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Home My WebLink About026-144-00-3700-LUP-2020-325 $l� C -�u 'l e� q a��-- • , r��A L � SUBMIT GOMPLETED ApPI.ICATION qND /� , FeeTo: - APPLICATION FOR LAND USE PERMIT Sawyer Counry C.._ WYER COUNIY,WISCONSIN q Z('j2 d r�j Zoning&Conservation Depart. "i �f�+. ;. �a�e__, `-� 10630 Maln St Sulte 49 ,I�t!• DaRe STamp�Re[cided� �" �(2 r\� ' Hayward,WI 54843 � " ; C�'11l#,� ��v (715)634•8288 ' '" �', �: � ��- � ,�.i� :_�f�� _ Rcpt#_, _ —sn�� INSTRUCiIONS: No permits will be issued untll all fees are patd. +��;.�,,. . ;_ -,' "- - � � � . l �' iChecks are made payable to:Sawyer County Zoning Department. " � 1 r").., • t : � ,--t- 1 � DO NOT S7AR7 CONSTRUCTION UNiIL�LL PERMITS HAVE BEEN ISSUED TO APPLICANT �Cirgi1101 A�tipliCation MUST be subn��itt�r_! FILL OUT IN INK (NO PENCIL) � Suhmi[[al of this application or receipt of fees does not constitu[e permi[issuance. � � � Owner(s)Name; Contractvr(s)Name I �, Y , �r� Maili � ng Address Malling Address: � Phone: /� Q � i /(J� ' S�O 1S� � 0 Phone: � Email: " • Email: i c � Site address; -�1�� Or Date a Iled for: Le a PIN p �! �" L —� .:>' 3S� Town of: v � � � I •Permit delivery Method � o Call Owner jtl,Mai1 O r, ❑Cali Contrector r Mail Contrector � 02� - i44 - �- 3�oa � ! !_Is Property/Land withfn 300 feet of River,Stream poci; �� Intermittent) Distance Structure is from Shoreline: Is You�F�opertV Creek or Landward side of Floodplain? if yes-•-coritinue� feet �n ciondp�a�n nre we�iands i I Shoreland Prese��? Zanc7 j G Is Property/Land wkhin 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: Yes ��S I� Ifyes---corttinun --� feet No �� Non-Shoreland i jValue at Time of pescribe ProJect Completion Project type Poundation Total#of � Number What Type&Capacity is the (House,garage,shed,deck, bedrooms Sewer y y ( � *include donated of Stories IBasement, /Sanitar 5 stem s I time&material Addition,etc,..) CraWlspaCe, �'ost i List separately Siab) �n�SCfU[tlOn � 5 � �� / I � Dweliing � ' I� S gt,�,o Attessory Bldg . i $ � Addition/AlteraHon � I � I Height: Total Square Lowest ; Proposed Use ✓ Proposed Structure Dimensions Footage Grade to {multipiy per Highest story) Peak i i Residence ( X ) Ft. wlth 2"d story or loft � x � Ft. with 8asement ( x 1 Ft. � �/ Accessory Structure(explaln� (/�� x �� ' � Residential Use �' (detaehedgarages,sheds,hoathouses,etc,� � �/ I � ��7 Ft. � Deck/Patio ( X ) i ❑ Agricultural Ft. i Use porch !�1;``E`" . _=; L1VIIl� aC X ) Ft. ❑ Commercial/ Attached Garage i : 'i it e erea ( x � � I Ft. Industrial Use � (2nd)Porch/deck/patio ; ~ t X � i ❑ Municipal Use ' Ft• � Other(explam) � X ) ❑ Other � Ft. i Princlpa)Stfutture(Agricultural,Commerc�al,Municipal,Etc.) ( X � � Ft. Addition/Alterat(on(explein) ( x 1 Ft, Total habitable squa�e feet; Total Non•habttable square feet; /, (decks,�ados,garages,sheds,skorage area&other structures) j��Y I • .. . • , , - , , , . � v;,�r;la; -��;19�ca iJr� v�;i;�T_Ge suIir75�iL�G � AICeCh e Plan Or .��:?iic 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 wetiands. Description Setback Description Setback 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 5etback from the River,Stream,Creek feet ! Setback from the Bluff If applicable Feet Setback from the North Lot Line Feet � Setback from the South Lot Line ou Feet etback from Wetland Feet ( Setback from the West Lot Line "�j� Feet Slope of construcY /dis r nce /Siope ISetback from the East Lot Line "� Feet ati 'n Feet i � Setback to Septic Tank or Holding Tank p Feet Setback to Well Feet Setbackto Drain Field �— Feet Setback to Privy(Portable,Composting) Feet Prior to the placement or constructiun of a structure wlthln five(S)feet of the minimum reyuired setback,the 6oundary line from wt�ich the seCoack must be rneasured must be visible(rom one previously wrvcyed corner to the othcr previously surveyed corner or marked by a licensed surveyor at the owner's expense. Prior to the placement or construction of a structure more than five(5)feet but less than ten(10)feet from the minimum required setback,the boundary line trom which the setback must be measured must be visible from one previously surveyed comer to the other previously surveyed corner,or veriflabfe by Ihe Department by use of a corrected compass from a known comer within 500 feet of the proposed site of the structure,or must he marked by a licensed surveyor at the owner's expense. .- Calculate impervious surfaces.(Roofed,concrete,paved,a�d other surfaces that water cannot penetrate.The Zoning Office can help you determine if a surface is considered impervious) Calculate lot area: Indicate lot size from CSM or NOVUS(circle one�: Acres;Multiply by 43,560=Lot area: Square Footage Calculate impervious surface area: iDetermine the total size,in square feet,of your projects listed above(include eaves): sq ft. � /� � j Determine the total size,in square feet,of all existing roofed structures(include eaves): sq ft. / I /� i V IDetermine the total size,in square feet,of all exfsting paved/bricked/blocked surfaces: sq ft. IAdd these measurements to determine total impervious surfaces: sq ft. iCalculate impervious lot percentage Total impervious surface: =Lot area: Sq ft.X 100=impervious surface % (Mitigadon Is requlred if total exceeds 15%) "`Notice a separate grading permit needs to be obtained i(disturbed area is within the Shoreland distritt as indicated on previous page and meets criteria below'•' Grading on a slope greater than 20% Grading of more than 1,000 Sq.Ft.on 12%-20%slopes . Gradin of more than 2,000 Sq.Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft. j riULuhF TO OBTAtN A P[HMITor STARTING CONS?RUCTION WITNOU'f A PERMIT WILL RFSULl'IN PENALTIFS � 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 tha[I(we)am(are)responsible for the detail and accuracy of all information I(we)am(are)providing and that it wlll be relied upon by Sawyer i County In determining whether to issue a permit. I(we)further accept liability which may be a result of Sawyer County relying on this informa[lon 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 described property at any reasonable time for the purpose of inspection.Additlonally,the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials. IOwner Owner , V Signature Printedname �ra� � �od� Date �z�dZ (Signature and Printed Name required) � NOTICE: AU Land Use Permits Expire One(1)Year from the Date of Issuance. For the Construction Of New One&Two Family pwelling: ALL Municipalities Are Required To Enforee The Uniform Dwel�ing Code. The local Town,State or Federal agencies may also require permits. You are responsible for complying with the requirements of the Sawyer Counting Zoning Ordinances and law and regulations of the State of Wistonsin.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 natural resources service center(608)267-3125 � Issuance Information(County Use Only) Sanitary Number: #of bedrooms: � Permit Denied(Date): Reason for Denial: I I Permit H: Issuing age , Date: � � 2� -�3Z� � �� a�� Is Parcel a Sub-Standard Lot f7 Yes (Deed of Record) �'No Mitigation Requfred CI Yes o ; Is Parcel in Common Ownership CTjYaes (Fused/Contiguous�ot(s)) U N0 Mitigation Attached 17 Yes 1 0 Is Structure Non-Conform{ng CI Yes o iGranted by Variance(B.O.A.) Granted by Conditional Use � IJ Yes No Case il: Ll Yes No Case#: ' Was Parcel Legally Created �Yes ❑No Were Property Lines Represented by Owner �'es No , Was Proposed Building Site Delineated "f�Yes ❑No Was Property Surveyed 'I�Yes No ! O�ce Comments: Zone District: Fee: �o�� O � ��c�� ,7 S� ' ��-� � Hold For Sanitary: (. Hold For TBA: __ Hold For Affidavit: � Hold For Fees�: ❑ . __ �Jun2020