HomeMy WebLinkAbout010-941-26-2120-LUP-2022-135 SUBMIT COMPLEfED APPLICATION AND
Feero: APPIICATION FOR LAND USE PERMIT
Sawyer County �N �
Zoning&Conservation Depart. � ; ' �• � �
30610 Main St Suite 49 —��-����'�_ 1
Hayward,WI 54843 .
��ls,6�-8zg8 APR 2 7 2022 ' c�
J�... �
iNSTRUC?��!v5 No permits will be issued until all fees are paid.
SAINYER COUPj�1'
Checks are made payable to:Sawyer County Zoning Department.
DO NOT STAR?CONSTRUC'ION llNT'l ALL�E�RMITS HA`_'E SF�N ISSUED TO APPLICAN7. D�y?i11�I ApplicdtiOn MUST b8 SUbTittP_d FILLOUT IN INK (NO�.PENCIL)
Submittal of this aDDlication or receiDt of fees tloes not constitute permit issuance. �
Owner(s)Name: Contrador(s)Name
�f�!'J�! � v✓nl ��J�hT�\O , ��'� A -7'� /1- �S
MailingAddress: MailingAddre : D J����i '
L�21�v e�✓ 'T�/�+�! -�+t G �-C/ �Ns
�o � �o �l�,- �4,�-� _ � , — rCs
Phorte:�a D^ ��_ !/D�� Phone: ���
7 �
Email: ���C-�-✓ � � Email: S a'"��
� Site address O � - �� Or Date a plied for:
,
�ePa�Y PIN# � � U '� �'�`'� �`� c�lP ` a� �--� Town of: t
PermitdeliveryMethod pQCallOwner �MailOwner ❑CaIlContractor ❑MailContractor
`_:Is Property/Land withi�300 feet of River,Stream (��d. Distance Structure is from Shoreline• is your Pr��.rn�,
Intermittent) —� ^ � � -�'`:t3�d5
Creek or landward side of Floodplain? �vP�-- or,rmue �( feet in FI�� _
'�„Shoreland 7"
�Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: �
� .�C3 feet �� �-'
3
i J Non-Shoreland
Oescribe Projed
Value at Time of Total tt of
Project type Foundation What Type&Capacity is the
completion Number bedrooms
• nrune�+aracec (House,garage,shed,deck, (Basement, Sewer/Sanitary System(s)
Addition,etc...) of Stories Crawls ace, 1'�s:
t me&mater�a' p construc:tior
List separately Siab)
s �e.�4��"' ,��`S , G ;^�„�r5�;�
owewn� c7-� -ry�.,rc� � Gc
� ���rir v�ee{-- /�
$ 'l" !�2�-'T� d f �
Accessory Bldg
$ �g xjt�C�
Addki� on� /�ration
Height:
7otal square Lowest
Pro osed Use ✓ Footage Gradeto
R Proposed Structure Dimensions (multiply 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.
Atcessory Structure(ezPiain) ( X )
❑ Agrieultural (detachedgarages,sheds,boathouses,etcJ Ft.
Use Temporary Guest Quarters or Bunkhouse(c��cie cype) ( X �
Ft.
� Commercial/ Deck/Porch/Patio � X 1
Industrial Use Ft•
(2"d)Deck/Porch/Patio ( X �
❑ Municipal Use
Ft.
Other(explain) � X �
❑ Other Ft•
Principal Structu�e(a,gricuiturai,Commerciai,Municipal,etc.) � x �
Ft.
Addition/Alteration(exPlain) � �� x �� ) �,�-
� ;�� t, ' � � Ft. 1`%�{
Total habitable square feet: (� Total Non-habitable square feet:
{ � �1� (decks,patios,garages,sheds,storage area&other structures)
Orig(nal Application MUST be submitt�^
, Attach a ' or - your Property on 8.5"x 11"or 8.5"x 14"paper.tMusN include location and set6ack of proposed and existing structures,roads,
Idriveway,sanitary components,well,lake,river,stream,and wetlands.
Description Setback Descriptton Setback
MeasuremeMs Meawrements
Setback from the Centerline of Platted Road and/or Feet Setback from the Lake(ordinary hiQh-water mark� , �� Feet
Setback from the Established Right-of-Way 3v C Feet Setback from the River,Stream,Creek Feet
Setback from the Bluff if applicabk Feet
Setback from the North Lot Line \p� Feet
Setback from the South Lot Line \� Feet Setback from Wetland Feet
Setback from the West Lot Line "L Feet Slope within area of construaion/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
� � _ - � :;i. �,�_� ,, -,.,r,ve:5,�ec:.�. .,_•n��,�����„ ,�;ac� r � ,� ��Y ene trom wn�cn me�emacK m,,r oe measurea must oe v�,;�;e tmm one
. . �_i.���> .._.�.,.. .. ._c t:;�.�tnr , � ,..;:s�v�,�rve/e�ce�ner or,narK,�J bo e c_ >... .., .c�ot at;ne er.,ic��exUerse-
m the placement or construction of a structure more than five(5)feet but less than ten(101 feet from the mimmum requ�red setback,the boun6ary line from which the setback mus:�e
�,,,,�., <�niA rm.���_�.���cu<„<�.�•.........-- � - � �,.��eu comer.���e��nabie oy tne Depattmen;bv use of a mrreeted eompass from a known torner
Ni_n���oC ree�o�me proposea site ot tne scruc;w e,or must be markea ev a�icenseo surveyor at the owner s expense.
� � � � •�• • • • • �- •
Calculate impervious surfaces.(Roofed,concrete,paved,and other wrFaces that water cannot penetrate.The Zoning Office can help you determine if a
wrface ls 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:
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 eaves): 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: sq ft.
Calculate impervious lot percentage
Total impervious surface: =Lot area: Sq ft.X 100=impervious surface S'o
(Mitigation is required if[otal 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 bebw'••
Grading on a slope greater than 20% Grading of more than 1,000 Sq.Ft.on 129�-209'o slopes
Grading of more than 2,Od0 Sq.Ft.on Slopes less than 12S'o Grading is in excess of 10,000 Sq.Ft.
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 1(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 inspedion.Additio�ally,the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
Owner c�•�-E+�.�.-e+� �C.: y�/'"+�c'�� Owner �C/L9�5 L. L.2-���k"p;..J�C'/ �/- .5'��
� -r �
Signature � - .- i c-, <�[_ Printed name J.��w.v C z a J I<<,._,.:i; Date � ' ' -! �
�
�
r �-' ;:�.r,,�. �����nnted Name reau�red)
yp?��� :.,�i��,r.:; .;;e Permits Expi;e One(1}Year irom the Dare of Issuance
For the Construcuon Ci�.vr: :�:��.s , , :an�ry Dwelling� AI L MunioDalities Are Reqwred To Entorre r�,,,��-;rr,�iwr���h Cooe
'r,��oc� �ee;.St:��.� � .- .,��s�. _ r,,a•, ,;�>o requlre permits.
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) Sanicary Number: �of bedrooms:
Permit Denied(Date): Reason for Denial:
Permit#: Issuing agen � Date:
a�- �� s� %���� - s ��a��.
Is Parcel a Sub-Standard Lot ;i Yes (Deed of Recordl f�'N� Mitigation Required ':i Yes �`�,/N�o
Is Parcel in Common Ownership �Yes (Fused/Cootiguouz lo[Is)) I No Mitigation Attached !_�Yes !I�Na
Is Structure Non-Conforming �Yes �NO
Granted by Variance(B.O.A.) Granted by Conditional Use
_;Yes �. No Case#: �]Yes � o tase�t:
Was Parcel Legally Created ,7.'Yes �'No Were Property Lines Represented by Owner �Yes No
Was Proposed Building Site Delineated '�Yes 1_i No Was Property Surveyed �Yes �
Office Comments: + Zone District: Fee:
�v� ��.r�:s.� E.�-� c—� 5-'e �-=� �-,-..z :� S>�y,. �
�'�v-..�..� C,,.� "�-`��.'` • �w<�i � �� `��, ��o�:.,�a...o��� �o���i � .-\ � 1
�
Ho(d For Sanitary: Hold For TBA: _ Hotd For Affidavit: '� Hold For Fees:
�Feb2021
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4/25/22
Hi-
�1/e are new to the arocess of applying for a land use pPrmit so I wanted to clarify
what we are wanting to do (in case I didn't fill out the application correctly).
We want to repair an already existing old cabin structure on some land we
bought.We are applying to repair a couple places in the foundation and
also the the roof(put a metal roof on).We plan to do the work ourselves.
We have enclosed a copy of the survey showing the building is not in the flood plain
along with other info.about the property.This survey should've already been filed
with the county last fall.
I have enclosed a check for$150.00. Please let me know if that's the incorrect
amount for the permit as I found this number online.
Thanks for your help!We are very excited to get started!
Sincerely,
dawn czajkowski
tom czajkowski
920-344-4083
206 Roller Ave.
Beaver Dam,WI 53916
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R2dl EStat2 Sawyer County Property Listing Property Status: Current
Today's Date: 5/4/2022 Created On: 2/6/2007 7:55:22 AM
—�
�'Description Updated: 1/18J2019 � Ownership Updated: 8/31/2021
Tax ID: 12820 THOMAS L&DAWN E CZAJKOWSKI BEAVER DAM WI
PIN: 57-010-2-41-09-26-2 01-000-OOOZ00
Legacy PIN: 010941262120 Billing Address: Mailing Address:
Map ID: .5.20 THOMAS L&DAWN E THOMAS L&DAWN E
Municipality: (010)TOWN OF HAYWARD C2AJKOWSKI CZAJKOWSKI
STR: 526 T41N R09W 206 ROLLER AVE 206 ROLLER AVE
BEAVER DAM WI 53916 BEAVER DAM WI 53916
Description: PRT NENW LOT 2 CSM 24/311 #6630
Recorded Acres: 1.530 �tt
Calculated Acres: 1.510
�` Site Address * indicates Private Road
__--_ . _._ _
lottery Claims: 0 10422N SAWMILL RD HAYWARD 54843
First Dollar: No
Waterbody: Hayward Lake �� Property Assessment Updated: 11/9/2015
Zoning: (R-1) Residential One 2022 Assessment Detail
ESN: 444 Code Acres Land Imp.
G1-RESIDENTIAL 1.530 51,700 0
� Tax Districts Updated: 2/6/2007
1 State of Wisconsin 2-Year Comparison 2021 2022 Change
57 Sawyer County Land: 51,700 51,700 0.0%
O10 Town of Hayward Improved: 0 0 0.0%
572478 Hayward Community School District Total: 51,700 51,700 0.0%
001700 Technical College
. Recorded Documents Updated: 8/31/2021 �Property History
WARRANTY DEED N/A
Date Recorded: 8/30/2021 434343
TRANSFER ON DEATH DEED
Date Recorded: 11/13/2018 415377
CONVEYANCE RECORDED NOT USED
Date Recorded: 9/28/2018 414608
CERTIFIED SURVEY MAP
Date Recorded: 7/23/2003 313405
WARRANTY DEED
Date Recorded: 7/3/2001 292125