HomeMy WebLinkAbout016-637-30-5403-LUP-2022-175 • SU9MIT COMVlEfEO A�LIUTION AND ♦�l �
FEE TO: �J
Sawyer County � N �
Zoning 6 tonservation Depart. —`-'=' '
10610 Main St Surte 49 can svmo IRx«.ee! � 1
Hayward,W154863 ��� 2 4 2p22 �3 -
(715)634-8288 \
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C�eeks are made payabk to:Sawyer Counry Zonin6 Departmeat. � .�,
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DC"�O-S'aRTCG'IS:AI,'CTIOV:1'+T'�._Pi'.?=Ch1'�.'SNA�'SBEEN'<$U_'c_'OAF7i:CdNT Origina�Fpc!�:ax;��MUSiMsubmitted FILLOUTININK (NOPENGL)
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' MailingAddrcss: � .� :^+ / MailingAddrtss: O� � ,�, ^r� /� " ' `
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Site�ddrets: j -���lf'� i'�" �t Gt,•f� I Or OaM appiied br. /"�� �/,y' - .d°v��- �_..__ � .
�ls��� j��C%-- ro�� .' ,, � -° � •
rn�• %.1�:- ` i / r'S:i�i . , ��.�.�L �._ �'11$�
i Vemtkdeliwry Method �Call Owner n Mail Owner o GII Contractor �Mail Contractor �`Q�' I��p r' ��1�.C,},�Y ,F{v'a�1_��'7��/
( ��'Gl .r l9 '1
' _.�t Property/Land within 300 feet of River,Stream;�nc�. � i� i
', i � Distance Structure is hom Shoreline: E Is your PropertY p,e wet±ands I
' �„an�:ue�.n
i � �� feet in Floadpiain
; Geek or tandwara side of Floodpiafn? ���+�es---c�^.t:^�e ' oreur.t? �
�Shoreland zontt
� Is Vroperty{land within 1000 feet of Lake,Pond or Plowage ! Distance Structuro is from S�ore!ine: Y� I �e`
I
� If y �-/ feet �N'O�1 �,��.7
es...Ccni��;lZ —� i�'_-J '
� 'NOfl�A10fluRd '_'__ ' .
p�Q�pe Project Total B of
VaWe at iime of P�o���� pum�' foundation y�rooms What Type 8 Capacity is the
�Om��O° (House,gnrage,shed,deck, (Basemeni, ) Sewer/Sanitary System�s)
} �ost I f
'^:`�`�c-''��.� Additbn,etc...) �St�� Cr2w15 Ce.
•{:^p g."-•a,qr�a' List u arot � t I tcn5:r�t.i�^
P �Y Siab) �
513o r���w�;�.: � n�� ' .�;�-'�i..: j I.�)f�� p' tl�� �-�.�<, - ",;t.,��
0 i t . ,
Dw Img . � ��. �/
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' $ i
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IActesSCry eld{ � '
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� � I � I
i
� 4ddR7en/Aleentan
� � �,
�
� Height:
� TotalSquare Lowest
� ppp� I 4 Pr d Structure Dfinensions Foot�e Gnde to
� Pr Use i �e ! (multiply per Mi�hest
� � story) Peak
r �
I I ( ��' X : t i .-- 5��
�� � Residence `�' � i���.C; ft. 1 3
t � x ) '
� with 2n°story or loft '4� ! Ft.
� x ; (
with BasemeM ��.%�� Ft.
� � ' X ' I
� ANached Garage • �� ; Ft.
�Residential Use i `v '
�� ( AecessoryStroeture;e�ia��) ,�` � i ( x '
�e.va.ee w•�¢e:.. :eoae nous.s a,l /"�� � Ft.
� Agriculturai ' "<'
USE � I 7emporary Guest Quaners or eunkhouse�o.�e rrx)je.�� ' � ( X )
, ♦ Ft.
( X . )
_ Commercial/ f Deck/Vorch/Patio ��#-}2,., jt�" f,; ��, r` ' Ft. ,�1 i�
Industriai Use { x µ ) � ���
(2"a)Deck/Corch/�atio �,cf*-r' .. ._'`> /f�' .�.i' :_r' Ft. :�'
L Municipal Use ( X 1 !
OthOf leav�am; �.� Ft.
' � Other r�-. .• � x 1
Prineipal Stroeture�aqnwM��ai,comnaoa�.M���.ca,ec<��j;;- Ft.
� ( X )
� � Addition/Alteretion;e.e�a„� J-./ �i�- Ft.
( �
' � Total Non-habitabte square feet:
fTotal habitable square feet: �L)L,t! j� ;�� � (decks,Datios,garages,sheds,storage area&other strucmrzs) ����`�.. �
i
Cregina!Rpplica�:c�s�s1=3'he s;:��csi;t_�
' Attach a Pt�n or Sxettk your Property on 8.5"x 11"'ar 8.5"x 10"Daper.•MusN Indude loation and setback of proposed and existint structurls,road5,
' drlreway,sanitary compa�eMs,weN,lakb river,aNeam.and weNends. ,
� Setback Setbatk '
LOesaiption Meawrements ��P� Meawrements '
' Set6a�k from the Centeriine of Platted Road and/or I Peet Setback from;he take(o.m�,ry n.en.«,�,m,�k) f �-/��t-, Feet j
Setback from the Establisfied Right-of-Way i �..._ � � Peet ' Setback from the River,Stream,Creek ,/�} j Feet j
� Seihack from the BIuH�r,00�;ao-:e � Fcet I
i Setback from the North Lot Line � t�jt�; Feet
� Setback from the South�ot Line � � �- Feet I ' Setback from Wetiand ,�..�,�-� ieet �
� Settack from the West Lot Lme ' ���--�,,.s fttt Slope wiffiin area of construction/disturbance " A:Slppt �
' Set6ack from the East Lot Lir�e ,_<�,j Feet � Elevacion of floodplain Feet
_ '
� Sertack to Septic Ta�c oc.�lolding�Fmrlr f`� Feet �' Se:back te Well .j�-�� Feet
i SetCack to Drain field � �. Feet
!, SetEack to PriW IGortabie.tompost�ng� ,J ,� Feet � I
j �<_ - �_ ..i . . __ .._ . .. . . .. _., - -.�_, , . .-^ . ., .._. . .._ ..... . �._.__ . .-_ . .. .. '.
� ._. .. . ...., . - . _ ._ . . . -. . _. . _ _ - . _..:---
�
� Calculate ImpeMous wrfaccs.(Roofed,concreta,paved,and other wAaces tha[water cnnnot penetnte.The Zonin6 Office can hetp ynu determine If a �
surface is consldered impervlous)
��. Calmlate lot area: ' �/ - ,�
'�, Ind��cate lot size from SM er NOVUS(cirde one):��L�' �i� Acres;Mu�tiply by 43.560=lot area: �"f�' t/��'Sqcare Gootage I
' Caiculate impervious wrFace area: ��
Determine the total size,7 square feet,of your projecu listed a6ove�inctude eaves)� ��`'�(-' sq ft. ���
. Determine the totai size,in square feet,of all exisung roofed strudures pnclude eaves;: f ���;.=j � sq ft.
I Determine the rotal size,in square feet,of all ezisbng pavedlbricked/blocked surfaces: �-�G c..- sq ft. /='�">>c.`.:l,1: t(
t
' Add these measurementt to oetermine tcta!�mpervious surfaces: '�` �'���� sq R
�: Calcuhte imperviouslot percentage
_'%,. 4 %r`f�'ftl.G' j.�Y
i Total impervious surface:f > � =Lot area: -!Sq ft.X 100=impervious surface 4a I
iIMi[!�[��,on�5 re9u'.retl��[cUl e�:rtdf 15%1 i
I
i "'NOUce a separate gea6ing permrt needs to be obeamed if d�sturbed area is wn�in the Shoreiand distnct as mdkated on previouz Rage and meets aRena Oetow"'
Grad�ng on a sloDe greate�than 20Y I Gradin of more than 1,000 Sq.Ft.on 12�-20%sloDes I I
j Gratling of more than 2,000 SQ.FC.on Slopes less than 12% � Grading is in excess of 10,C00 Sq.Ft. i
-- - - ._., .. . . . - -- ,. _ -_ _ _.
I�wP�CP[iarp ihat[NS app6[at�or(in[Iuding d�y dt[OMp3/ry�ng io�`ermaPcn)h'aS be?�2*amineC by me�us;ana to the oesi ot rny(our�krrowl¢dg=ana beliaf rt�s ttue,mrre:t and
� como�e�e.i(wel acknov,�^dge that i(wel am(are)�esponvoEe to•the detad anC actur;cy of a:i�nfo�r+a[ron I(we)am�a�e)D�ov�C�ng and that rt wiil be mlied upor by Sawyer
[ounry m determ�nmg w�ether to usue a pe�mlt.t(wel f�rther ac.ep:�ebllity wAlch may be a�esu!t o`Sawyer Govnry re�ymg o�th¢�n`ormatlo�.�Iwe)am(areI Drovidmg�n or �
' w��M tti�s appl�caLon.i(we�consent to counry off:c�ais charged wrth atlm�naienngcou�ry o���naaces.o have access to the above descnbed property at ary reasovaEle fime fcrthe �
purpos ef InsC°tt�on.Addrtionaliy,the unCers�gned perion�s;h=reby give pern��ss�o��fo�a.cess m ihe Oropertv for onsite�nspechon try M1tuni ipal Officials. j
� � � ��� � �
` ow�, ow�e� , �6��C:.�A�rz
� Signaturc •'�1�� �C/ Printed name�i��"hlf�s'� . Dat �
_ _ _ . _ -_� �c i
i _. .. . .. r- - _• ^e:-:_.. .,_ -�._::= �
� -- . ., ._.' . E .. . .
Vou are respo�s�0�e 10�compqmg wrt�the.eq��emens ef tne Saurye•Cou�bng Zo��rs Ora�n ncn a�d aw antl regWar�e s o�Np State ef W rs<o�v�.�ou are aiso responvb'e so� �
' <omD�r��B`^"�h Stace a�d FeCeral lawz concerm.ng consvuttion near or on wetlands,�akes,and streams.�a��u�e to comply may�auk in remova!c�modffcaGon o(constr�am� �
( tha;�,o�ares the-aw o�o:her penaitir or costs.Fo�more�nfo�matwn,vrslt the department of naturai resaurces weNands�dennfication web vage or contact a dcoaK�+ent of �
naturai resources serv�:e center(W81267-3125 �
I
� lssuance Informatfon(Counry Use Only) � Saniiary Number. �1�� � �u ' b of�edrooms ` � C ST ��r�S�
..0 1
'. Perm��t Denied{Oate1: � Feasun for CennC i
i �
i
; �ermlt M: �1 � Issuing agent: Date:
�'� _ \ 1 S ��� _ �, p o1�
r
; h 7arcel�Sub-StanCard lot �c Yec �Deea of aemra� (�•^� Mrtigat�on Reqwred '� Yes o ! .
j Is Parcel in Common Ownersfiip (-Yes (fuse0lContguous lot{sR N� MRigation Attached � -��Yes �No '
; is 5truaure Non-Conforming i � ves �o � __I
� Granied by Variance(B.OA.) Grante�yy Coodit�ona�use
Yes Case M: Yes TNo ose s:
was Parcel Legaily treated e� No � Were 7roperty tines Reprnsentea Dy Owne� � a __. N�
Was Proposed Buildmg Ste Deiineated i�'�'es No was Droperty SorveyeC � �Ya �° I
i j
Otfice Comments � 2one Distrkt: � Fee� ��
n 1 I
i I�1� J � ' L� {
; re��far Sar!:aru. rio'���er t6? � Hc�d�cr�£i da�,�: � �I No!d�or Fees:
w.�om
PIAN VIEW: Provide sketch beiow of system(include direction of slope and aH distsnces in acoord with H62.20.Well loca-
tion shai!be included an tha skett.h. indicata or dimension locatio�of all weiis on the property or neiphbon
property. If wall hss isat basn drilltd�lesse indicata.
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5/24/22,2:26 PM Novus-Wisconsin Access rev. 13.1108
Real Estate Sawyer County Property Listing Property Status:Current
Today's Date: 5/24/2022 Created On:2/6/2007 7:55:33 AM
i��}
''��'Description Updated: 12/17/2021 �Ownership Updated: 12/17/2021
____ ___ .� ......_ _.__�� __.._ ...__� _-_� ________ ____._ _� �_.._�_ __.___,.� ___...�____..
Tax ID. 19376 ROBERT P&CHERYL M BLICHARZ TRUST LADYSMITH WI
PIN: 57-016-2-37-06-30-5 OS-004-000030
Legacy PIN: 016637305403 Billing Address: Mailing Address:
Map ID: :43 ROBERT P&CHERYL M ROBERT P&CHERYL M
Municipality: (016)TOWN OF MEADOWBROOK BLICHARZ TRUST BLICHARZ TRUST
STR: 530 T37N R06W N5633 HILLTOP RD N5633 HILLTOP RD
Description: PRT GOVf LOT 4 I1�DYSMITH WI 54848 LADYSMITH WI 54848
Recorded Acres: 10.800
Lottery Claims: 0 � Site Address *indicates Private Road
_ __
First Doilar: Yes 504N LUND RD EXELAND 54835
Waterbody: White Birch Lake
Zoning: (RR2)Residential/Recreational Two � property Assessment Updated:7/8/2015
ESN: 440 ___�_____ _ ___ .._____ _.�__ _r _ ____._,.,__
2022 Assessment Detail �
Code Acres Land Imp.
*�Tax Districts Updated:2/6/2007
___ ___ _ .. __ _..__...., ,___� __ __ ._..___- �_____... Gl-RESIDENTIAL 10.800 31,500 21,700
1 State of Wisconsin
57 Sawyer County 2-Year Comparison 2021 2022 Change
016 Town of Meadowbrook Land: 31,500 31,500 0.0%
576615 Winter School District Improved: 21,700 21,700 0.0%
001700 Technical College Total: 53,200 53,200 0.0%
.�Recorded Documents Updated 1/20/2011
�.. _.�..�._ _. .�. __...._�_ _._ .__ ..__�_ . �.__.._._..... -
� DEED IN TRUST Property History
Date Recorded:9/28/2020 426751 �"����" ��'"�". ____.�.,,,,._._,_______.___._�_..__... _._.___�_
N/A
� MAP OF SURVEY
Date Recorded: 5/27/2010 30376-4
� QUIT CLAIM DEED
Date Recorded: 8/24/1990 219973 454/95
1/1
https://tas.sawyercountygov.org//Access/master.asp
- USE BLACK INK ONLY - I I I I�I I',1�� Illi{II�11
I� I IIIIII 1 ,1
� �� .5q � i'! 4
POWTS MAINTENANCE AGREEMENT Tx:�03�;1�
For Statement of POWTS Capabilities �39616
�A�LA CHISSER
Owner's Name(s)as shown on deed: � �� �'� ,���Z �;,y1 �2EGISTER OF QEEDS
' �AWYER COIINTY, WI
� `�\�,Cl.�Z., c � ���,e�y,� � '�'���e:..�,•e=•Z �5 �J�:��. �6J 10 j2U22 01:12 PM
��c:•��`� !2��ORQING FEE 3Q.00
Parcel Identification Number:
(12 Digit Legacy ID) � � � - �_� � - �� -� L� � 3
--- — — — PAGE�: Z
Legal Description of Property:
-SEE ATTACHED SHEET -
We acknowledge that application is being made for the installation of a holding tank(s)on the
property described on the attached sheet.
Return To:Sawyer County Zoning and Conservation Administration
10610 Main St.Suite 49,Hayward,WI 54843
I (we) understand the POWTS servin the structure on the above parcel located at: (fire number and
road name) �C�`� � �-....-� � was designed for the following capabilities:
Treatment Tank(s) Approx. ��J l� GPD, Soil Absorption Cell(s) Peak �� � GPD
Permit Number SAN `� ( - 13`� Year installed Jct�(
The POWTS serving this structure is presently sized to accommodate a total of C r��_ ( ( )
people, in a dwelling containing � �n� ( 3) bedrooms. With the addition of bedroom(s), the
estimated daily wastewater flow of the structure will be based upon per capita occupancy rather than
the total number of bedrooms. (75 GPD per Person)
WI Dept. of SPS 383.54 outlines the management requirements for these POWTS and I agree to
comply with those maintenance provisions as they apply to this system.
Should the use of the structure described above increase flows above the capacity of the POWTS,
I agree to upgrade my system to meet the standards required in WI Dept. of SPS 383.
Should my POWTS fail, as defined in Section 145.01 (16) Wisconsin Statutes, I will obtain the
required permit for the installation of a code-compliant POWTS with the installation completed as
ordered.
-Onl one ner si na ure re uired- ACKNOWLEDGMENT
Owner's Signature: � � :j� � State of: �,�v�SC J����
�/ �i �✓ L/ ,
Count�of: Sa� w� ��
wner's Name (Print : ) Subscribed and sworn to before me on this
r -
( �ih �� �, � �'C��+ ( 1 �� : n -Y ��hC1 �-� / �dayof .��n� , 20���
Date: • / / (� � By(Owner's Name): ;'u n 1�f1 IZ I;C.l�cc 'Z
`� Notary Public Signature: -�
�,,,� „ , � I/
Drafted by: J� Notary Public Nar�`'�� . '' , �� "�c�L�J Lu���
�r��Jrc�J+� � G��� �� Mycommissior����ires'o'n':'��._'f�{'�-,j:�� �;��-,
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