HomeMy WebLinkAbout002-940-36-5605-LUP-2020-464 ^� ' S�6MITCOMVLFTEDAPPUCATIONAND �� N
reeio -� APPLICATION FOR LAND USE PERMIT
sawyercounry _ .yVY„�,RCOUNTY WISCONSIN I` , � O
Zoning&Conservation DepaK. - � ' / � Z VZ� �
30610 Main St Suite 99 �'�� �u�J,�°��"�°E�`°���� �a�e.. -� � 1
Hayward,W154843
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(715�634-8288 �+ �!(}1�( � � 20�0
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r s : o ae.m�c�„,m ee a �m,n re �e=�a. SAV`JYER COUN I Y � Vi'� � S�
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Z NING AQMVNlSTRATiON
olt � 5 n rCONSrRUCTONUNi aEnMIrSHa ceEENISSUED�OAVVtICaNT. OriginalApplicationMUSTbesubmitted FILLOUTiNINK �NOPEN L)
Subm��tta of[M1�u apolication or recciol ol fcrs dors not��n�titule Oermit i«uance.
Owner�s�Name: �Ontraclor(s�Name
Uf tclh �.Gs� ������h �i�N�
Mailing qddress: Malling AAEress:
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Pno�e:��y�3�y�j Phone:
��5-699-`�,33 s`v8�co
IEman: br'i.:�nCi��v.a,� £ Y�hc„^.Co;+t em,�i: rn«f�CIn�HS� ,tc.�,l.. c��
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u ama �D.L o3(vs(eo5� rowoor: ;3«Si Lc..ke
i vermitdeliveryMethoe oGllOwner yfMailOwner uWIlConiracror xMailtontrac[or
� ISPraperty/W^dwlthin300feetofXiver,5tream i��d. DistanceSttutture isfrom5hareline: IsyourProperty
' �°^') —� lreWetlands
feet in�loodplain
Creek ar LanEwaM 5itle Of Floadplain? I(yes—ront�nue Presem?
�Shoretaed zo�e?
K Is Property/Land within 1000 feet ot Lake,Pond or Flowage Diswnce Scructure is from Shoreline: ryes Yes
Itve;--continue--► ��J feet �y�u� �
/
Non-Shoreland
Descrfbe vrojeR
Value at Tme of Total p of
Project type Foundation W hat Type&Capaciry is[he
Clmpletion (House,garage,shed,deck, Number (gasement, bedrooms Sewer/Sanitary5ystem(s�
��c uce dona[ed qddition,etc._) �Staries Pos[
i�me&macer�ai Crawlspace,
Listseparetely Slab) mnstruc[ion
5
owelling
ar ��i�' ��,., v�e �-1�..b i�%a
S�o.cxo
att<ssory BIE`
S
ndd�tioNNrcratian
Height:
TotalSquare Lowest
Vropozed Use � Proposed Structure Dimensions Footage Gradeto
(multiply per Highest
story) Peak
Residence ( X �
Ft.
' with 2^^story or loft ( x �
Ft.
with 8asement ( x �
Ft.
Accessory Structure(e.Pia��� ( X �
f$Residential Use �aa �.a.,eoa�no�u,.e��.i Ft.
Deck/Patio ( x �
❑Agricultural Ft.
Use Porch ( x �
Ft.
I Lommercial/ Attached Garoge ( X �
Industrial Use
Ft.
(2n°)Porch/deck/patio ( X �
Ft.
J Municipal Use ( x '
Other lexoiam� Ft.
r' Other ( x �
. Prineipal5trueture lasricurcurai,[ommerciai,Mun�c�oai,etcl F�
Addition/Alterotton�e�oia��)(�����.� �d�fi�,�� �l x x 2(p � 3 i 7� ct. 1�
7ota1 habitable square feet: j.-% Total Non-habitable square feet: 3 J,�
/j�-�' (decks,patios,garages,sheGs,storage area&other structures)
' Original Application MUST be submitted
Attach a Plan or Skecch your Property on 8.5"M 11"or 8.5"x 14"paper:•Must•Indude�ootion and setback of proposed and existing rtructures,rwds,
`d�iveway,sanihry tomponents,well,lake,river,stream,and wetlands.
^ Setback Setback
� ����� Measurements Description
Measurementz
� Setba Ihe Centedine of Platted Road and/or Feet Setback from the Lake(om�oa.v n�en-w.ee,m,.k) Feet
�; Set om the Established Rlght-af-Way Feet Setback from the River,Stream,Creek Feet
' ' Setback from the BIuH ��r,00i�=aeie Feet
Setback from[he North Lot Line Feet
� Setback from the South Lot Line Feet Set6ack from Wetland ieet
Setback from the Wezt Lo[Line Feet Slope witbin area of mnstmction/distur6ance %Slope
Setback from the East Lot Line � � Feet Elevation of Floodplain Feet
iSetbacktoSeptic7ankorHolding7ank ,j Feet SetbacktoWell Feet
Setback to Orein Field /[��i '� feet
i Setback to Privy�Portable,Composting) Feet
�' �� � � -� ( �nd��. tl t �, i itt u.m� .t -'L� � 1 � da,y _. .urliinesemarkmisibemeasradmust� vai�lrfminon=
o , . , . .. � . .�,i�. � r „ it..,� �.- ..�.ii n o�r. , �
i P �'� t tr p -'. - � n 'ofart��u'� . .F r e� ._- b I�>;V�. ,e �1011�c�1 � nn�,d; c � etlstba: teb �.-0 ryl'�iefomn�ic�N=setbackmesibe
suretli.�m.bcds�le(romoie0evousry�wveved�a e t the�tnerpre�ously ee�etlmmer.o�verfa0lebYt�eDe.artmentGy o(imrre[teo[omoazslromaaowncomcr
' �nithin500teeto'tteo�oocscr.speofVest�ucturc.orirustbxma-�ear,yallcerseUs�neyo�aetneowreisexoensc.
I
� Glculate impervbus surfaces.(Roofed,concrete,paved,and other surfaces that water nnna penetrate.The Zoning ONice wn help you determine'rf a
isurface is considered impervious)
� ICalculate lot area: /
Indicate lot sire from CSM or NOVUS(cirde one�: � � �DV Acres;Multiply by 43,560=Lot area: '��i �3 bsi.Il- Square Footage
�I I Calculate impervious surface area:
IDetermine the total size,in square feet,of your proJects listed a6ove(indude eavesl' 3 « sq ft.
Determine the total sfze,in square feet,of all ezisting roofed structures(indude eavesJ: 2,LO �/8 sq k.
�,, Determine the total size,in square feet,of all eaisting paved/bricked/blotked surfaces: �� .�. 7 v sq ft.
'� Add these measuremen[s to determine total impervious surfaces: 5 � 3 � sq k.
I I
�' ' Calculate impervious lot percentage
I Total Impervious surface:�-z-) ��__ r Lot area:.Zb� /.3(o Sq ft.X 300=impervious surtace '�d q
�M�,[igatlon Is repuired if mtal exceeds tSXf
'•'Notice a separare grading permit needs to be obtained if Oisturbed area is within the Shoreland district as indicated on previous page and meets criteria below^•
� Grading on a slope greater than 20% Grading of more[han 1,000 Sq.F[.on 12%-20%slopes
�I Grading of more than 2,00�Sq. Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft.
I ,
� FAiLUhF TO 06TAIN A PFRMIT orSTARiWG CONSTRl1Ct10N W ITMOVT A PCRMIT W ILL flES6LT'N PENALTIFS
i(we)dedare(hat this application(induding any acmmpanying information)has�een eMamined by me(us�and m the best o!my(our)knowledge and bellef It is true,mrrec,and
� mmplete. I(we)acknowledge Ihat I(we)am�are�respansible for the detall and acwrary of all information I(we)am(are)providing and that R wlll be relied upon by Sawyer
I Coumy in determining whetherto issue a permit I(we)further accept liabilky which may Ce a resWt of Sawyer Counry relying on Mis information i(we)am(are�orovid�ng in or
���. with this application.I�we)consent to munry officials charged with administering monty ordinances ro have access ro the above descri6ed property at any reasonable ilme for the
purpose of inspeccion.Additionally,the undersigned person�s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
�� Owner /� D Owner .
signature �..��—/��H�--.�—� Printedname �riah �YnCn Dace �� � �-c0
�nrur+;�n c��mm�h=me my.�lroa7
NOTICE �LL L _�Gn-. C f�ra..r.I11 �.�: ho�nN=D t =...=i ..�
�n-iFr:��str�n o0(Nev�One& iv.< K.n.lypwelbre qLL .t�'r,^.,,I � _. .,Wrd � rfc-rP�hali rn .:::ilras�.dr.
-he Io�al7own,Slate or FeAcr�l t-"- I ��._u re p�rn ts
You are responsible for mmplying with the requirements of ffie Sawyer Counting Zoning ortlinances and law and regulations of the State ot W iscons�io.You are alm responzible(or
� romplying wi[h State and Federal laws conceming wnstruction near oron wetlands,lakes,and stteams.Fallure ro romply may result in removal or modification of mnztruction
that violates Ihe�aw or other penalties or msts. For more Information,visit Me department of natural resourcez weHands idenUfication web page or mntact a department of
naNral resources service oencer(608)26]-3125
� Issuance Information(County Use Only) SaniWry Number: k of bedrooms:
� Permit Denied(Date): Reason for Denial:
I
iGermit#: Issuingagen Date:
i Z� — � � 4' ������--- 11 �„ aoao
IZVarcelaSubStandardLot i-yes �DeeOofaemrE) �NO Mhigationftequired J�Yps �y�y','�o
j Is Parcel in Common Ownership pCYes �FuseE/Contiguous Lot(s)� C No Mitigation Attached �Yes ANo
I Is Struc[ure NomConforming C.Yes �Na �
( Granred by Varian<e(B.O.A.) Granted by Conditional Use
i I1 Ves }�No Cau M. 0 Yes �No Use k:
� Was Parcel Legally Created �Ves C No Were Property Lines Represented by Owner Y�Yes No
WasProDasedBuiWingSiteDelineated 'IdVes CNo WasPropertySurveyed �tYes No
� Oftice tomments: �,�-�„��„ �(k�� \V Ia 1 a�i� `Y,.,�� zone olstria: Fee:
�/� la�a.a /t/� � �Z- � � �
NOIdForSaniSary: HOIdPo�TG��. HoidForAffidavit: HOIdForfeez'.
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