HomeMy WebLinkAbout002-940-05-1122-LUP-2022-191 �
SUBMIT COMPLETED APP�ICATION AND
FEETo: APPLICATION FOR lAN[�J.1S�RE T �
5awyerCounty `s�� (E ��i���� A�S.IN, �
. ���, ,
Zoning&Co�servatio�Depart. I 4.� :�:� `-�'�'-``� v=---=°`
10610 Main St Suite 49 ��C a(��e�°edJ _J
Hayward,WI 54843 � ,�N a 9 �p�� �
(715}634-8288
�+�,y�JYER CQUNTY !
INSTRUCTI�NS: No permifs will be issued until all fees are paid. `�� DMyNfSTRATION
Checks are made payahle to:Sawyer County Zoning Department.
DO NOT START CONSiRUCTION UNTIL�LL fERMiiS H�VF.BEEN ISSUED TO APPLIUNT O�iRindl App�iCdtion IVIUST bC StIbTiCtE'd PILL OUT IN INK (NO PENCIL)
Submittai of this app���catlnn or recelpt nf fees does not constitute permit issuance.
Owner(s►Name: Contractor�s)Name
�,, n � 1 ,� �� �
1 pw.�_� �\od �"r� sZ ��'�ti�"�"�N�,.i ,�2G'fi_�`�� �GG_ �_�S_ �—' `T�'
Mailing Address: � � Maifing Address:
�2> (�-�G� �
1 I S� ; r �� � :� -��j J �,��Ge
Phone: ��S _ r�S JIj� (',�� Phone: ,�t�,r h�Q.�/ ,/
� l �v CJ
Email: � �GL-(N�vL�j � a' L;_y i►� Email: � C� � � V✓�'2(j , , C ^Vln
Site address: � �T ►�£ /V � G-�U'J � Or Date applied for:
Legacy PIN# ��� � � i/ � Town of: { l �U I�
Permit delivery Method ❑Call Owner o Mail Owner ❑Call Contrador 'y�.Mail Contractor
` Is Property/Land within 300 feet of River,Stream (mci. Distance Structure is from Shorelfne: Is your Property
i�ce.m�tte�r) � Are Wet�ands
Creek or Landward side of Floodplain? If yes--continue feet in Flaodplain present?
i i Shoreland -- - ---- —� Z°"ej
Yes
Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: Yes
If yns--[ontinur —� feet N^ ;
No
!`�}-Non-Shoreland
Describe Project 7otal q of
value at Time of project type Foundation What Type&Capacity is the
Completion House, ara e shed,deck, Number bedrooms
'indude dor,�,r�-�f ( g g ' of Stories (Basement, post Sewer/Sanitary System(s)
Addition,etc...) Crawispace,
time&rnaeerial �ist separately Sldb) �onstrurtion
$ A����'�,���� �. �i a� a�3
I G,-� I � �
Owelling -'-
$ -
Accessory B�dg
s ��o��
Addition/Alteration
Height:
TotalSquare Lowest
Proposed Use ✓ Proposed Structure Dimensions Footage Grede to
(multiply per Highest
story) Peak
Residence ( x �
Ft.
with 2"d story or loft � X �
Ft.
with Basement t X )
Ft.
Attached Garage ( X �
�d Residential Use Ft.
Aecessory Strueture(exPia��) � X �
��� 14g1'ICU�tU�B� (detached garages,sheds,boat houses,etc) Ft.
Use Temporary Guest Quarters or Bunkhouse(cirde cvpe) � X �
Ft.
❑ Commercial/ Deck/Porch/Patio � X �
Ft.
Industrial Use ( x �
(2"a)Deck/Porch/Patio
Ft.
0 Municipal Use
Other(explain� ( x , Ft.
❑ Other � x �
P�I�CIpeI St�UGtU�O(Agriculturel,Commercial,Municipal,Etc.) Ft.
� Addition/Alteretion�expia�r,) ������� � C� V'�v��i^l�+ ��j X �)t� � �3-
� , � � � ' ' 3g/ Ft. rS s
Total habitable square feet: '�� `'� Total Non-habitable square feet:
(decks,patios,garages,sheds,storage area&other structures)
Original Application MUST be submitted
z-- -----——._ __._
Attach a Ptan or Sketch your Prope�ty on 8.5"x 11"nr 8.5"x 14"paper.'Must*fnclude location and setback of proposed and existing structures,roads,
driveway,sanitary components,well,lake,rlver,siream,and wetlands.
Deuri tlon Setback
Setback �
P Measurements Description Meawrements
Setback from the Centerline of Platted Road and/or � feet Setback from the lake(ordinary high-water mark� Feet
Setback from the Estabiished Right-of-way Feet Setback from the River,Stream,Creek Feet
____ Setback from the Bluff if applica6le 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 \1(o feet Slope within area of construction/disturbance �Slope
Setback from the East Lot Line �I Feet Elevation of Floodplain Feet
Setback to Septic Tank or Holding Tank �—' Feet Setback to Well Feet
Setback to Drein Field '—" Feet
Setback to Privy(Portable,Composting� Feet
Prioi to the pl��.enrent ci cnn�trucGon of a suucture wiihin five(5)feet of the minm,um rt�.qul�ed set'ba[k,the bound:�ry line from wh7ch[he setbatk must be me�uu��°d n�ust be vislble from or�e
p���-viously w�vayed miner to ti�e other prevlousty surveyed corner or marked by a hcensr�;surveyor at the owner's expense.
Pr�or 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 from which the setback rnuzz be
measured must be visible from one previously surveyed corner to the other previously surveyed comer,or verifiable by the Department by use of a corrected compass from a known comer
within 500 fee[of[he proposed sile of the structure,or must be marked by a licensed surveyor at the owner's expense.
� � � . •.• . . - .• . �
Calculate impervious suAaces.(Roofed,concrete,paved,and other surfaces that water cannot penetrate.The Zoning Off7ce can help you determine if a
surface is considered impervious)
Calculate lot area:
Indicate lot size from M or NOVUS(circle one►: Acres;Multiply by 43,560=Lot area: Square Footage
�alculate imperviaus surfac rea:
Determine the total size,in square et,of y r projects listed above(include eaves): sq ft.
Determine the total size,in square feet o II existing roofed structures(include eaves�; sq ft.
Determine the total size,in squar eet,of all e 'sting paved/bricked/blocked surfaces: sq ft.
Add thes measurements to determine total impervious surfaces:__ sq ft.
Calculate impervious lot rcentage
Total impervious surface: =Lot area: Sq ft.X l0U=impervious surface /a
(Mitigation is required i(total exceeds 15%)
'"'Notice a separate grading permic needs to be obtained it disturbed area is within the Shoreland district as indicated on previous page and meets criteria below'•'
Grading on a slo�e greater than 20% �—Grading of more than 1,(100 Sq.Ft.on 12%-20%s�opes
� Gradi�g of more than 2 000 Sq Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft.
FAIIUkC TO OBI AIPJ A P�ntvi�1 ar STAR?��NG CONSTHUCTION WITHI;CT A VFitMIT VVIL�HESULI iN PENALTIES
I(we)dedare that this appllcaUon Qncluding any accompanying information)has been examined by me(us)and to the best of my(our)knowledge and belief it is true,correct and
tomplete. I(we)ackn�wledge that I(we)am(are)responsible for the deCall and acaracy 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 liabllity which may be a result of Sawyer Caunty relying on this information 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.Addlilonally,the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
Owner Owner `� � �
Signature ��'�'�`� �. -i'-'�- � Printed name � v r�r�o� �� T l 1 ti y l� Date G' �oZ
��i��,raic,,:arsd��nn[c�;]f9ame rrtnuired)
NOTICE. i111 L��r��'-Us��I':=nui[s k.xp�re One(l)'le��r trom the Uat�ct issuan�_c.
For the lomtrurti��n Ot iVew One L Two Fainily iT�vullui€;: AlL Munu ipali(ies Are IfequireJ Ib Lrifcr[e Tf-ic'.inrurni U���r�l np;(:uUc.
1-hF�inca�I�nwr,Sl�itr<,r Federal agencit�s ntay als��require permiiS.
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
natural resources service center(608)267-3125
Issuance lnformation(County Use Only) Sanitary Number: tt of bedrooms:
Permit Denied(Date�: Reason for Denial:
Permit k: Issuing agent: Date:
"1 �� ' ( � � o� � ��e��a�
Is Parcel a Sub-Standard Lot I!Yes (Deed of Record) _ �No Mitigatfon Required ':Yes o
Is Parcel In Common Ownershlp 1}kYes (Fused/ConUguous Lot(s)) I�No Mltigation Attached !_�Yes �No
Is Structure Non-Conforming ��Yes �cNo
Gronted by Varlance(B.O.A.) ` Granted by Conditional Use
I Yes � No Case k; !Yes�LNo Case#:
Was Parcel Legally Created 7Yes C'No Were Property Lines Represented by Owner �Yes No
Wes Proposed Building Slte Delineated * Yes i:No ��` Was Property Surveyed Yes No
Offlce Comments: Zone District: Fee: �
� as
Hold For Sani[ary: Hold For TBA: ______ Nold Fur Affidavit: _� Hold for Fees:
�Feb2021
i �
,�,I - - ���r`�' ,I�,I - �,
,���`� �
fll I
� � I 1 l � � I
„ { { )
, , ; �, �
� � ���r�I � ; i i
-1L- - ��t�l�l �� �� ' ;
� � - � �
� �}���r�r - ;'� - - ' � i
� �
� � 1}I�1{it �� - �
� �
+ � ��� ��� `��r�t�r � � ,
° O � 77 � " I
� Z li � ! = x� ' �
� . m � � � I
� � ° �
m � R � � � � � � I
� � o
,m
< � � o❑ lI � � I � , ,
� � � � k r � � I
� '� � � � rn � �
� ���������� < � � �
z { � � � �, D � �
�i � ii ,
� ���k�{�4�� o
I � z � �
', �; �- - - �4��l��4�� I I '
� �
"- - - � � ���������� ;� ; �
� � ���������� � � �
� �
� �
� � kl ! � - ;;--
II � II �
i � l � I �� �
� IIII � ��
'� Ill � l " � 0
'� � { II1I � � �
� ; ���k������ �� �
� � � fi0
� ; �I�I����l� � ;
� - - �I�I�t���l '�� - -
Fp5�9j�1y�{ � �h R '� �i.'% PQOPOSEG RENOVATION FOR: ` � T �p: m
� � g s ES ��f � �� W � �Z � JOB NIJMBER:
��31��1��D��3� � �� m�;� �`6 ��� ��a �s ' ��s fis ROD � DONNA � c� �����A� i
_ .8. 4c{ �, h� k F 9 . A A;e�t. �0
�. � �' � f � � PRINC�LE W:ti n ^/�/1
`�' � � ' aa ,3 sa �;
N Y �� p a��, ;V�+.{ '.i 6�4�h5 � �' Li�O�
N67L4RC.WISCCNSIN ;� II� k � m
—------�
,—�— -_i
���
6 �
� 1�
fi � � 3� �
6 h 4 � � 3�I i s^
o �
n � "
�
�._
i
, .E-�,
i .._.__ -c-.�_� �.-_::::::: - ���
n
�� ���o. " O ,
� � '
2
aD °, � ,V D N
Z =� Y
� _ s:
O h
O 9 D
/U �� � ' :
i � '
� ' JC - , D
F.'
z --
D 6: � � ��' � II
Z =
��
� � �� �
< ' r _ _ 'I
■ - - - -
,. n
�1
- -.....--- � 6
�
- A
3
I ni
Y F
A
�' � I ID =__�:__-
m I
I
I
i
� -. __...
i
h a * " $i:v��� F'. PROPoseo ReNova,icu FOR 3� r ��` ^ JOg NUMBER:
r �
N ro � � i yk+ n , dl"vi a� � �', �
�j��p'��p�(��y7 �p,(�{��p � � � '' � J ROD � DONNA � � :A: _
LS'L�JLmI W 1I92S1JISUCC_5li.)LS n ��mY r a # �.3� A z 9 hy1 (, A ,:Y, i
6�o.
N 'n E � E "E� ` P ' � ` � PRINC�LE �a W �' � 22-05
��, � ,'�:,,i ��� ��s,f� ' �� �'�� �
NG7W4RD,WISCONSIN ;� �3 4 a
.� . r
_ � .. �Y� � �,� � �-_ �i
, '�"c . .. ,�
� � .� � .. ��Ki.. r
�'�`� y�.t � f
. .� � ��:. �,.
. � . . .� � .�4 " ,. � . .
�: I
. _. . . . _ ' . ...i�n.p,.. .�,. .�'I� �I
. `,. �. ._ � . ". ^ r�:.
� � • �' -�'� c�
. . TM r. � �`� .. � J'
'_ .. - . . t . ' � .
� " �.� � ��' � •
1: � ' �• t f .e-: i ap^nv���� '
�,�. .' � � r ��,� �J �� .
+� r Y tr.. �,,y p �
;� �� � Yi,�T:�.
+� � . � � .. �"-'.� 4�
.- ^�,.: .- p � r � b
_�F a63 v�'A`A .,',��� .r'G3' �4 �(; l � :.�..,
• p-_ � , !� µn
. A,•`y`' •�„ wl�{.1^ ,�? ��.
.0 ��
>•'�y _.. ya .v
�� 9'� w _ � .
.. ; ,_ -
. ,
, .
r: r
�f 4 �,,f��,,. _. � ; $ -�:1��
:•:. ��" tP.a'�" ,�.► .,; ...� : _ •_.. yy,� ^'.�,..
�
f,. t.' �1 .. '- ' ' x...._ �f' . °k"F„,o�'a,�1y
! � q Ht'
� �.,ti �,M1 'S', �� j� • � - 6 c�+ .'.� •� F ��i"'}�. ., ���i�j'
.y r' .F;�� .. � ' .l% .- ! f.
•'�d-•.�� -?* � y,��,��pr�'.� �'.��. " _. ' ,
1�� �: � � �w �w. � �� .
. .�s. � �tii-�.
, .:�`F.' #i� ' . T
�Y� ' _ -,s..�.,. � '"+.� . Y °+�:.
r: 4 _
� 'w, . � _
' �rh. f �
. � � �A�t'� �4' .. .� II �
,�`•• r � � � � �;�h� �� ..�� s ' �I+yi.� Gp�� �
- �� �l �h� � ':�'�r � l{+"h�.+,�2..• ���..
^� �
_yt{� .� .�' .- .- !t �
'., �4 '`.���'da ..,�, ��' �, �.?l: -:i': ....k .s�`" � :�.+„.
.;�'�y .r ...,� �`• r
�:,.,p��M� .�� ,� y` r+�y,�_ . �"..$_i.r�.
�� � �_ � � ,� ��� �� ,�' .r.. r �a� • ' ~ f,
� � :� r � ..�,• � ..� 7 ' •, �. �i• . .' � '
r.,t. s .:�!.. ..�� '' � ��F 0,=
�ty�Yy` ._.�'."�ya_Yy �r�} � ��' �
-rs`�`� s #�R � ..t ��'* },[ ry�;�. � '
��� � �; ��::� �.f.:; , _
':�. �v"�.! -:+! f�
, .�
.:'�.h � ;� _ ���h �s��.
z.
619122,2:49 PM Navus-Wisconsin Access rev. 13 1108
Real EState Sawyer County Property Listing Property Status:Current
7oday's Date: 6/9/2022 Created Om 2/6/2007 7:55:06 AM
�Description Updated: 12/17/2019 �Ownership Updated: 12/30/2020
TaxID: 2814 PRINGLETRUST HAYWARD WI
PIN: 57-002-2-00-09-OS-1 01-000-000220
legacy PIN: 002940051122 Biliing Address: Mailing Address:
MapID: .1.22 PRINGLETRUST PRINGLETRUST
Municipality: (002)TOWN OF BASS LAKE 16156W PINE LN 16156W PINE LN
STR: 505 T40N R09W HAYWARD WI 54843 HAVWARD WI 54843
Description: PRT FRAC El/2 NE LOT 3 CSM 6/67
#1149 � Site Address 'indicates Private Road
Remrded Acres: 1.600 16156W PINE LN * HAYWARD 54843
Lottery Claims: 1
First Dollar: Yes U dated: 5/24/2019
Zoning: (R-1)Residential One � Property Assessment P
ESN: 406 2022 Assessment Detail
Code Acres Land Imp.
� Tax Districts Updated: 2/6/2007 G1-RE4DENTIAL 1.600 15,200 96,100
1 State of Wisconsin Z_yearComparison 2021 2022 Change
57 Sawyer County Land: 15,200 15,200 0.0%
002 Town of Bass Lake Improved: 96,100 96,100 0.0%
SR478 Hayward Community School Distri[t Total: ll1,300 111,300 0.0%
001700 Techniwl Gollege
+ Remrded Documents Updated: 1/29/2014 ��Property History
O SPECIAL WARRANTY DEED � � � - � -� - --
Date Recorded: 12/10/2020 428571 N�A
O CORREC7IONINSTRUMENT
Da[e Recorded: 1/26/2018 410832
O CONVEVAIVCE RECORDED NOT USED
Date Remrded: 9/6/2017 408536
� WARRANTY DEED
Date Recorded: 3/24/1993 234091 504/147
O CERTIFIED SURVEY MAP
Date Recorded:9/7/1978 166550
https://tas sawyercountyg ov.org//Access/ma ster.asp
1/1
J�° �' '` PRIVATE ONSITE WASTE TREATMENT county
��--�,.`.���
;�7 oSp ��j SYSTEMS Sawyer
������ ( POWTS)
\k\FSSlO`�P�y/
INSPECTION REPORT Sanitary Permit No:
Safety and Buildings Division (ATTACH TO PERMIT)
GENERAL INFORMATION ��� �� �
Personal infonnation you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)]
Permit Holder's Name: ❑City ❑ Village [�,Town of: State Plan Transaction ID#:
L=n`'��-'�e.v�l 1�..,oer,�►sa►;��► ��.�� l.,�'•A. —
Insp BM Elev: Description: Parcel Tax No:
�o�,�` � el,e.�._ o�Y -��t( - 3Q - .S�=y r'i
TANK INFORMA ION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEU
Septic W�� _ �pC�p Benchmark �o.o'
Dosing _� o � -
Aeration Bldg. Sewer —
Holding St/Ht inlet 9'0.IS�
TANK SETBACK INFORMATION Stl HtOutlet �9,Fs'
TANK TO P/L WELL BLDG vENr To ROAD Dt Inlet
AIR INTAKE
Septic .}-�n` ��� (�,` �-��, � NA Dt Bottom ?,IS�
Dosing ,� k k c, NA Installation
Contour
Aeration NA Header/Man. �o I.2�'
Holding Dist.Pipe
PUMP/51PHON INFORMATION Infiltrative �oa 7��
Surface
Manufacturer �� � Demand Final Grade
Model Number 53 GPM ���� '��: ���•�J �
TDH j Lift Friction Loss Sys Head TDH Ft
Forcemain L �-qo� Dia a`� Dist.To Well
DISPERSAL CELL INFORMATION
DIMENSIONS W ',j � � �� #of Cells Type of System Distribution Media Manufacturer:
SETBACK OHWM of Nav Conv ❑ Aggregate
INFORMATION P I L Bldg Well Waters � GP ❑ Chamber Model Number:
� EZFIow
CELL TO � -�- � �-sb r}-S'a' o Mound o Other
-- ---- - — ------------
DISTRIBUTION SYSTEM x Pressure Systems oniy
-- -- — —
Header/Manifold Distnbution Pipe(s) X Hole Size X Hole Observation Pipes
Length Dia Length Dia _ Spac Spacing ❑Yes ❑ No _ _
SOIL COVER
— _ _— _ —
Depth Over Depth Over Depth of Seeded/Sodded Mulched
Cell Center I Cell Edges Topsoil _ ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code tliscrepancies, persons present,etc.)
s�., s�N ��-t�r ��.,.) ���11,e9/ � 1 a4 (a.�
a�- a �o
Plan revision required?❑Yes � No �� �� �� I < . � �� � '�
� lif,.�
Use other side for additional information Date POWTS Inspector's Signature Certification Number
SBD-6710(R.3/01)
A��ITIONAL COMMENTS ANO SKETCH
SANITAAY PEAMIT NUMBEA: �-�•-I�
a �,
�'o Wl�� (.�.k.e,
. �,.� �c�. . :
a�`�
-� . .
_ . . _ . -..- . --.- . - -
�___._ . -- - - -. _ �
�� ►S'r-.�
.� ��� T .
,
e�� ,
-��' - , . ' � - ,
. �
_ , ►,� � _ _
_ - - � - _.__ � _ . , _-- � _.�.__� _T---, :
, ��1 , .
, . -- ,_ ._ :. . .__ __�. .;._ _ ; --- .
, , ,_ ., �.
3 � �
���_ , ,
�
w� I . .
)�p . . --- -. . i.... _. . _ _ ;.-__
i
� �`��O b _
°� �, w�g.�'��,,
`t' �, �(-f
\
� �lolotN �
�
�� y .��� �`l�.�QY r4d(,
� d.�>�.-�4
��,� � ��n. ��.���
�4� � �� �
9� / � �
i ��
Ky_�
, ��J � �
"li� �
Vq
J/1�,� �\
n �.
,
GQ��,�-- ,/�
�;
�
R
�
�
I
�