet
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'� � Setback to Septic Tank or Holding Tank � Feet . Setback to Well , Feet
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, Setbac�in Reld i � Feet ; . .__ ___ _�
� ( Setback to Privy�Portable,Compostingj T ���/Peet , �� � _ �
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, � Gk�dite impervious wrfaces(Raofed,canaete,paved,and odxv s�rfacez that water ca�not penetrate.The2oning Office can help you deMrmine if a
` surface is consldered impervious)
Cakulatelotarea: -/G ��
.�; indicate lot size from CSM or NOWS(drele o�e)-.._. .j_F_�.�_Acres;Multiply by 43,560=Lot area:_,z Square Footage
Windate impervious surface area:
' Determine the total size,in square feet,of your projects Iisted above(indude eaves): � /L sq ft.
� Determine the total size,in square feet,of all existing roofed strudures�indude eaves): �_4�sq ft.
' Determine the total size,in square feet,of all existing paved/bncked/blocked surfaces:_ � _zq ft. !
Add these measuremenu to determine total impervious surfacez: ���� _�sq ft. �
� talculate impervious lot percentage
! Totai impervious surface:, =Lot area: Sq ft.X 100=impervious surface %
� � � fMrtga[ron-sreaWredi�co[ale.oeed515%� ��
•"Natice a separate grading permR needs to be obWined if dntur6ed area is within the ShoreWnd diArict as indicated on prevaus page and meets criteria below••`
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• Grading on a slope greater than 20% � . Grading of more tban 1,000 Sq.Ft.on 12%-20%sbpes �
• Grading of more than 2,000 5a.Ft.on Siopes less than 12% Grading is in excess of 10,000 Sq.Ft.
i(we)tlecWre that this application{ir,duding aoy xcomparrying�nformation)haz been exammed by me(us)and to the best of my(our�knowledge and belief R is true,mrrect a�d
. complete. i(we)acknowledge tha±��,(we)am(are)resporuibk for the detail and acwracy of all information I(we)am(arej providmg and that it will be reNed upon by Sawyer
��. Counry in determining whether to Issue a perm�t.I(we)fuKher accept IiabilKy wfiich may be a resuh of Sawyer Cowrty relymg or,this�nformation I(we)am(are)providing m or
with 2his application.1(we)consent to county off,nah charged with administering county ordinances to have access to the above described property at arry reasonable Ume fa the
purpose of t�spection.Additionally,the undersigned person�s)hereby give permission fw access to the property for onsite inspedion by Municip I ORiciais.
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� S�ture t '�I� Pnnnted name '�V�i � '-'^'-` ��1 Date ` � `� I
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You are responsible for complying wr,�the requirements of the Sawye�Cou�ting Zonirg Ordinances and law and regulations of the Sta[e of Wisconsin.You are aiso responsible for
compfymg wr,h State and Federa!laws mnceming const��uction near or on wetlands,lakes,and streams.Fallure to comply may resuR in removal or modifcation of constn�ction
that violates the 7aw or other penaRies or costs-For more,nformation,vrsit the department of natu2t resources wetWnds identrfication web page or contact a department of
! natu�al resources service center{608)267-3125
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! Issuance Information(County Use Only) �^��'Number. ' tf of bedrooms: I
!. Permit Denied(Date): Reason for Denial: �
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- Permittt: � � O� � Issuingagen� Date:���
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� Is Parcel a SubStandard Lot � Yes (Deed of Recordl � Mitigation Repuued : Yes ��o
'�� iz Parcel in Commoa Ownership �'es (Fuxd/Co�2guous tnc�s�! �� No �. Y� A�_ �
� � MltigaUon Attached I
IsStnxtureNon-Conformmg ' Ves xTlo I /_
�—
� Granted by Variance(B.OA)� i Graate�byCondiCanal Use
�i --Yes No Gse k: � Yes�o Case�:
as Parcei LegalN Created j��es No � Were Property Lines Represented by Owner I�Ves No
� Was Proposed Building Site Delineated "�es No � was Property Surveyed �/'Yes :No
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; Office Comments: Zone Dlstrict: � Fee:��--_�---�-
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m7an2020 _____'
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