HomeMy WebLinkAbout002-940-05-1220-LUP-2022-305 SUBMIT COMPLETED AVPLICATION AND (� \
Feero: APPUCATION FOR LAND USE PERMIT ��
Sawyer County �N �
Zoning&Conservation Depart. f-ilf? � � J�' �� �
10630 Main St Suite 49 1; �J`� ���t R�� �a�E_, � '� a.�. �
Hayward,W154843 '` I
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INSTRUCTIONS: No permits will be issued until all fees are paid. �AW��R C'���jY
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Checks are made payable to:Sawyer County Zoning Department. _,. ._-
DO NOT STAR7 CONSrttUCTION UNTIL All PFRMITS HAVE BEEN i55UED TO APPLiCANT. Original Applit8tion MUST be submitted FILI OUT IN INK (NO PENCII)
Submittal of this application or receipt of fees does not constitute permit i55uance. �
Owner(s)Name: Contractor(s)Name
� ` �;c ���T �
E ��� �j <.�<��-�r
Mailing Address: , Mailing Address:
���-1 � /�� l-I �Z.s�.S�� ��1�`�
Phone: �(�_ �� _i ��S Phone:
IC
_f � I —
Email: �I V�r51U '�'.v^Y1VS1� ��,.V�2�ei= ��� Email:
Site address: �Q Or Date applied for:
Legacy PIN# l�,Q r' �j�'10— G -- � �i � rown ot: 1��1 S� L cl l�-�.
Permit delivery Method Call Owner �Mail Owner ❑Call Contrector ❑Mail Contractor
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Is Property/Land within 300 feet of River,Stream I�nci. Distance Structure is from Shoreline: Is your Property
Intermitrent) _.� � Are Wetland5
in Floodplain
Creek or Landward side of Floodplain? If yes--continue PresP�
�ghoreland - -- �- zone? es
Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: Yes
If yes--continue --� teet NO No
'.� Non-Shoreland
Describe Project Total�of
Value at rime of project type Foundation What Type&Capacity is the
Completion (House,garege,shed,deck, Number (gasement, bedrooms Sewer/Sanitary System(s)
"include donated Of StOfi85 Post
time&material Addition,etc,..) CfawlSpate,
List separateiy Slabj construction
5 � �'���. �.
Sc eN� � �
1 pos-�-
Dwelling
S
Accessory Bldg
$Z�c�,C_�C,
Addition/AlteraUon
Height:
Total Square Lowest
Footage Gradeto
Proposed Use ✓ Proposed Strutture 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.
Accessory Structure�expiair,� � X �
OAgrieultural (detachedgarages,sheds,boathouses,etc) Ft.
Use Temporary Guest Quarters or Bunkhouse{cirde cyPe) � X �
Ft.
( X )
❑ Commercial/ Deck/Porch/Patio Ft,
Industrial Use X
(2"d)DeCk/Porch/Patio ( �� a � � ) S,j�� Ft. �
❑ Municipal Use � x y
Other(expla�n) Ft.
❑ Other ( X )
P�I�CIPBI StfUCYUYE(Agricultural,Commercial,Munitipal,Etc.) Ft.
( X )
Addition/Akeration�exPia��� Ft.
Total Non-habitable square feet: j G'g
Total habitable square feet: (decks,patios,garages,sheds,storage area&other structures) J
Original Appiication MUST 6e submitted
Attach a Plan or Sketch your Property on 8.5"x 11"or 8.5"x 14"paper:'Must'Include location and setback of proposed and existing strudures,roads,
driveway,sanitary components,weli,lake,river,stream,and wetlands.
Description Setback �� Description Setback
Measurements Measurements
Setback from the Cenferline of Platted Road and/or �la �-' 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 y�`-"^Feet
Setback from the South Lot Line � � Feet Setback from Wetiand -f— Feet
Setback from the West Lot Line 1 � feet Slope within area of construction/disturbance_ �j- %Slope
Setback from the East Lot Line (p O Feet Elevation of Fioodplain feet
Setback to Septic 7ank or Molding Tank ~ Feet Setback to Well � feet
Setback to Drain Field. � Feet
Setback to Privy(Portable,Composting) Feet
P;o-to tF� ,, .� �.. .,r�„ ,,r.irtlnn�,f.��.��,dure�.vlthin five i5)feet uf[h .-���num requlred s�tback,[he boundery line from which the setback must be mensured must be vlsible irom one
,.�evrou<ly s�.�iv�•y�d corncr te tlie othei p�uv�u�,sly surveyed corner ur marked�v e I��r�nsed surveyo�at the owner'z expense.
c>nor ro the placement or construction of a struciure more than five(5)feet but less than ten�10)feet from the minimum required setback,the boundary line from which ihe setback must ne
measur��d must be visible irom one previously zurvevr.d corner to the other previously surveyed torner,or veritia6le ny the Department by use of a corrected compass trom a known corner
wi,hin SGO feet of the proposed site of the structurc,or must he rnarked by a Gcensed surveyor a:the owner's expense
. • � - �� • . • .
Calculate impervious surfaces.(Roofed,concrete,paved,and other surfaces that water cannot penetrate.The 2oning O�ce can help you determine if a
surface is 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(inciude 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 %
(Mltigation is required if total ezceeds 15%)
•"Notice a separete grading permit needs to be obtained if disturbed 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 than 1,000 Sq.Ft.on 12%-20%slopes
r Grading of more than 2,000 Sq.Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq.Ft.
� ),1l3TAI(4 A PFRMIt or51ARTING CONSTRUC"i0N J. ���� _ � -^.itl '� _�.F'�JJ�.i'.N Pa_^,q�_7�ILS
I(wej 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. t(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 I(we)am(are)providing in or
with this application.I(we)consent[o county officials charged with administering county ordinances to have access to the above described property at any reasonable time for the
purpose of inspection.Additionally, e undersigned person(s)hereby give permission for access to the property for onsite inspection by Municipal Officials.
Owner � Owner • "� `
Signature �-c--- Printed name�Ql"�"h �VC�I).�'\�Y��I Date � ' �� `�oZ
(Slgnature and Printed Natne required) T
TICE�, �II Land Use Permits[xpire One(i)Year from the Date of Issuance
For�hr Constructior Of Mew Orie&Two Family Dw�lling� ALL Municipalities Are Reoulred To Enfor[e The Unifr,rm Uwellln�Cod��
l he local Tuwn,Siate or Pederal agencies may also require permits.
You are responsible for complying with the requirements of the Sawyer Counting Zoning Ordinances and�aw 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: #of bedrooms:
Permit Denied(Oate): Reason for Denial:
Pefmit tt: Issuing agent: Date:
a � - 3 os ;/ __ �/s��,,�
Is Parcel a Sub-Standard Lot i:Yes (Deed of Record� x No
Mitigation Required Yes No
Is Parcel in Common Ownership �!Yes (Fused/Contiguous Lot�s�) i:No Mitigation Attached ! Yes �IVo
Is Structure Non-Conforming I'Yes ��No
Grented by Variance(B.O.A.) Granted by Conditional Use
'1 Yes _ No Case 7t: Ves No Gase p:
Was Parcel Legally Created �'Yes No Were Property Lines Represented by Owner 'aCYes I No
Was Proposed Building Site Delineated �Yes No Was Property Surveyed �Yes �i No
Office Comments: Zone District: Fee:
� � � �� �
Hold For Sanitary: Hold For TBA: : Hold for Affidavit: Hold For Fees:I
�Jan2o2o
7/26122,2:15 PM Novus-Wisconsin Access rev.13.1108
Real Estate Sawyer County Property Listing Property Status:Current
7oday's Date:7/26/2022 Created On:2/6/2007 7:55:06 AM
�Description Updated:9/30/2011 �Ownership Updated:9/30/2011
TaxID: 2834 KEITH M DOUGHERTY HAYWARD WI
PIN: 57-002-2-40-09-OS-1 02-000-000200
Legacy PIN: 002940051220 Billing Address: Ma_ling Address:
Map ID: .2.20 KEITH M DOUGHERTY KEITH M DOUGHERTY
Municipality: (OOZ)TOWN OF BASS LAKE 9542N HORSESHOE DR 9542N HORSESHOE DR
STR: SOS T40N R09W HAVWARD WI 54843-2596 HAYVJARD WI 54843-2596
Description: PRT W12 NES/4, LOT 18 CSM 5/307
#1058 �Site Address *indicates Private Road
Remrded Acres: 1.620 9542N HORSESHOE DR HAYWARD 54843
Lottery Claims: I
Firs[Dollar: Yes
Zoning: (R-1)Residential One J Property Assessment Updated:9/13/2012
ESN: 406 Z022 Assessment Detail
Code Acres Land Imp.
�Tax Districts Updated:2/6/2007 G1-RESIDENTIAL 1.620 15,200 110,100
1 S[ate of Wisconsin Z_year Comparisan 2021 2022 Change
57 Sawyer County Land: 15,200 15,200 0.0%
002 Town of Bass Lake Improved: 110,100 110,100 �.0%
572478 Hayward Communiry School Dishict 7otaL 125,300 125,300 0.0%
001700 TechnicalCollege
+ Rewrded Documen[s Upda[ed:11/21/2007
O QUIT CLAIM DEED �PropeRy History
Date Recorded:10/15/2a07 349666 N�A
O WARRANTY DEED
Da[e Recorded:5/15/1997 260706 603/195
https:l/tassawyercountygov.orgllAccess/master.asp 1��
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