HomeMy WebLinkAbout010-173-00-0400-LUP-2022-084 SUBMIT COMPLETED APPUCATION AND
Feero: APPLICATION FOR LAND USE PERMIT (v
Sawyer Counry SAWYER COUNTY,WISCONSIN � �
Zoning&Conservation Depart.
� � .Da[e Stamp(Received) � ,
10610 Main St Suite 49 � _ O
Hayward,WI 54843 `
(715)634-8288 ° ;,� 7 �`t�L� �
_ _ �
iNS7RUCriOnlS No permits will be issued until all fees are paid. , .
Checks are made payable ta:Sawyer County Zoning Department.
DO NOT 51ART CON4TRUCTION UNTII ALL PERMITS HAVE BEEN ISSUED TO AvvL��CANT Original Application MUST be submitted FILLOUT IN INK (NO PENCIL)
Subm�ttal of this appl��catlon or rer,eipt of fees does not constitute permit issuance.
own (s)Name: Contractor(s)Name
�� � ��"�/1 ,�/�.�1��- i��l .��-� '`Sar' C��'f��
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Mailing Address: Mailing Address•
� � �� � ��- � /��� C�> �� �� �-` ��-�
Phone• � Pho e•
�, l�- �30 .�y(�3 �js=s"�/���'
Email: Email:
Site address / O G-�/� 'f/� ��� Or Date applied for. �`— � �
Legacy PIN p � D � U Town of: t P`�
Permit delivery Method r.Call Owner �;Mail Owner �all Contrador -Mail Contractor
�,�►K.- �1 o r.se �.T� I�'� �O r'
' Is Property/La�d within 300 feet of River,Stream {�nd, Distance Structure is rom Shoreline: Is your Prop�rty
Intermi[tent) ' � �,�j/fj Are Wetla,ds
�j�f� feet in Fioodplain
Creek or Landward side of Floodplain. �f yes--continue Present.
i Shoreland zo�e?
Y Yes
Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is fro Shoreline: �^, No
H����s--continuP —► feet V7J
! Non-Shoreland
Desc�ibe Project Total�t of
value at Time of projed type Foundation What Type&Capacity is the
completion Number bedrooms
, �House,garage,shed,deck, (Basement, Sewer/Sanitary System(sj
.' ��i" ,addition,etc...) of Stories Crawlspace, Post
List separately Slab) constructior�
$
owelling
$ ��� � e / S ��� nev S S �
r� �f � l / r�
$ ��ous�d-l���s' l rrr�.��u..
Addi[ion/AI[eration
Height:
TotalSquare Lowest
Footage Gradeto
Proposed Use ✓ Proposed Strudure Dimensions (mU�tiply per Highest
story) Peak
Residence t X �
Ft.
with 2n4 story or loft � X �
ft.
with Basement ( X !
Ft.
Attached Garege i X ►
�Residential Use Ft.
Actessory Strutture(explain) �� �` � �� ,.J ( Q x(� � ��1 1Q � �
❑ Agrieultural (de[ached garoges,sheds,bort houses,etc) I'I� v U Ft. �
_ �
Use Temporary ues�t Q_uarters r Bunkhou5e(Cirdetype) << (� � h�J � ��J Ft.
C Commercial/ �eck/ orch/Patio z � X �
Industrial Use i;;x�,o �31 x y �'3��C 1, �1 S � Ft. �
(2"d)Deck/Porch/Patio ( X '
Ft.
u Municipal Use
Other(explain) ( x ) Ft.
❑ Other � x �
Prineipa)Strudure(ngricuiturai,Commercial,MuniCipal,Etc.) Ft.
Addition/Alteration(explain) ( x � Ft.
Total habitable square feet: �.�'J Total Non-habitable square feet:
(decks,patios,garages,sheds,storage area&other structures) ��
iS0
�� �Sb
�pSo �1S-u
. Original Application MUST be submitted
, Attach d?lan or Sketch your Property on 8.5"x 11"or 8.5"x 14"paper:'Must'Inciude location and setback of proposed and existing structures,roads,
I driveway,sanitary components,well,lake,river,stream,and wetlands.
l _
� — Setback Setback
Oescription Description
Measurements Meawrements
Setback from the Centerline of Piatted 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 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 construdion/disturbance %Slope
Setback from the East Lot Line Feet Elevation of Fioodplain Feet
Setback to Septic Tank or Holding Tank Feet Setback to Well Feet
Setback to Drain Field Feet
Setback to Privy(Portable,Composting) Feet
P��r.�te th: „ .��.,�rn:_r,�corstn,,.uen of a s'-u�tui�within froe(5)fee?o`*he•n���mum rPqulred seTback,tl_ � ..�,����.;r�I.ne from wMiCh the�etbar4:must be meav��ed must t..��i�-.;!e f�om ooe
���.'.i��usly�u �c,��c��rr.er tu lne u[her p��v�cus�y:�iveyed�omer or mar���by,hcensed surveyur at the o��r�e� s expense.
Pr�or to the placement or constructfon of a struc�ure more than five(5)feet but less than ten(10)feet from the minimum required setback,the boundary line from which the setback must be
meawred must be visible from one previously w�veyed comer to ihe other previously surveyed comer,or verifiable by the Department bv use of a corrected compass from a known comer
wichin 500 feet of ihe pioposed site of the sVu�wre,or m�st be marked by a licensed surveYor atthe owner's expense.
. . . . •.• • . • - . . •- •
Calculate impervious su►faces.(Roofed,concrete,paved,and other surFaces that water cannot penetrete.The Zoning Office can help you determine if a
wrface is considered impervious)
Calculate lot area: � �
Indicate lot size from CSM or NOVUS(circle one): � � ���'Y Acres;Muitipiy by 43,560=Lot area: 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 eavesj: � C�� � 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: ���U sq ft.
Calculate impervious lot percentage ��
Total impervious surface: =Lot area: Sq ft.X 100=impervious surfac ��gi
(Mitigation is required total exceeds 15%'�
••`Notice a separate grading permit needs to be obtained if disturbed area is within the Shoreland district as indicated on previous page and meets criteria below""
6rading on a slope greater than 209� Grading of more than 1,000 Sq. Ft.on 129'a-20%slopes
Grading of more than 2,000 Sq.Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq. Ft.
��i3rniry n,�:_ �� ����,NG Cor� ,�.�1;r:�_ , �;;7 Wi��rzt5ui_��
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)responsible 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!{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 o inspection.Additionally,the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
Owner �IG � . ��/ Owner �� /> ���� �l ��
i Signature �� Printed name L' Date , ���
��� �nn�'rinted Name�eq�� _dl
NOTICE .. _ � � � - . . , �;f�. . , - � �,�uarce
F�;r the Construr i ..�PJr�r���_ . - �. . . . , � . , . , r �Thr,Jni'crrn Gw�"�ng Cude.
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 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
naturalresourcesservice center(608)267-3125
Issuance Information(County Use Only) Sanitary Number: A of bedrooms:
Permit Denied(Date): Reason for Oenial:
i
Permit#: Issuing agent: Date:
2Z " C;��f � � 7 a�
Is Parcel a Sub-Standard Lot (i Yes (Deed of Record) N Mitigation Required � ' Yes ';No
Is Parcel in Common Ownership �!Yes (Fused/Contiguous Lot(s)) o Mitigation Attached !'Yes No
Is Structure Non-Conforming !'Yes 'No
� Granted by Variance(B.O.A.) Granted by Conditional Use
�Yes `'No Case tt: Yes ='No tase#:
Was Parcel Legally Created I;Yes �'No Were Property Lines Represented by Owner Yes No
Was Proposed Building Site Delineated Yes iJ No Was Property Surveyed I I Yes No
Office Comments: 2one District: Fee:
�r�+,�k�cd 4 s �e�►Q�-�'`I �,�t--�w�-rdcrs
� ��. w �, � � � - � -� �'s-o
Hold For Sanrtary: ` Hold For TBA: __,___ Nold For Afrioavl! Hold For Fees:
�Feb2021
i -- _ --- � � ����������������
""!'� BUNKHOUSE/TEMPORARY GUEST QUARTERS II IIIIIIIII I I
� AGREEMENT � �� � a � �� �
Owner's Name(s)as shown on deed `
---__._._--------- Tx:4G,�7573 "
�d v,�4 S �. �/^x �C� 4387g2
�4 �,f/GG� � • „CJ�'a�'�'�— �1�OGA� '}'��AS'�" PAULACNISSER
___-------
-----
--- --- R��ISTER OF DEEDS
Parcei Identification Number: ��¢,WYER COUNTY, WI
(12DigitLegacyiD) � I � -���- G�- ��"I�� p4/25/2022 10•30 AM
--.---- RECORDING FEE 3Q.00
This Agreement must inciude the following exhibits:
� Exhibit A:Leq�l Description of the reai estate for which this Agreement appiies("property') PAG ES: 5
Exhibit B:Land Use Permit Mapis)-shows an accurate location and layout of designated
bunkhouse or temporary guest quarters.
. ____.___._,.__ __----- . _... ._._._.�..___.
� Return to: Sawyer County Zoning and Conservation Department
10610 Main St.Suite 49,Hayward,WI 54843
� ___ __._,�____..
i����S � y�t�� hereby enter into an Agreemeni for Bunkhouse/Temporary Guest
Quarters on (date of agresment) �'�' � ��i ��"Z for property located at(address}
ll���� �'1��-�e� �� �y�'�-r�- �� as described and attached hereto.
This agreement,signed by owner of property attached,hereby certifies that the requested bunkhouse or temporary guest quaRers
meets the requirements as specified in the Sawyer County Zoning Ordinance Section 4.26(4)including:
The independent stand-alone 13unkhouse Accessory Structure does not exceed 250 square feet of footprint measured as the
exterior wall.The creation of walled off bedroom areas are prohibited. Enclosed porches and entryways will be included in the square
footage not to exceed 250;decks will not be included in these amounts. NO other Accessory Structure components allowed as part of
this structure(i.e.no garage portion,no bathroom portion,etc.). Plumbing of the Bunkhouse Accessory Structure is prohibited.Cooking
and Food Preparat�on facilities are prohibited.A Bunkhouse shall require a voluntary Uniform Dwelling Code(UDC)Inspection.'i he
height limit of the Bunkhouse Accessory Structure shall not exceed sixteen(16}feet from lowest grade!o highest peak.Leasing,rental or
use as a residence is strictly prohibited.
Tern_�ar�Guest Quarters which are tocated within or as part of an Accessory Structure shall not exceed 50 percent of the gross
floor area of the accessory structure with a maximum of 499 square feet of temporary guest area.Guest areas including bathrooms,
utility rooms, entryways,and closets will be included in the square footage not to exceed 499.The creation of walled off bedroom
areas are prohibited.Storage area must be separate and segregated from any guest area(can have a door from the guest area to the
storage area). Plumbing,if installed,in the Temporary Guest Quarters Accessory Structure shall conform to the State&Sawyer
County Sanitary Codes. If there is an exisiing Private Onsite Wastewater Treatment System(POWTS)on the lot it must be sized to
handle the number of occupants in the Temporary Guest Quarters.Cooking and Food Preparation Facilities are prohibited.A
Temporary Guest Quarters Accessory Structure or bunkhouse shall require a voluntary U�iform Dwelling Code(UDC)Inspection.
Leasing,rental or use as a residence is strictly prohibited.
The owner(s)further agrees to allow autho�ized representatives of the Governmental Unit to enter onto the owner's property at the
abe�:e�es�r'ptio�b�t:vee�the ho::;S �f$:n�DI� ?il'��:QO�F:r,".�en�+?y th�e4;h G!?d2;/. fcgrtin!1 9.13(1) PO�AIFRS, S�wyer COutlty
Zoning Ordinancej to determine if Bunkhouse Accessory Structures or Temporary Guest Quarters meet specified ordinance
requirements and may be subject to internal inspection by the Sawyer County Zoning Department.
Violation of this Agreement will authorize, in addition to other penalties and relief required under the Sawyer County Zoning
Ordinance,injunctive relief, restoration of said property,citation for Falsifying Permit Applications. All parties agree that this Agreement
shall be filed with the Sawyer County Zoning&Conservation Department and recorded with the Sawryer County Register of Deeds.The
property is subject to this Agreement in perpetuity,regardless of ownership transfer.
---
-Onry one owner siynature requirod- �4CKNOWLEDGMENT
�Ow�r's Signat : State of: ��Z ���!'1 �
`�/' " �',� .
-� --�—_-��'�� � � � ' County of: �C.�'r 1 Cr���,7�,
� Owr�er's Name{Print): � ��_ ^+ b� Subs+rihed and s orn to before me on this
�Jd�1�/a.S � /�2 __ �� _ _ i y -'�`day of �L��1 � . 20�
Date: . � ' � By(Owner's Name): � ` � � '�'z.�C.,
�i� ����t� Notary Public Signatur
-----__�.�_.__. -__.. _ _ _
Drafted by: Public Notary Name ( rint): . C�lrl����_ K� �
�____ _�%�=�•��--� ��--��'`�---______..___ My commission expires on:""( i i �; ' ��;l� �
=r " - - ---�' '
tu ar�� OF 1 � Sc=.� ;
��� JANE� LE hC1�lAP'P �� `
Person�l information you provid�� ,� fdf3�jB��{�G�{F4ri�cy Law,§15.04(I)(m)] Rev.05112/21
,V , + COMM#547?g4
ti ° ` My Catnrn.F�fre�Juty 10,2022 �;
Lot Four (4) of Round Lake Retreat, being a part of Government Lot Three
(3), Section Fourteen (14), Township Forty-one (41) North, Range Eight '
(8) West, Sawyer County, State of Wisconsin.
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3/29/22,2:42 PM Novus-Wisconsin Access rev. 13.1108 -
Real Estate Sawyer County Property Listing Property status: Current
Today's Date: 3/29/2022 Created On: 2/6/2007 7:55:18 A:�1
�Description Updated: 6/16/2017 '� Ownership Updated: 4/27/2017
Tax ID: 10060 DOUGLAS ALBERT DRAKE REV TRUST EDINA MN
PIN: 57-010-2-41-OS-14-5 15-2Z7-000400 KATHLEEN DIANE DRAKE REV TRUST EDINA MN
Legacy PIN: 010173000400
Map ID: -5.4 Billing Address: Mailing Address:
Municipality: (010)TOWN OF HAYWARD DOUGLAS A&KATHLEEN D DOUGLAS A&KATHLEEN D
STR: 514 T41N R08W DRAKE REV TRUST DRAKE REV TRUST
Description: ROUND LAKE RETREAT LOT 4 5802 VERNON LANE 5802 VERNON LANE
Recorded Acres: 0.800 EDINA MN 55436 EDINA MN 55436
Lottery Claims: 0
First Dollar: Yes � Site Address * indicates Private Road
Waterbody: Round Lake i1110N LINDEN RD HAYWARD 54843
Zoning: (RRi) Residential/Recreational One
ESN: 444 C:, property Assessment Updated: li/9/2015
2022 Assessment Detail
� Tax Districts Updated: 2/6/2007 Code Acres Land Imp.
1 State of Wisconsin G1-RESIDENTIAL 0.800 308,300 143,100
57 Sawyer County
O10 Town of Hayward 2-Year Comparison 2021 2022 Change
572478 Hayward Community School District Land: 308,300 308,300 0.0%
001700 Technical College Improved: 143,100 143,100 0.0%
Total: 451,400 451,400 0.0%
:r Recorded Documents Updated: 6/30/2011
O QUIT CLAIM DEED
Date Recorded: 11/18/2013 388324 �Property History
_ .______ _ _
O WARRANTY DEED N/A
Date Recorded: 8/7/1984 19Z354 365/245
https://tas.sawyercountygov.org//Access/master.asp ���