010-941-23-4320-LUP-2022-149 SU6MIT COMPIETED AP9lICATION AND
FEeT�: APPi�I��l"1�1R! F�R I�AIVD US�P��MIT C, �
SawyerCounty Y�� dUNYY,WISC8iV51N C���-��
Zoning�Conserva4ian pepart. D �.n /"'
1063tl Main St Suite 49 Ce1 r�-i n �
Mayward,W!54843 __
(�as)��a.sase MAY 2 O 2022 �
-s�
INSTRUCTIONS: No permiLs wilf be issued un[il all fees are paid. sAy���R �i17������i
Checks are made payable to:Sawyer County Zoning Department,
DO NOT S1ART CONS7RUCTION UNTIL�LL_PERMITS HAVE BEEN ISSUED 70 APPLICAtJT. C)�iginal Ap;'�'c,�tior,h1U5T�bC Subriitt2d FILL OUT iN INK (NO PENCIL)
Submittai of this application or receipt of fees does not constiWte permit issuance,
z._' —'�"
Owner(s)Name: Contractor(s�Name "srn— ___
Ro��id � Qon��e l�� �-e�. N IA
Mailing Address: Mailing Address: �
tS�SSjw Q���S �rJ e l-�a �ar�
Phone: �~ Phone: W
��S— l03'�-����7
Emaii: ���•��ek�o�,�i�� �.v�
Email:
Site address: I V�7�� �� b� Or Date applied for. �� �
-._-- ----- —
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Legacy PIN p 4� //� � �O Town of: �,�J(�Y�
Permit delivery Method ❑Call Owner �Mail Owner ❑Call Contractor o Mail Contractor
�.: Is Property/Land within 300 feet of River,Stream (ind. Distance Structure is from Shoreline: is��our Property
Intermi[tent) —. A(��.^.'Ptl3r,r�5
feet in Fioodplain
Creek or Landward side of Floodplain? If yes--continue i'resent?
i Shoreland - — ------- ---- zo���
Yes Yes
- Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: r�F-
If yes--continue —�. feet iVo
:.1 Non-Shoreland
Describe Project Total#of
value at Time of project type Foundation What Type&Capacity is the
Completion Number bedrooms
'indur,'e donatrd fHouse,garage,shed,deck, (Basement, ,,,., Sewer/Sanitary System(s)
Addition,etc...) of Stories Crawls ace,
tir�e&material P consYructicn
List separately Slab)
S ;- ` it�ble Living area
Owelling
s �� 0 .;, �,.�:;.,��sary structures
AccessoryBldg �11 �+���n��� I 'v � � � � �
$
Addi[ion/Alteration
Height:
Total Square Lowest
Proposed Use ✓ PrAposed 5tructure Dimensions Footage Gradeto
(multiply per Highest
story) Peak
Residence � ( X �
Ft.
with 2"d story or loft � x �
Ft.
with Basement � X �
Ft.
�Residential Use Attached Garage � �� ( X , Ft.
X ACCe55ory StrUetu�2(explain) � �h� �gD f � x �(v � � O
J AgYICUItU�BI Idetachedgarages,sheds,Goxthouses,etcJ �� �f(� L � FL.
Use ( x }
Temporary Guest Quarters or Runkhouse(a�de cyPe) �t
❑ Commercial/ Deck/Porch/Patio � � X �
Ft.
Industrial Use
(2"d)Deck/Porch/Patio � X �
Ft.
L7 Municipal Use -- - ( X �
Othe�(explain)
Ft.
0 Ot�jer _ _ � x �
Prineipal Strueture(ngri��ic��ai,Commercial,Municipal,Etc.) Ft
Addition/Al4era4i0e�(explain) ( X ) �Y
T'oYal Non-habi4ak�le square feet: 3�Cj
To4al habitable square feet: (de�i<s,patios,garages,sheds,storage area&other structures)
L3riginal�;pE;��ca'ticn i�JiU51_be �s;�bF��it4ed
� —.�___�.._ __,__._.__ __�__ — _.
_—�__ _ . --- --
Att�ch a Pian or Sketch your ProK�erty on 8.5 x 11"or �.5"x la"pa�:�er •Must*Include location and setback of proposed and existing strudures,roads,
driveway,sanitary components,well,lake,river,stream,and wetlands ��
Description � Setback ^� Dessription ` T Setback
Measurement� Measurements
Setback from the Centerline of Platted Road and/or ���T� Feet Setback from the Lake(ordinaryhigh-water mark� � � Feet
Setback from the Established Right-of-Way Feet Setback from the River,5tream,Creek Feet
�� �� Setback from the Bluff if applicable PeeL
Setback from the North Lot Line � Geet �
Setback from the South Lot Line Feet Setback from Wetland � Feet
Setback from the West Lot Line S Feet Slope within area of construction/disturbance 90 Slope
Setback from the East Lot Line 1 S Feet Elevation of Floodplein � Feet
Setback to Septic Tank or Holding Tank Feet Setback to Well Feet
Setback to Drain Field Feet � �
Setback to Privy(Portable,Composting) Feet
Prin�to the ul�i�-am-nt or construction of a structure within five(5)feet of the minimvm requlred setback,the boundary line from which the setback must be measured must be visible from one
previc,usly suiveyed corner ro the other previously surveyed comer or marked by a licensed wrveyor at the owner's expense.
Prior to the placement or consvuction of a str�dure more than five(5)feet but less than ten(10)feet from the minirnum required set6ack,the boundary line from which the setback must be
measured must 6e visible from one previously surveyed corner to the other previously surveyed comer,or verifiable by the Uepanment hy us��of a corrected compass trom a known comer
wicnin 500 feet of the proposed site of the ztructure,or must be marked by a licensed surveyor at the owner's expense.
. � • � • .�• • � • .- � . •- .
Calculate impervlous surfaces.(Roofed,concrete,paved,and other surfaces that waeer cannot penetrate.The Zoning Office can help you determine if a
surface is considered impervious)
Calculate lot area:
Indlcate lot size from CSM or OVUS(c cle one):� �' ��� Acres;Multiply by 43,560=Lot area: � �i Gr �_�J Square Footage
Calculate impervious surface area:
Determine the total size,in square feet,of your proJects listed above(include eaves):_ ��� � sq ft.
Determine the total size,in square feet,of all existing roofed structures(include eaves}; 3�� sq ft.
Determine the total size,in square feet,of all existing paved/bricked/blocked surfaces:_ sq ft.
Add these measurements to determine total impervious surfaces: sq ft.
Calculate impervious lot percentage
Total impervious surface: y� 70 =Lot area:1 O [G S Sq ft.X 100=impervious surface 3+� �J %
(Mitigation is reyoired i(total exceeds 15%)
"•`Notice a separate grading pemiit needs to be obtained if disturbed area is wiehin the Shoreland district as indicated on previous page and meets critena below'*`
�__.. _-- �_ _
• Gradln�on a siape greater than 20% . Grading of more than 1,000 Sq. Ft.on 12%-20%slopes
___ _
� • Grading of more than�,000 Sc�. Ft.on Slop�s less than 12% • _Gi,ading is in excess of 10,000 5q. Ft.
��+��:i!. �� v.. . a. ��J�t:� � ��I ...�,:fv., i � � . � ,�)i �� � ,�-,2[viITVJILLIiI_`�UL�'In1PE_NA!�fIE�
I(we)declare that this application(including any accompanying information)has been examined by me(us)and to the best of my(our)knowledge and belief it is true,correct and
complete. i(we)acknowledge that I(we)am(are)responsibie for the detail and accuracy of all information I(we)am(are)providing and that it will be relied upon by Sawyer
County in determining whether to issue a permit, I(we)further accept liability which may be a result of Sawyer County relying on this information i(we)am(are)providing in or
with this application.I(we)consent to county officials charged with administering county ordinances to have access to the above descri6ed property at any reasonable time for the
purpose of inspection.Additionally,the undersigned person(s)liereby give permission for access to the property for onsite inspection by Municipat Officials.
Owner rf Owner //� �,�, �/
Signature `-^�G�� _printed name �Oh��C/� ��'�/I�r��v Date ��� ��
(Si�{nalur'e and�'rintr��l r�:arnc reyuired)
NOTICE: All Land Utie Perini[s({xpii���:ne(1)Yc�ar troin th��Date ot Itisuance.
For the Construction Of New On��&T�,vo f amlly Dwellln�: ALL fvlunicivalities Are Required To Eniorce The Uniform Uwelling Code.
ThF�iocal lown,St�te or p�d�ral a,enrir[ntay alcu requlrr�p�nnits.
You are responsible for complying with the requirements of the Sawyer Counting Zoning Ordinances and law and regulations of the State of Wisconsin.You are also responsible for
complying with State and Federal laws concerning construttion near or on wetlands,lakes,and strearns.Failure to comply may result in remova�or modification of construction
that violates the law or other penaltles or costs. For more information,visit the department of natural resources wetlands identification web page or contact a department of
natural resources service center(608)267-3125
Issuance Information (County Use Oniy� Sanitary Number �of bedrooms:
Permit Denied(Date): Reason for Denial:
�.s —.____.._.__-_ ���__�.-- _
Permit N: Issuing age : Date:
�� - I �{� `1 G� �' �-�-����
Is Parcel a Sub-Standard Lot I i Yes (Deed of Record)w� ��� Mitigation Required Ci Yes � o
Is Parcel in Common Ownership 1�1 Yes (Fused/Contlguous Lot�s)) ��� Mitigaeion Attached !_�Yes �No
Is Structure Non-Conforming !I Yes _ _ Y�No
-- � _.__^.�_:— __w.T_, . _ _. _ �-_.
6ranYed by Variance(B.O.A.) Granted by Conciitional Wse
�)Y@s �. No Case fi: �!ves Mp Case A:
- - ------ --_ _, .-
Was Parcel Legally Created Yes ;'Mo __^._.___ Were f�raperty Lines Re�resented by Owner �Yes fVo
Was Pro�osed BuilAing SiYe Oelineated '�Yes i_i Np Was�roperty Surveyed �('Yes _ _ No
- - _ -.r�=- - _—�----- - -_ _
- -- ._.._- - _ _
OfEice Comments: Zone District: fee:
�- I ��?�
- � _..�_-- ---. _`- ___ -� - _
- _.
Hold For Sanitary: Hoid For TBA• I � Hold For Affidavit I Hold For Fees� '� � ' I
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�Feb2021
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5/20/22, 1:06 PM Novus-Wisconsin Access rev. 13.1108
Real Estate Sawyer County Property Listing Property Status:Current
Today's Date: 5/20/2022 Created On:8/1/2016 2:15:03 PM
�Description Updated: 1/18/2019 �Ownership Updated: 7/30/2020
_ _
_._
__
_ . _.
_____ ___.---
Tax ID: 42493 RONALD&BONNIE KUBAREK HAYWARD WI
PIN: 57-010-2-41-09-23-4 03-000-000200
Legacy PIN: 010941234320 Biliing Address: Mailing Address:
Map ID: RONALD&BONNIE KUBAREK RONALD&BONNIE KUBAREK
Municipality: (O10)TOWN OF HAYWARD 15551 DAVIS AVE 15551 DaVIS AVE
STR: 523 T41N R09W HAYWARD WI 54843 HAYWARD WI 54843
Description: PRT SWSE, LOT 1 CSM 33/64#7962 t�
AND PRT LOT 1 CSM 6/51#1139 r Site Address *indicates Private Road
Recorded Acres: 2.490 - ---
Lottery Claims: 0
10580N RIVERSIDE RD HAYWARD 54843
First Dollar: Yes
Waterbody: Hayward Lake � Property Assessment Updated: 5/24/2017
_._
Namekagon River 2022 Assessment Detail
Zoning: (R-1)Residential One Code Acres Land Imp.
ESN: 444 G1-RESIDENTIAL 2.490 67,900 158,200
��Tax Districts Updated:8/1/2016 Z'Year Comparison 2021 2022 Change
1 State of Wisconsin Land: 67,900 67,900 0.0%
57 Sawyer County Improved: 158,200 158,200 0.0%
010 Town of Hayward Total: 226,100 226,100 0.0%
572478 Hayward Community School District
001700 Technical College �
M3t Property History
Y� Recorded Documents Updated:4/2/2013 Parent Properties Tax ID
---__ .
O WARRANTY DEED 57-010-2-41-09-23-4 03-000-000160 41750
Date Recorded: 6/29/2020 424704 57-010-2-41-09-23-4 03-000-000190 42492
O ORDER
Date Recorded: 1/9/2020 421989
O MAP OF SURVEY
Date Recorded: 1/29/2015 23419-32
0 CORRECTION INSTRUMENT
Date Recorded:4/29/2014 390157
0 AFFIDAVIT OF CORR CSM
Date Recorded:3/21/2014 389709
O CERTIFIED SURVEY MAP
Date Recorded:2/14/2014 389377
0 WARRANTY DEED
Date Recorded:4/1/2013 384281
O CERTIFIED SURVEY MAP
Date Recorded:8/29/1978 166383
HISTORY O Expand All History White=Current Parcels Pink=Retired Parcels
O Tax ID: 12658 Pin:57-010-2-41-09-23-4 03-000-000100 leg.Pin:010941234310 Map ID:.15.10
O Tax ID:42492 Pin:57-010-2-41-09-23-4 03-000-000190 Leg.Pin:010941234319
fax ID: 12652 Pin:57-010-2-41-09-23-4 03-000-000040 Leg.Pin:010941234304 Map ID:.15.4
fax ID: 12650 Pin:57-010-2-41-09-23-4 03-000-000020 Leg.Pin:010941234302 Map ID:.15.2
O Tax ID:39735 Pin:57-010-2-41-09-23-4 03-000-000140 Leg.Pin:010941234314 Map ID:.15.14
O Tax ID:40046 Pin:57-010-2-41-09-23-4 03-000-000150 Leg.Pin:010941234315 Map ID:.15.15
0 Tax ID: 12660 Pin:57-010-2-41-09-23-4 03-000-000120 Leg.Pin:010941234312 Map ID: .15.12
0 Tax ID:41750 Pin:57-010-2-41-09-23-4 03-000-000160 Leg.Pin:010941234316
42493 This Parcel Parents Children
https://tas.sawyercountygov.org//Access/master.asp ���