002-940-13-5510-LUP-2024-068 SUBMITCOMPLEfED APPLICATION AND
FEero: APPUCATION FOR LAND USE PERMIT ��
Sawyer County �
.w„
Zoning&Conservation Depart. [���;(�{ �
10610 Maln St Suite 49 �R �e�"'-� 1 1 f � �� ay �
Hayward,WI 54843 °v _.. �---
,�i5►6�a-aZ88 MAR 1 1 2024 ;,�.?�w..._ s� �� _�...._.u..� �
�S �
iNSTRUC710NS: No permits will be issued until all fees are paid. J1q�L��f'�' �iCiUNTY �� - � � � - � ��-""""""'- �
Checks are made paya6le to:Sawyer County Zoning Department. ,
DO NOT START CONS7RUCTION UNTIL AlL PERMITS HAVE BEEN ISSUED TO APPLICANT Original Application MUST be submitted FILL OUT(N INK (NO PENCIL)
--�� ____.. .
Submittal of this apPlication or receipt cf fees does not constitute permit issuance.
Owner(s)Name: ��-f '��Q Q, Contrector(s►Name �-�(1
'�Jl � f1n2S S(�'� �'(.� � � 7 �� �� `i�� C< rl�-P r
�CS �cu.J� �L- �
M ling Address: L,� Mailing Address:
�S��v N9 I�"�'n�+ �C.;Z ��l��i:I� 1 O�l.� � � �� � cc L o ti ��y l.�l c'r c1
�
Vhone: �/ � ^ S� 1 - ���3 Phone: •/1�-' r�1 L) Q 3��{
�a 7
Email` ��f�.k e 5 �4 y, h�fiQ r� .�h [7 Email: _-
Site address: �'��h2� Or Date applied for:
LeBacy PIN# �� ol l '1� � � �`� �Q Town of: `.�Gl S S �-G��(�
I �ermit delivery Method n Call Owner �Mail Owner �Call Contrador -Mail Contrador
Is Property/Land within 300 feet of River,Stream (�nci. Distance Strudure is from Shoreline: Is your Propercy
mce�mrttentJ —► feet in Fioodpiain Are WeNands
Creek or Landward side of Ploodplain? If yes--continue � Present?
�I Shoreland - zone.
' Yes Yes
Is Property/land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: ��
If yes---continue � feet �
�
"J Non-Shoreland
Describe Projed Total#of
value atTime of p�oject type Foundation What Type&Capacity is the
Completion Number bedrooms
; � „ , � (House,garage,shed,deck, (Basement, Sewer/Sanitary System(s)
of Stories Post
'- " Addition,etc...) Crawlspace,
time&mater�ai List separately construction
Slab)
$ ^�z�'�� �'d'r�ti
Dwelling Y'� � S� � �
s Acc�Q
$
Addition/Aheration
Height:
TotalSquare Lowest
Proposed Use ✓ Proposed Structure Dimensions Footage Grade to
(multipiy per Highest
story) Peak
Residence � X �
Ft.
with 2^d story or loft ( X �
Ft.
with Basement ( X �
Ft.
Attached Garage ( X �
�Residential Use Ft.
ACC0550n/St�UCLU�C(ezplain) { X �
❑ Agrieu Itural (detachad gangos,sheda,boat hous�s,alc J Ft.
Use Temporary Guest Quarters or Bunkhouse(a�de cype) � X �
Ft.
i� Commercial/ Deck/Porcnj►�atio � X �
Ft.
Mdustrial Use ( x �
(2"d)Deck/Porch/Patio Ft.
❑ Municipal Use
Other(explainl �^ � �` ' �,` �! � q
^ ,� .. ,� ;�- A�t�a_ CI r ��- �� t1A► �g�'•�0 1 �.�o 0
_ Other � x �
Prineipal Strueture(t+gricuicurei,Commerclal,Munidpal,Etc.) Ft.
Addition/Alteration�exPia�n) � x �
Ft.
Total habitable squa�e feet: Total Non-habitable square feet: ��C'L'• �v�
(decks,patios,gareges,sheds,storage area&other structures)��
V�,��{
Original Applica[ion MUST be zu6mitted
�.Attach a Plan or Sket<h your Property on 8.5"H 11"or 8.5"z 14"paper:•Must'Indude bntion anA setback M proposed and ezisting rtruRureS,roads,
driveway,s�nitary camponents,well,lake,rlver,stream,aad wetlands.
Descri ion Secback Setback
� � MeasuremeiHs Oescriptlon Meawrements
—.
Set6ack from the Cenrerline of Platted Road and/or ! Feet Setback from the Lake(o�dm,.y n�¢n-waoe�m.rk) � Feet
Setback Bom the Established RighEof-Wry Feet Setback from the Riveq Stream,Creek Peet
Setback from the Bluff a awik,ni< Feet
Setback from the North Lot Line Feet
Setback from the South Lot Line Feet Setback fwm Wetland Feet
Setback from the West I.ot Line Feet Slope within area of construction/disturbance %Slope
��Setback from the East Lot Line Feet Elevation o(Floodplain Feet
I Setback to Septic Tank nr Holding Tank Feet Setback to Well Feet
5 t6ack to D F eld Feet
Setback to Privy(Po ta61e,Comppst ng) Feet
, � . �e e . ...�.i�,., iclazt.�Rurewt�rf�e�5lfie[o`i�cm�mu�r � r ..i. ,.I.� i i mwF�ichthesetbackrtusibeneasuedn��ib:��i„L�_'nnone
� . .i ., �t�ii��V-VcvosY 'Y��c..n�. . rke.�nY'n.r � �ie. i���eV..�c.
Pr��to t�e placemen[or cons[ruc� f ruct�r h n(ive(5)feet bu�less�ha�ten(10)lee[i � �n mum repu re�setback._ b �A ry f 1 h c�t�e setback mus[be
,r retlm�stbeviblelromon p _I��s �d.� �.�,thz���pvouslvs�neyedcor r. c f�p'i-b�eFeJ^parcmcntny i„�.aro ,t_ �uasslomaknowncarner
_ u5:'.11feetoft�epuPos��iie __ �..iii �,_�e�.�ahe. Yalcensed Y .�:�Inf. .r.i.��is�.
�
Calculate impervious zurfaces.(Roofed,convete,paved,and other surfaces that water cannot penetrate.The Zoning Office wn help you determine if a
wrface is considered impervious)
Calcufate lot area:
Indicate lot size irom CSM or NOVUS(cirde one�: Acres;Multiply by 43,560=Lot area: Square Footage
Calculate impervious surfacearea:
IDetermine the total size,in square feei,of your projects listed a6ove(inciude eaves�: ��C� sq ft.
j Determine the total size,in s uare feet,of all existin (i � `�
q g roofed structures ndude eaves: ,�J�� sq ft.
Determine the total size,in square feet,of all existing paved/bricked/blocked surfaces ��� sq k.
Add these measurements to determine total impervious surTaces: —I' v ` sq ft.
Calculate impervious lo[percentage
Totalimpervioussurface: +Lotarea�.__Sqk.%100=impervioussurface %
�Micigatonis eQuiredif�otalexceedsl5'Y)
'^Notice a zeDarate grading permit needs to be obtained if disturbed area is wlthin the Shoreland distric[as indicated on previous page and meets criteria below""
�I : Grading on a slope greater Ihan 20% Grading of more than 1,000 Sq.Ft.on 12%-20%slopez
Grading of more than 2,000 Sq.Ft.on Slopes less than 12% G adl g�s� of t0 OfNJ Sq Ft
�— =.1�LJRLi��I�TaIN: -;rAF1�NGCONSTRUC G��eVI�rv�;JT '-RMi�"✓JILLRCL�:iNI�LNnLiIFs
I(we)declare that Ihis applitation(including any aCcompanying information)has been ezaminetl by me(us)and to Ihe best of my(our)knowleCge and be(ief it is true,mrcec[and
omplete-I(we)acknowletlge that I(we)am(are)responsible tor the detail and acwracy o/all informatlon I(we)am�are)providing and[hat it will be relietl upon by Sawyer
County in determining whether to issue a permit 1(we)further accept Ilability whic�may be a result of Sawyer Counly relying on this informafion I(we)am(are)providing in or
' with thrs avvlication.i(we)consent[o munty off�cials charged wrth admin�istering coun[y ordinances to have access ro the above descr'i6ed property at any reasonable time tor the
purpose of Inspection.Addiiionally,[he�ndersigned person(s)hereby give permissionlor access ro the property for onsite inspec[�on hy Municipal O�cials.
ow�e, °w�e' m Q2.r'c�K �/ �`{- 7
'. Signature PrinteA e 4.i.Q 'f'C� Date J � o�
._. . ,.�,..._,. ._�, _. � /
NOTICE.AII� , I.i�.iii_ :il� ��i1�..G� ,��� �
�r'
.--t�i.� ._1-it��..� _�'t.�r'w I..v.I�r.� Ll�u iiil�.,l .1�z i��.i�ri L I:.r[Nli I�:.. ..iut1�.
�����J = r" r-State o�Federal agenc�es�nuy a'iso reQi�lr:•i„=rin::�. �
vou are responsible for complying with the requirements of the Sawyer Counting zon�ng Ordinances and law and regulations of the State of Wismns�n.Vou are alm responsible for
omplying with State and Federai laws mnaming construction near or on weUands,iakes,arM sheams.Failure to comply may result in removal or modifica[ion of construction
Ctha[violates the law or other penalties or costs.For more Information,vish the departme t of natural reso�rces weHands identlfication web page or contact a depanment of
� na[ural resources service center�608)267-3125
Issuance Information(County Use Only) Sankary Number: p of 6edrooms:
Permit Denied(Date�: Reason for Denial:
Permit p: Issuing agent� Da[e:
��;-cco8 3 a� a�
Is Parrel a Sub-Standard Lot '�Yes �o.ea ofnecord� 1('No Mi[i ation Re
Is Parcel in Common Ownership�`�;Yes �Fused/Comiguous�oqs�) �:'�i No g quired ez ..No
IS$[ru[tureNon-COnforming '�.'�.Ves � Mi[igationAttacheE � YM ��.. No
Granted by Variance(B4O.A.) Granted by Conditional Use
-:i Ves . No Caze N: ��Yes �
Gse a:
Was Parcel�egally Crea[ed �Yes :'No Were Property Lines Represented by Owner �Vez No
Was Proposed Building Site Delineated ,�� _No Was Property Surveyed >lYes rya
o4ff�;�ment"__��.?� � „�^ T��� S �,.� 2one Distria: Fee:
\ �� `
i ����� , e„^L_t eaoJ.� "3\m�tr�t�.e�a...�� �_ t�'.
� \ -1 ��S -}-i�m
Hold Fo�San'itary- __ HOId ForT9A_ __ Ho�d For�ftida��i;. Hold Fo�fees' �
mFeC2021
�
Sawyer County Application for Grading �D
�
10610 Main St. Suite 49 r:
Hayward W I 54843 *� '�'.
715/634-8288 ^�
�-
;�
..,
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ` i;
ISSUED. SIGNATURE OF PROPERTY OWNER IS REQUIRED. o
�
Owner: �,.c--�-z--� ��c-, � Contractor: � r''
� �
Mailin Address: Mailin Address: �` '
� -
Cit , State, Zi : Cit , State, Zi : �-
Phone: Phone: �
v
�
�
Email: Email: �D
�
���
Site address: ���� /� �\.,\\��� ,�J
Calculate grading area: (Total area disturbed including excavation, fill, grading, �.
landscaping, equipment rutting, and/or other areas vegetation will be removed resulting �
in exposed soil) =
w
Determine width of disturbed site in feet: ft. x depth of disturbed site in feet: ft. ��.
Total = sq. ft. (this is the area calculation) �=
Determine Slope of disturbed area: Vertical height in feet = Horizontal distance in � �
feet = Slope X 100= % Slope �
(1 V/1 H= Slope X 100= Percent Slope) �
�
. . �,
*For any filling or grading of any area which is within 300 feet landward of the ordinary ;t;
high water mark (OHWM) of navigable water and which has surface drainage toward the �
water and on which there is either: �
(1) Any filling or grading on slopes of more than 20%. �,
(2) Filling or grading of more than I,000 sq. ft. on slopes of 12% 20%. �
(3) Filling or grading of more than 2,000 sq. ft. on slopes less than 12%. ;�
(4) A Grading Permit is required for any filling or grading in excess of 10,000 sq. ft �
within 1 ,000' OHWM of nav9gable lak�s, ponds, or flowages OR within 300' of OHWM of �
navigable rivers or streams. c,�
Date activity wi I be in if permit is issued: �J � a' date to be r
completed: 'S 1 S ` ��� � c�_\� �V� a� ��� S
�- �� � � � �--
Attach engineering design or complete the following using additional sheets: �'
1 . Describe proposed erosion control installation, construction phases, and finished site grading. �n
Include timeline, methods, and materials. (Silt Fence alone is not ample erosion control for c
most sites) ��
�
�� cQ
�rr`.e. � -�— � �ti I S ' �i � � `�� �.,��, �
�^ � � �:�: �'.'°"— .
C � � a,� ��-
- � �� � f���--'�- �� ,�, ��
C'� 5 �s �-�, � Io� � �
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C, � �;1�.- � u n � � �.t� 1� � � �� � r � � �-�-�, � `� � ' �-
� �, �� � 2 s�
1�j �b �r—,
� �� S�y� �� �� � �� o
� � � � 1 � � � � �
<- _ �,,.� s��� e-
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(� �— a"ti << DI`" � , ��--� r "`1� '.-. �
�-�..�.��� _
� � 5s�.� . �
� r
� � 2 �� , S.� �S n�� �.(�� �� 5
' �n,e� �
t�(�.� �� p� I��e�-
2. List temporary seed type and rate,permanent seed type and rate,fertilizer type and application rate
(if applied),and mulch type and application rate.
j l�z �r C� -�a � :� a /� �.2 cs,cX , S�l��'h'�'1� �>�/'c"l�"j!�„��aJ
�7"�-`�`.--o-� �C�-��,.-���.o—� �'-e�. S`-c9._-\� �C. �`�_ '.�
CJ�N��j<1c,+�lv�� a-:� .���o-��`J� �.�-o,�*'�`��\
3. Attach a plot plan of project area including location of any wetland(s)and/or waterway(s)(indicate
area between grading project and water body to be left undisturbed),location of excavated material,
location of all storm water and erosion control Best Management Practices(BMP's),property lines,
existing drainage,post grading drainage pattern,and north arrow.(Silt Fence alone is not ample
erosion control for most sites)
EROSION
SIIMFLE EROSION -- � C�TR�Pu�
CONOR�i OHLµ ` '� LEGEMD
Fa.,���' ��� � �� H �
a������ , � � -
, -- ,--,�.�, a„��
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�+ � � —1,j; � --�.,�
O � � • • .�.,�
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1�� � — .,���, �`�..b.
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`.� _ _ o.oEE...��
, �,`� �,` ti: �J �`�EE�"��
�
�.���-- - `� �- ��,.�
SCLLE�'
4. Attach a cross sectional view of project area including the existing and proposed slope of the bank,
water level of any existing waterway,and horizontal and vertical scale.
Initial below
'�All BMP's and erosion control devises will be inspected weekly and after rainfall of'/'or
greater within 24hr period.
� In accordance with the Sawyer County Zoning Ordinance section 4.281(Adverse Effects On
Adjacent Properties).I hereby declare that the construction and/or grading permitted under
this permit will not affect or interfere with neighboring properties drainage patterns.Any change in
drainage patterns which are determined to be detrimental to neighboring properties will be
corrected at the expense of the property owner referenced on this permit.
The undersigned certifies that the listed information and intentions are true and correct,that all work
shall be performed in compliance with the requirements of the Sawyer County Zoning Ordinance
and the laws and regulations of the State of Wisconsin.The undersigned person(s)hereby give
permission for access to the property for onsite inspection.
�
�/ i
Original�ficfnature of property owner(or agent with Power of Attorney�. x \S
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Permit Fee: ��oC� �'� z°'
r�
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�oJ � ,�ev-1/2020
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3/11/24,9:16 AM Novus-Wisconsin Access rev. 13.1108
Redl Estdte Sawyer County Property Listing 7roperty Status:Curtent
Today's Date:3/11/2024 Created On: 2/6/2007 7:55:07 AM
�Descriptlon Updated: 1/14/2015 �Ownership Updated: 3/6/2023
Tax ID: 3187 DEREK G&AIMEE M SLAUGHTER CHANHASSEN MN
PIN; 57-002-2-40-09-13-5 OS-005-000100
Legacy PIN: 002940135510 Billing Address: Mailing Address:
Map ID: :5.10 DEREK G�AIMEE M DEREK G&AIMEE M
Municipality: (002)TOWN OF BASS IAKE SLAUGHTER SLAUGHTER
STR: 513 T40N R09W 8260 BENWOOD CIRQE 826�BENWOOD CIRCLE
Description: PRT GOVT�OT 5 LOT 11 CSM 7/Z02 CHANHASSEN MN 553ll CHANHASSEN MN 55317
#1433
Rerorded Acres: 1.620 � Site Address *indicates Private Road
Lottery Claims: 0 8516N HILLTOP RD HAYVJARD 54843
First Dollar. Yes
Waterbody: Grindstone Lake
Zoning: (RRI)Residential/Recreational One `-� Property Assessment Upda[ed: 10/10/2023
ESN: 406 2024 Assessment Detail
Code Acres Land Imp.
� Tax Districts Updated 2/6/2007 G1-RESIDENTIAL 1820 216,000 247,000
1� 5[ate of Wismnsin Z-year Comparison 2023 2024 Change
57 Sawyer County Land: 276,000 216,000 0.0%
002 Town of Bass Lake Improved: 247,000 247,000 0.0°/
572476 Hayward Community School DistriR Total: 463,000 463,000 0.0%
O01100 7echnical College
•� Rewrded Documents Updated: 10/6/2021 �,+�property History
0 WARRANTY DEED N�A
Date Recorded: 2/27l2023 443458
O EASEMENT
Da[e Recorded: l0/5/2021 q35089
O TRUSTEES DEED
Date Recorded: 10/5/2021 435088
� SGECIAL WARRANTV DEED
Date Remrded: 12/22/2014 393698
0 WARRANTY DEED
Date Recorded: ll/1/1988 211543
� CERTIFIED SURVEY MAP
Date Remrded:4/14/1960 ll3756
https:l/tassawyercountygov.orglAccesslmaster.asp 1l1
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SH(?RELAND tV(f'iIGATfON AGREE�1fENT r;,;4�;�;��`;`,
- ��833�
Ov�mmet'sMame(s)asshownondeed: PAULA CHIS�ER
� ^ REGISTEIt �F DEED�
';,-1�.�� � `���...-���� � !�� .►� ����.� SAWYER C�t1NTY. WI .
Paraei tcfentifis�Hen Namber. 03/15 J 2024 09:32 AM
�uo�c.e�ro� �G�- -,`�",l `1 �-��,- S S\v RECORDING ��E 3�.��
Ttets,4gteeme�t ust Irtclude the followtng exhibi�: PA��S: 3
Exhtbit A:�gaaf desuiat�of the real esbie tor vrhk�lhis Agneem$r�app�ies CProF��? • �
E�ch[bit B:�I'j'�a.5art Checici*�-Prcfer�mk3gaGon praclius must be setecteQ sl�arss -
doa,meni is rocartied.
Ezt�sit C:4ocat�en p(s1_sho�rs an acarrate Eocatlan(s)oi¢ach m�iga�Con prac�.s{s) - .
astast�and sttved by tt►Rs Agrct�menL
R6ium to: Savhr9t Ccsmty Zon1nQ and Cansetva!!oa Depattmertt
'0&10 dla3n SL Sutt��,tiayMrarrt,YYi�3
� ��-�� ������ hereby eniet into an Agreement for S'�areans Mftigatlon
�
on(date of agreement) ___(�1����^ �v �v�
for property Iocated at(aridress} ���� l�:a �'-.\\���
as described and�ttached heteto. '
This agreement,stgned by owner ot properry attached,here5y c�c�&es that the seJeded trrIifgation pradic�s an said property
will be compleiedRr�sntained Mittgation pradic�s sf�i bs sdeGed try�gner of this agreemer�t and'aiit'rated on fcdow;�9 Fa9�-
ihe cnvner(s)here5y agrees ths ps�a�erty subjed io Uais Agreemsnl shaaA have aq seleded mi�gatian campfebed sEx months
aft�Land t)se Pean�is�Ssued. The property is subJect to t�Is Agreement Fn perpet3aJty.regarcitess of owaiership
transfer. .
'i'he rnmer(s}further agrees to atlow authorized represen�tauves of ihe GowG-nmer„a;�r,3�tc3�:anto chs oxrner"s prn?e.rty at
the above descriptian beiween the hcurs of 8:OOAM an�6:OOPM,Monday ttuaugh Friday.(Sec�ian 9.13(1)POWERS�Sawyet
Cotuiiy Zaning ardmanr.�J to detem�ine if selected m�igatton Is complete and thaf ft ts being preserved. . .
Viataation of lhts Agreemsnt�n�i authacize.In addtioa tQ alher penalttes and rePef requh�ci under Ehe Sawyer Caunty?.oNng
Or�inance,�junc�v�rer,er.restorat3on of s�td property,cltatlon for Fatslfyittg Perrnit App�rcat�ons. All parttes agtee that this
Agteement sha�be filed with the Savvyer County ZaNng 8 Conservation pepartment and�ecar�fed with�e Sawyer Catmty
Reg�stet of Oeeds.
. . �- � �
.ort o�e ovmer sI re utred- ACKN4�lL�DGMEM'
Uwner's Signa '"
State of: � � r�✓,�5��-�,
Owner's me ' t): County of: ����'��`� �a��--�,
e, � 1 Subscnbed and srvom t b��on thfs
? ( �'� � �day of ��.�-� � ��.�
Date: BY(OwnefsName): �� � - �.����os-
���' `��'`'�� Notary Puhl3c Slgnature: - % �-
OraftedbY� ��' Pub!(cNotaryName(Print). J- r ��•f � ���r.-�`Z
�G-� l � �`'� N1y cammission expires or� G/„_ /����yz �
Gregory Ray Goetr
NOTARY PU6t1C-MINNESOTA �
Personai informatian you prutiide may De used for secondary purpases�rivaq {rr�}'COMMISSION IXPIHES Ot/31/70?5 �•��16
Mitigation points are required for developing Propertyowneroptfons to eam mitigation points
property underthe following conditions. include:
• Impervious surFace coverage is greater Removal of a structure within shoreland setback
than 15%but less than 20%-3 potrrts ❑ ❑ 5100 Ft�-1 Pt.
❑ 101 Ft1—250 Ft�-2 Pts.
❑ 2251 FtZ-3 Pts.
• Impervious surface coverage is greater �nstallation oF a rain garden
than 20%but less than 30��-4 points ❑ ❑ Treats 0-250 Ft�-1 PL
Q Treats 251-SOD Ft2-2 Pts.
❑ Treats greater than 500 Ft�-3 Pts.
s 5 200 ftZLateral Expansion of ❑ Passive Restoration (Natural Recovery) of a
Nonconforming prindpal structure within compliant shoreland buffer- 1 po1M
theshoreland set-back-2 points ❑ ❑ Reducing width of aHovtable view and
access corrido�(s)- 1 point for every 10
foot reduaion
• Refocation of Nonconforming prinapal � �ncreasing depth of an existing compliant
strutture within the shoretand setback- shoreland buffer-1 poin!for every 10 feet of
depth
1 point ❑ �
❑ Eliminate shoreline lighting 5 35'from lake
shore-1 point(Must submit before and aRer
• Open sided structure�requiring at least photographs)
70%of the half of the shoreland setbadc � ��ng compliant shoreland buffer 2 points
area that is nearest to the water is covered
by a vegetative buffer zone as per � �rye Restoration (Accelerated Recovery) of a
5.59.692(Sv),Stats. 35'shoreland buffer-2 points
� ❑ Sra Wal! Remcval and Bank Stabiiization-2
poinu(DNR perr»its moy be required)
❑ Replacement of steel septic tank-2 points
(Tank must be installed before SMA is
recorded)
❑ Instailation of a Storm water infiitration
System-3 points
❑ lncreasing Shoreland Setback-i point for
every 15 foo[increase beyond required.
(maxtmum of 3 points)
�+�t � "� �� ��+���d� �n Va�lum� 7 c�� +�e�if'r�t� �u�`�y �apr�� p��:e
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�`��� �� ���s �..��C�, ���ye� �oc�n�y►, 1�►iscc�ns��, �►���� � �art c�f
��►v�rn�rn��t� L�t 5, ��c��ot� � �, T�v��sl��� � ����, ��t��� � 1��s�.