010-171-00-2302-LUP-2024-073 SUBMIT COMPIETED APpLICATION AND
FEETo; APPLICATION FOR LAND USE PERMIT
Sawyer Counry SAWYER COUNTY,WISCONSIN �
Zoning&Conservation Depart. S
10610 Main St SUite 49 Da[e Stamp(Recelved�
Hayward,Wi 54843 :.,��"�� J oZ�1 0�-� �^ �
(715)634-8288 �j
��k# 1 t�'1 q �
INSTRUCTIONS: No permits will be issued until all fees are paid. aa - :�}4:. ��� V"
.. .
s, _,-.
Checks are made payable to:Sawyer County2oning Department. �` i"'_` "` "" ''_,—'--'—
DO NOT START CONSTRVCTION UNTII All PFRMITS HAVE BEEN f55UED TO APPLICAN7. Original Aoplr[ation MUST be submitted FILL OUT IN INK (NO PENCIL)
Su6mittal of this application or receipt ot fees does not constitute permit issuance.
Owner(s)Name: Contrector(s)Name
� ��� �_ � < <� ► c�rrn S �T'Q�
Mailing Address: � Mailing Address:
I �� � � �.
�
Phone: "
� I�— / _ ��^ /',,�I � .__Phone:
l..P CJ
�— �(
Email: L���1�L�l Lj[.,���vl �/ � 1- �-�� Email:
Site address: ( � r'
Q 04'"R s iA � ���� Or Date applied tor:
legacy PIN 1! � �^ Town of: w Cn��
Permit delfvery Method all Owner o Mail Owner �Call Contractor a Mail Contrector
�,Is Properry/Land within 300 feet of River,Stream p�ci. Distance Structure is from Shoreline: i< �„r aro e
Intermittent) _� � Y p � Arp Wpttand�
horeland Creek or Landward side of Flood lain? If es--continue _ feet in Floodplain
p Y Present?
7nne.
�s Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoretine: 1'� �
If yes---continue --� fEet o �
':�Non-Shoreland
Describe Projed
Value at Time of Total#of
Project type Foundation What Type&Capacity is the
Completion Number bedrooms
��nclude donated (House,garage,shed,deck, (Basement, Sewer/Sanitary System(s)
Addition,etc...) of Storles Crawispace, {'�s�
time&matenal ��st separately const�nrtion
Slab)
s � �'� ��a��� ��
Dweliing
-'—�
S,.
Access Bldg_...
$
AdditionJAltera[ion
Height:
Total Square Lowest
Proposed Use � Proposed Structure Dimensions Footage Grade to
(multlpiy per Highest
story) Peak
Residence ( x �
Ft.
with 2^d story or loft ( x �
Ft.
with Basement � X �
Ft.
esidential Use Attached Garage ( X �
Ft.
ACCCSSOPy StfUCLUt'E(explain) ( x )
O Agricultura) (detachedgarages,sheds,boathwses,etc)
ft.
Use 7emporary Guest Quarters or Bunkhouse(ci�cie cype� ( x �
Ft.
( X )
❑ Commercial/ � Deck/Porch atio ��,� ,�.�.� ��Ar 5�- �I � q Q Ft. �
Industrial Use � X �
(2"d)Deck/Porch/Pat(o Ft.
0 Municipal Use
Other(explain) ( x �
Ft.
0 other ( x i
Principal Structure�ng�i��ic��ai,Commercial,Munidpal,ecc.) Ft.
Addition/Alteration�exPia��> ( x �
• Ft,
Total habitable square feet: Total Non-habitable square feet;
(decks,patios,garages,sheds,storage area&other structures) i� �
fl�n S�.�c, � S���C�t(f�. � � �,� �.+s;��c
- �
Original Appiitation MUST be submitted
Attach a Pldn or Sketch your Property on 8.5"x 11"or 8.5"x 14"paper:'Must•Include location and setback of proposed and existing structures,roads,
driveway,sanitary components,well,lake,river,stream,and wetlands.
— �v 5etback � ` Setback
Descriptfon Description Measurements
Measurements __
Setback from the Centerline of Platted Road and/or Feet Setback from the Lake(ordinary high-water mark) Feet
Setback from the Established Right-of-Way Feet Setback from the River,Stream,Creek Feet
Setback from the Bluff if applicable J Feet
Setback from the North Lot Line Feet
Setback from the South Lot Line ! Feet Setback from Wetland Feet
Setback from the West Lot Line Feet Slope within area of construction/disturbance %Slope
Setback from the East Lot Line Feet Elevation of Floodplain Feet
Setback to Septic Tank or Holding Tank Feet Setback to Well � Feet
Setback to Drain Field feet _ ~ .
Setback to Privy(Portable,Composting) � Feet �"
Piloi to thc placemen[or con�truction of a sVucWre within frve(5)feet of the minimum reqwrca setb,,ck,the boundary Iine from which the setback must be measured musi be visibie from oiie
prev,outily wrveyed cornei io the othei previously wiveyed comer or marked by a lir.ensed surveyor at the owner's expense.
Prior to the placement or construction of a structure more than five(5)feet 6ut Izss chan ten(lU)feet from the minimum rzquired setback,the boundary line from which the setback must bc
measured must be visible from ane previously surveyed corner to the other previously surveyed comer,or veritiable by the Department by use of a corrected compass from a kr,cwn comer
within S00 feec of the proposed site of the svuaure,or must be marked by a licensed surveyor at the owner's expense.
� • - . . . . . - . • �• .
Calculate Impervious sunFaces(Roofed,co�crete,paved,and other wrfaces that water cannot penetrete.The Zoning Office can help you determine if a
surface is considered impervious)
Calculate lot area: � J`��] c� 2
Indicate lot size from,CS�r NOVUS(circle one);�� " _Acres;Muitiply by 43,560=Lot area: �"'- �� Square Footage
l/
Calculate impervious surface area:
Determine the total size,in square feet,of your projects listed above(include eaves): I 1 � sq ft.
a�{ �a��
Determine the total size,in square feet,of all existing roofed structures(include eaves): LI��� SQ ft• �� " �'C �
2 a s � �'
Determine the total size,in square feet,of all existing paved/bricked/blocked surfaces: J�� sq ft.
I �. ��►� �,.��`"� �g`
Add these measurements to determine total impervious surfaces � sq ft.
�7p "�t,` ����
Calculate impervious lot percentage
Q 3s� ,��K�,y
Total impervious surface: l �� � =�ot area:l I V � Sq ft.X 100=impervious surface_J_,�_%
(Mi[igation is required if to[al ezceeds 15%)
"`Notice a separate grading permit needs to be obtained if disiurbed area is within the Shoreland d'+strict as indicated on previous page and meets crlteria below"'
_ __�--____ ---- -
�Grading on a s�e greater than 20% � Grading of more than 1,000 Sq.Ft.on 12%-20%slopes �
Grading of more than 2,000 Sq.Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft.
I(we)declare that this appiication(including any accompanying information)has been examined by me(us)and to the best of my(our)knowledge and bellef it is true,correct and
complete. I(we)acknowledge that I(we)am(are)responsible forthe detall and accuracy of all information i(we)am(are)providing and that it will be relied upon by Sawyer
County in determining whetherto issue a permit. I(we)further accept Ilabillty which may be a result of Sawyer County relying on this information I(wej am(are►providing in or
with this application.I(we)consent to county officials charged with administering county ordinances to have access to the a6ove described property at any reasonable time for the
purpose of inspection.Additionally,the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
. +
Owner �:'1�� ��� /l/ �j Owner ���S� �• �/�� 1�@�Te � �� �
Signature Printed name
(Signature and Printed Name reyuired)
NOTICE: All Land Use Permits Expire One(1)Year frorn the Date o�Gsuance
f'or the Constniction Ot New Une&Two fam�dy Dwi�lling: ALL Municipalities Are Required?o Enforce The ilnlfonn Dwe'�I��ng Code
The local Town,State er Federal agencies may also require permi[>.
You are responsi6le for complying with the requirements of the Sawyer Counting 2oning Ordinances and law and regulations of the State of W isconsin.You are also responsible for
complying with State and Federal laws concerning construction near or on wetlands,lakes,and streams.Failure to comply may result in removal or modification of construction
that violates the law or other penalties or costs. For more information,visit the department of natural resources wetlands identification web page or contact a department of
naturel resources service center(608)267-3125
Sanitary Number: #of bedrooms:
Issuance Information{County Use Only) �
_.__ ______�__ _r
Permit Denied(Date�: Reason for Deniai:
------------ —-——— — _ .
-- _____�___._____--
Permit tt: Issuing agent• Date:
�� -o� 3 � 3���1�y
-- — ---- -- �
Is Parcel a Sub-Standard Lot '!Yes (oeed of Record) M'�g on Requ ed Yes �'.No
Is Parcel in Common Ownership Yes (Fused/Contiguous�oqsl) i' ation Attached i:Yes i�No
Is Structure Non-Conforming �:Yes ' o
Granted by Variance(B.O.A.) � ^ Grented by Conditional Use
' Yes '�No Case p: ;Yes ':No Case tl:
Was Parcel l.egally Created Yes No Were Property Lines Represented by Owner l.Yes 'No
Was Proposed Building Sfte Delineated Yes No Was Property Surveyed � Yes � No
Office Comments: ^ � �� Zone District: Fee:
o s.�,� s�-n.�c f�-- --------- -- Q_ � ��
Hold For Sanhary: _ Huld For TBA: ' _____ Hold For Afhdav��t�. ����old For Fees: ___ ___ -___
�7an2020
�t� 5� -�f o� ��- s'de.1 �.�.s t,ol ,
R2dI EStdt2 Sawyer County Property Listing PropertyStatus: Current
Today's Date:3/14/2024 Created On:5/4/2007 2:1221 PM
�Description Updated:6/ll/2011 �Ownership Updated:9/10/2007
Tax ID: 39259 PAUL R&DENISE E WILLIAMS HAYWARD WI
PIN: 57-010-Z-41-08-23-5 15-112-002302
Legacy PIN: 010171002302 Billing Address: Mailing Address:
Map ID: -4.23.2 PAUL R&DENISE E PAUL R&DENISE E
Municipality: (O10)TOWN OF HAYWARD WILLIAMS WILLIAMS
STR: 523 T41N R08W 10666N PENINSULA RD 10666N PENINSULA RD
HAYWARD WI 54843 HAYWARD WI 59893
Description: ROUND LAKE PARK PRT LOT 23 LOT 2
CSM 29/171#7412
Remrded Acres: 0.980 �Site Address *indicates Private Road
Calculated Acres: 0.935 10666N PENINSUTA RD HAYVJARD 54843
Lottery Claims: 1
First Dollar. Yes J property Assessment Updated:I1/9/2015
Waterbody: Round Lake 2024 Assessment Detail
Zoning: (RRl)Residential/Recreational One �ode Acres Land Imp.
ESN: 444 G1-RESIDENTIA� 0.980 439,400 324,200
��Tax DistricGs Updated:5/4/2007 Z-year Comparison 2023 2024 Change
1 State of Wisconsin Land: 439,400 439,400 0.0%
57 Sawyer County Improved: 324,20� 324,200 0.0%
O10 Town of Hayward Total: 763,600 763,600 0.0%
572478 Hayward Communiry School Distrid
O01100 Technical College �
�'L'9'Property History
�. Recorded Documents Updated:2/17/2016 parent Properties Tax ID
QUIT CLAIM DEED 57-010-2-41-08-23-5 15-112-002300 9999
Date Recorded:12/7/2015 398941
DESIGNATION OFTOD BENEFICIARY
Date Recorded:12/7/2015 398940 ��l�
TRUSTEES DEED
Date Rewrded:6/16/2007 347145 `�I
QUIT CLAIM DEED ��/�.a'I��
Date Recorded:9/15/1997 263120 613/101 �
�CilG Hi$CON Record Count 1-__ - _- - _-____---__ . I p!����
HISTORY�Expand All History White=Current Parcels Pink=Retired Parcels �
0 Tax ID:9999 Pin:57-010-2-41-08-23-5 15-112-002300 Leg.Pin:010171002300 Map ID:-4.23
39259 This Parcel Parents Children
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• -USE BLACK 1NK ONLY- � �i i�llll� il illillill�I��II I�I �
�a�Tr;:�,��aT��?�
SNOREl.AND MITiGATtOtd AGREEMENT >>;:���5�7�4
- ��90Z6 _
o,��sr�am�tsy��n�►�;a�a: PAl.1LA CNISSER
P�.V� �, . �'I� 'q�M1 �� �G/1•x. �i. `�"� �f:�s SAWYER CC?UN YE WI
Parcet tderttifiuHfln Numtxr. I � i]3 J 2 2 J 2{�24 0 2:�6 P M
tta����pl ..t1..LLL'.1.�.L-��-?-�0 a` RECO�tDiNG FEE 3fl.{30
This Agreemeni�nust Jncl�de the foJlowtng e�chlbH�: �����: 4
Exhit�it A:l.eaat DesaiatiDr,of tha real estafe Eor whkt�this Agrcemani appSes("P�P��? '
E:htbtt 8:�' a5�Cheetct�-Orcfemd mktgaGon practixs must bo sefected si 5me �
doa�meni Fs retctded.
E�t�it C:�.cat�an MaMsl-shovrs an nccvrate focal�anjs)oi each m9iga�on pracfIte(s) . �
setecle�and s�rued by Ur's AgreQmenL
Retum to: Sawyat Couniy Zflnlrtp and Cansetvation DepartmerK
l0810 TAak�SL Suttc 49�liay�var�d,Wl�d843
� • _
� % � hereby enter into an Agreement for S'harepne N�tJga�on
�
on(date of agreemertt) ,��C d���� c_„Q�� � �
farproPertYlocatecf at(addressj � C��� .� �i��K�a l��
as described and�tiached heteto. �
This agreement�signed by owner o!propecty attached,herebycEcUfies th�!Ihe sefeciesi mfttgatian pradic�s on said ptvperty
wilt be wrr�rJeiedlmaintained Mi�ga6on pradic�.s sF�(1 be seieded by�g�er of this agr+eemert and ini�ated on foaowun9 Fa��-
i'he cwner(s)hereby agrees ths pmgerty subJe.�f!o Ihis Agreemsnl straaJt have aq sdecfed mt�gation campfeted sEx months
afte�Land Use Perm�is issued. The properfy is sabject to ifils Agreement In perpQtiaity�regardtess of+owriership
traqsfer.
'i'he cnmer(s)furthe�agrees to ailow aathorized representaGves of the Gavemmentaf Un�t to es►ter onto the ownei's prapert}r at
the above descriptian trQtweeri the haurs of 8:OOAM and 6:OOFM,Monday thraugh Friday.(S�ction 9.13(1)POWERS.Savryer
Courtty Zoning Ord'mance7 to determi�e tf selected mt�ga�on is camplets and that ft Is betng preserved . .
Yolation of this Ag�eement�n'�autharize.tn addtion tQ oShsr penatttes and relieE requir�d under Ehe Sawyer Caunty Zonfng
Otdnance,�junc�ve rer,er,restorat3on oi satd properiy,citatton for Falsifying Permit Appficatfons. All pa�ttes agree that this
Agreem�t shaa be filed with the Sawye�Ccunty Zordng&Conserva6� � d reco�ed wiw�e Sa�vyer Cozmty
Register of Oeeds. ,.�•°y .
. . . .�, �P 'pTq,4's�
_On one ovmer st ature re c�ltact- � —•— y �;C p��{',�j�'
er's Signatur � ; �j� G o� :�
i�-��� �� i �n�,.aF_, w 4!`
er's Name(P� 1 ' ,� � ��r�-_' p�j om to 5efore me on t�is
"11 �� W � �1�'1 -� � '" �of I'''��r4�- .2Q�
Date: ` �:� � sy{Owner's Name): � � w�Il•�^�S
Z �� r ` Notary Pubilc Signature: '
Drefted by: � / Pnbl�c Notary t�ame(Prinf): � � �,�k.'
�< u�iZ l o w�J�!-, My s�mmission expires or� ►
Persenaf information you prot�de may de used for secondacy Pur�rases tPrivac�taw,§t5.44(t)tm)I Rev.04lS4116
A part of Lot T�ienry-Three (23) of the Round Lake Park Subdivision ]ocated �n
Government Lot Six (6) �n Section Twenty-three (23), Townsh�p Forty-one (41 ) North,
Ranae E�ght (8) West, more particularlv descnbed as Lot Two (2) of Certified Survey
Map recorded as Document No. 346007, Survey No. 7412 in the Sa��yer County Register
ofDeeas off�e. volume 29 page 171
Mitigation points are required for developing Property owneropt(ons to eam mitigation points
property under the following conditions. include:
+ Impervious surFace coverage is greater Removal of a structure within shoreland setback
than 15%but less than 20%-3 points ❑ ❑ 5100 Ft�-1 Pt.
❑ 101 Ft�-250 Ft�-2 Pts.
❑ 2251 Ft2-3 Pts.
• Impervious sur(ace coverdge is greater �nstallation of a rein garden
than 20%but less than 30%-4 points ❑ d Treats 0-250 Ft1-1 Pt
❑ Treau?51-500 Ft2-2 Pts.
❑ Treacs greater than S00 Ft�-3 PCs.
• 5 200 ftZLaterei Expansion of ❑ Passive Restoratfon (Natural Recovery) of a
Nonconforming prindpal structure within compiiant shoreland buffer-1 poiM
theshorefand set-back-2 points ❑ ❑ Reducing width of allovrabie view and
access corridor(s�- 1 point for every 10
foot redudion
• Relocation of Nonconforming prindpal � �ncreasing depth of an existing compliant
structure within the shorela�d setback- shoreland buffer-1 point for every 10 feet of
depth
1 point ❑ '
❑ Eliminate shoreline lighting 5 35'from lake
shore-1 point(Must submit before and aher
• Open sided sirudure requiring at least photographs)
70%of the half of the shoreland setback � ��ng compliant shoreland buffer-2 points
area that is nearest to the water is covered
by a vegetative buffer zone as per ❑ �rye Restoration (Accele�ated Recovery) of a
5.59.692(Sv),Stats. 35'shorefand buffer-2 points
��� ; �y�•'�-- � ❑ Sea Waii Removal and Bank Stabilization-2
a� points(DNR permits may be requiredj
"'��a� I / ❑ Replacement of steel septic Wnk-Z points
��a� �/ (Tank must be instatled before SMA is
recorded}
❑ Instatlation of a Siortn water infilttation
System-3 points
❑ Increasing Shorefand Setback-1 pointfor
every 15 foot increase beyond required.
(maxfmum of 3 poinu)
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