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014-842-28-2106-LUP-2021-478 SUBMIT COMPIETED APPUCATION AND FEE70: � APPLICATION FOR IAND USE PERMIT I � Z UZ I , N 5awyer Ccunry SAWYER COUNTY,WISCONSIN ���t� �_� Zoning&Conservation Depart. �ir�� ���rt(1� �j �^ � � ' 106]QMainS[Suite49 f I�I"�I_f` 11�/( � ., !'^k..l.dil �, - Nayward,WI54843 �N� 1�!�/7 i l �v� D l,�i IR3T (715J 6348288 t--J C.� V I/� //� ��:�1'�# "� � -�. tN�iqUCT!ONti.Nopermitswillbekweduntilallfeesarepaf. OCT L Z �OL� �/ � i� Checki arc made paYable to Sawye Cou ry ZoNng Department DO HO 5�nRi[^'v5�w�r�pN 1N7-�tt;�EHnt T5 Na-�p aeEr�sSt,-1 � `G pp'���/yy� -��y) n R4i)57 h�submitt¢d FIIL OUT IN INK (NO PENCIL) S�bm r'.'.�l t�'i a{;nlicat�r....r e P,�t feEs d L .,rst .pe..t s7F�dF-• ����,`�'�� .. . c ��c• ri ------- -.____. __�- --..__—�BNINC-A�Mthl1�TRATIQN----- ..._�_� . .______ ___- i_Uwne�(s)Name �� Co tractor{s)Name � � � 1 �r�� R�� � � ; � -------- —_ ___- ____ ---LL------ --- -- __ _---- — ----- ': Mailing Addresr. I Mai6ng Address. '�.. �f /� � - �.'��j_��i ►1���_TI Gc-/E �i/C��e� - - �-- ___�..-------�.�____ �hone: � Phom � �` ��`�♦y �� � � �� ��, ' � ' .. ,• ' i £mafl:_V�"�J..f����iZ�._�'vVd� dG_S.:L!L��__---� ' Ema�l ': :. __ _-. _.___ ____. ,..�Stte address: �.����e�P!_�`�_ et''f� . � �°�,,(� ` Or�ate appMed fo�s___._ ___.. ..—__ __ _ _ ..._ _ _. �� I r__ ..-__ ' _-._:�, �/ --"s.� ---_ -r"'-- I G (� /�/'� , --- - --- �: Leqxy VIN tr-'O�y� �1��.��.l t/� — ----... I Town of ; 1�--1��'(--V V�----._ . __-_. '. I PernM delivery MethoA ,� '�Gali Owner �-.Mai:6wner -:Cali Contractor '�.Mail Contraaor ! � . __.._-__.------------__.. . .___. '. -- _... ...____.......------- - . ------- _39�5_�- -- -__---- - - ___ __ . -- -- , Is Property/Land within 30Q feet of ftiver,Stream i�od. � O�stance Structure is from Shoreline ' is your Property � �.�.�,.•��i1 -►� feet � A.e Wetiarrfls � m Floodolain Geek or.Landward side of floodplain? it yes--ccntinue ' ' PresenU I Shoreland �,L ___ _ --- _ ____ � ioee? ves � _ ' Is Property/land within 1000 feet of Lake,Pond or Flowage ��. Distance Structure is from Shoreline: �; YCS I j No � � If yes--.cantinue --►!. feet � �+IO � i -- --- --- - _ .._— �..-- --- -- '�j+bn ShoreWnd _ ' Desvibe Praject Value at Time of � TOWI p of Project type , � Foundation f What 7ype&Capacity is the ! Completwn I � Number � bedrooms f (House,garage,shed deck, i � (BasEment, i i Sewer/Sanitary Syitem(s) of Storie5 i �ost � Addition,eic ) � r Crawfspace, � � :. .r:�. � r�teu[;;ur. r ! List separately i � S;ab) � I 5 �����, C��' , --/ �J/�_--� ( �/ �� �.� � , ` I �,�„m� �-- --� 1'l_C ���'�------- ;---__�____�_� �_� �«n,�� � i�,�. d —�_ / � �ds �� ' � � s �— ; ; Addition/Alterdtion i � � �— i � '� j � Height: Total Square � lowest Pootage � 6radeto Oroposed Use � Proposed Strutlure f Dimensions i I (mukiply per ; Highest � i � — � story� �eak ` � , � ; �Residerxe ! (�� X S J � ' �V�J j Ft. �� � with 2"°story or loft � + X l � ft. '--T- � - -X ---�-7---- -�------ � with Basement i •� Ft. ! ji��,c� xy� � ; '^n � --; �Residential Use � Attached Garage �51,►V I Ft.��� 1 k� Aecessory Strueture(expi���i � � X � i � I � Agricultura) ( I i��ta�^Fae��¢f,,�nmacoa:no��a+,o«.1 ` Kt. I Use i� Temporery Guest Quarters or Bunkhouse(a�dE�vn�i � X � i FL. � Commercial/ Deck/Porch/Patio i t X 1 Ft. � Industrial Use , { x } i ; (2nd)Deck/Porch/Patio � � Ft, i � !.: Mu�icipal Use � ( X � � Otber Ie�piar�7 � � Ft. i I � Other � ( x ) Prindpal Stru[tute(Agriculnral.Commercial,Muni6pa!,Etc.� I Ft. Addition/Alteretion texpia,�1 � � x ) i , E F�. ( Total habiYable square feet: Totai Non-habitable squa�e feet: (decks,patios,ga2ges.sheds,storage area&other shuctures) �- ��K� :,,iri�:.�I Rp,:!c.:i�='t MU5T bP SwC:r•5i.ta� �._.. -----_---....._--- - .. _ __ _-----.e -- ----------'-- � Attach a Piar�ar Skeich your Property on 8.5"x li'or&S'"x 14'"peper:•Must'Indude lowtion and setback of proposed and ezisting siructures,roads, �'- : driveway,sanitary components,wHt,lake,river,stream,aad wetlands. ,--- -- ---- -- .__._ . _. - ------_ ____---- _..._____ __— i Setback � De� i Setbatk _ i Descriptron ; D�1� � ' Measurements ( � Meawremenu ���. • F---- -.._ ..__. _.__ _.. --.-_..�__ �- �_--t- _ . . --- - �----___ _ - -- • __- ---�--�------- _ — _� _�__ . ; Setback from the Ceoterline of Platted Road and/or i (,*� Feet I ! Setback from.he take l•d �Er wa« . -�.� �Feet j - ----�- --- -_. _. _..._..---�--_ _.__.....�.-. I. Setback from the Estabiished Right-of-Way � :{:l, Feet�-Setback from the River,Stream,Geek ; Feet � , -�__. _ .__.. ._._ _ +_._._. ...�_�----_ .__ . � � I I Seiback from the Bluff��t a�r:_,tie � '� Feet '. - - --- .___ .._ .......__ _�_ _.__-._. _. Setback from the North Lot Lme � � Feei � ..._ -- -_. ___.. �as .__.. .-- .- __ �" i � Setback from the Soutb Lo line K Feet� Setback from Wetland � Feet � ._.___.- -. --.-_ i . _ — � ._ ... .._� -----'-- r Setbacii from the West lct Line i.(t1'L1 Feet �Slope withm area of tonstruction/disturbance %Slope � , _. -_T . - --- - _-- — - _._..____ __ - �i Setback from the Eart Lot Line �(,` Feet � I Fievation of Roodplain ; Feet ��, ___ _ __ _----------- - .L_ --- -+-:- _._ _ _-----r---- ; ,--.__...__._-- --.. _.��- --- '1 _.__.__ .. _ ___._.. �---� ---�- I i Setback to Septic 7ank or Holding Tank �_�(, Feet , Setbatk fo Weli � v_ FeM - _._...._._...___-- -- - - ---.- ,_..__.._. _ .��._---- i Setback to Drain Field i' rJ Fee[ ; �-- --- — -,��'- ----�—,-------- --__—�-_.__ ______._a � Set6ack to Privy(Portable,Compostmg) Feet � � i ir,.. . �.—. ..:.-��.�,: t .,.;,,�.i�:t,. -i�-.�,;. —__.. ...,.,,..:-. ]tn_.".s'tbdck.lnoi:ound3.yl�in.efrpr�tr„� .:.�.5'•�,a�f'�;ls.�,p, .-.. ..--.-^ne _.. . ,�.., ..',.... i i [;- . . . ,.. i���:. _�r_ r .> ... ..- . . ,"'atthrer..�2�'se�pence. : .. 1 I � j ;_. ,--- - ...__ _.__ r.�.,. _ . � - .. . .•��.�. ,p<c..� , � ,ea�>teacw,�nerc...iarv:�nerrnw-.-,:hr .e��...s i,.^ne � . ... ,. ., i .n,_ . - . ,. ... .. ..�... ,...:.� . 1�..�-�, � -;�.�. , , .':.. ._.�: � .. .. . . . r F.�.� ..,. �,�,:_ r...,_,,.,: :.. *• . .... ,.� . ... .,, . . , . ... �...., :,..,�. � . .. . , . . . . ` _. . � ,_______-_. _-'_.__-."__ ___._....... .._._.____ _"_'_.._.. ,_ _..."_"_'_—_' -'__..�_ � ' Caiculate imperv{ous wrtaces.(Roofed,concrete,paved,and other wrfaces that water nnnot peoetrate The Zoning dffke wn belp you determine if a-� ' wrface is considered impervious) � ; Calculate lot area: . � I Indicate lot size from CSM or NOVUS(��rde one}_ _. :,.ses:Muliiply bY 43,560=lot area: ,_ Square Poatage I. � ------.,,----------- i ��. Calculate impervious surface area: ' Determine the total siee,in square feet,�f your projecu listed above{include eaves�: ____sy ft. , ; Determine the total size,in square feet,of all existing roofed strudures(include eaves�:_"_,.�_,_ _sq h. � i� Determine the totai size,in square feet,of a!t existing pavedJbricked/blocked suriaces:_ _._sq ft. � , i ndd these measurements to determine total impervious surfaces: _ sq ft. � Calculate imperviaus lot percentage I � � Total impervious surfaw: =Lot area. Sq ft.X 100=impervious surface % � (Mit�iga::on�.s re_�i�ed d to:al exceeds.5%} � _ " � "'Notice a sepa�ate grad"+ng permit needs to be obtained if disturbed area is wi.hin the Shoreland districe as indicated oa prevfaus page and meets criieria beiaw"'" J'� i � :�- _- _ --- -_—_____.. _____--- - _ ,. . ' I i 6redin on a slope greater than 20% Grading of more than 1,000 Sq�ft.on 12%-2G a slopes � ' -!— � -'-�-_._._._. :. ' - --__..�.___ _� -- - : 'i . Grading of more than 2,D00 Sp Ft on Slopes Iess than 12% � Grad�ng is in excess of 10,0005q ft. V ___.�� i }------- � �. -;: a� t.. � � .�,��ti . ..,_a�; ,,. ., •.:. ,�>, _ _,;, ,,,. t�we�tledare that this application(including any atcompany�ng nforma,on)has oeen examined by me{us)and m the best of my(ou-}tnvwledge and belie(it��s true,corretY a� I complete.!iwe)acknowledge that I(we�am(are)responsible fo•thz detaf�and acwracy c+f all irlcrmation I(we)am(are)prowding and that i;will be reiied upon by Sawyer '�, �, County In determining whether co issue a perm-�t.I(wr_�turther ac�ept I�abiliry which may be a resul:of Sawyer Counry re�yir.g on thls Informat'on!(we1 am�are�provi0ir:g Ir,ar ' '� with[his appilcation.I�we�consent to cour.ty ufficials charged with administering county ordinances to have access ro the a6ove descNbed property at any rea«nable!�me for thn � purpose of inspecrion.Additionally,the undersignetl peaon�s)hereby glve permtsslon for access to the property(or onsite mspection by Municipal CHIc.�is . � ��- OwneC ... . Owner ���g�-�� � � � Signature / " ' '�/ _.,,____Printed name��-^�'� � �� Oate���'� �� rdC`n F --I Lan _.._�, _ . .. . . . � _ .. :ti:..,;;. .. '-woca,v0o.ra�-,� .:�_ . . � . . . . , . �,. ..,,,:; ,...... , -h: .a!T� _...... _ . , ,_. , ,- -.._. �' vci �e respce b�. fo�����-�,��o���.�v-�g with the requiremenu of[he Sawyer Countmg Zoning Ordinances and law and reguta:ione o(the State of W isccnsin.vou are aiso resoonsible tor icomp'.ymg wi;n S[a;e and federal laws mncemir.g const:�ttion near or on wetlands,takes,and strear^.s.Fa��lure!o c�mp�y may res�!t ir removal or modi(icatien of construcilon � � tha!v�olates the iaw or other penalties o�ces8.Por more information,visit the department of natur;l resources wetlands identification web page or contact a department of � natural resourczs serv�ce center(608?267-3:25 � ��. ___. . ..... _._ _._._..__ _��—,------��-- --..� _J , .. _._._.. ...n.._.._-- — ; Issuance information(County Use Only) �"'�ry Numbec� J_ 3 (� a or nedrooms. , � / �� �--' �.__.._ _._.._._ ___ ._- -- --- -=--- __.�._ _� � Permit L�enied{Datt)� , Reason for Denial � � ,, ._._.._ _.__. .._.._...___ _....,,._.. ..-------- .._.______._� ._.--.- ---...__. .._.. �_� . _..__.. _._ ..._ i , Permit p: � ' � � /� lssuing agent Date: \la � �/. i� �3 l�-� .-- ___ ___ _ __T__ _-- ___ _ .------- _ __ ----- Is Parcef a Sub-Standard tnt � � Yes �oeed ot Remm�__� .. �?CNc Is Parcel io Commort Ownersh�o 'x Yes twseaJContiguous iotisp rya htitigat no Required ., Yes o Mlti6a?wn Attached '� �Yes _ �I +s Strvcture Non{onformm� �. Yes ___ tio ._._ ' : _.._. .__._.. ,. .--, .__. __. �- - - - ----�._.�...._..______._._�_. Gcan.ed by tianance(B O.A j Gra�tr•d b tonditional Use � � Yes Gsar N, .Yes No Case!t: r- �"°--- - �,(�_ __-____. _- . __ _ ------- _- _ -- ---1 Was Parcel Legalry Gcatcw /':e= No Were Property Lines Repre>ented 6y Owner ��.�Yes _ . No ' ' Was Proposed 8uifding Site Deifnea!ed >/''+=s No __ '. Was Property Survcyed �Nes _ No ��', ._.___ ..__...__ ._______._ .__c_-_-. ____._. ...____ ..___. ___, � . Off�ceComments._c . _ ........ �..,�,��_ �c7 r�.7�' `��� c--. �.. . Zone��strkt �`�;_.� � __ ��.._c-�.�c� � i �� `� /'%�_ F'"_45�/7�r3�- �'�.' ` , ``�\_ �i � _ __. __ .__ _ ___ - ,� �.: t��:: �;oid ForTBA: . ... : ... .ioid�c'-���' . . . �_.....� � . _ _ .... _�___ ---_.._--------_.�—�_._..__.. . . . �7an2o2o