HomeMy WebLinkAbout010-941-26-1301-LUP-2022-419 SUBMIT COMVLETED APPLICATION AND
FEETo: APPLICATION FOR LAND USE PERMIT
Sawyer Counry SAINYER COUNTY,WISCONSIN O� �I �� ��
Zoning&Conservation�epart. ���' ".�_.'�,-`�'."""." :""—' `..,...'.." �
10610 Main St Suite 49 �r �i' f���P��� ��� P�1,, J.F h
HaY�+�ard,WI54843 � � � . ,. , �. � � l.l lktt.,.._...,_�' V� ,�,�.�.,_
(715)634-8288 � ''` .s:_ _ .�_ . .. . -. � �
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� SE�' 0 8 �022 ' Rcpt;:_!�ew._.�v.,Qr �_d �3SS�- � ,
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tYSTPUCTIONS�. No permiu will he issued until alllees are pa� � µ. (�
Checks are made payable to:Sawyer County Zoning Department. ._y
DO t10T 5'ART CONSTRUCTION UNTIL All PFP.MIT$HAVE JEEN ISSI;ED�APPI��arv7 Diiginal P.pplkation MUST be submitted FILL OUT IN INK (NO PENCIL)
�t, --- �
Submittal of this apv���aY��.on or recelpt of tecs tlnes no;con t tute permR dS�rydte�.��i : .. _
Owner�s�Name: " " '" 'Co4�tfact � � ame �Y/
`�"t-�l�'L'Ll ��(. !`�.V"�"" ----
MailingAddress: MailingAddress:�
7r � �tt� ��� ti c�-rs��:'M�/ �<,Kz�
Phone: ��� ��< ��� � Phone:
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Email: � �tvi'.� l/c.,C �ev�(�WTi��•�r� Email:
Ske address: � �7� <:, �� l�V l i r � �'� ! r� Or Date applied for:
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)
tegaty PIN it � � � �? -U � �� � 7own of: F..i�-. �n.�� �.^ �
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I Oe!m8 delivery Ma!no4 i :;Call Owncr �(Maii Owner -..'al!Contractor �Mait Contra:W r I
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�- Is ProDerty/Land within 300 feet of River Stream p�d. _._. �„ �
InLe•m,t`e^') �: Distanr �^ e is from Shoreline: Iz your vrovcrty
are wetlands
: i / feet in Floodpiain
Creek or Landward side of Floodplain? If yes--continue � ��-1 v� Zone? P�esent?
�Shoreland � ves
Is Properry/land within 1000 feet of Lake,(pond r Flowage I Distance Structure is from Shoreline: Ye
�I"'pes--[cntinue --� �7 feet O
No
(i�/
''�Non-Shoreland
Describe Project
Value at Time of Total 7f of
Project type Foundation What Type&Capacity is the
Completion Number bedrooms
'�.ndude donaud (House,garage,shed,deck, (Basement, Sewer/Sanitary System(5)
Addition,ecc...) of Stories Crawlspace, Post
cime&�•ater�a' �ist separeteH Slab) mnstrudion
5 (,"���� � ��`��
Dwelling
5 �����
Accessory BIEg
� �� ._ .,.. .,.. . . .
nddition/N[eratlon
Height:
TotalSquare Lowest
Footage Gradeto
Prorosed Use � Praposed Siru�lre Dimensions �multiply per Highest
story) Peak
Residence ( x �
Ft.
with 2n°story or loft � x �
Ft.
with Basement ( x �
Ft.
� Attached Garage ( x �
Residential Use Ft.
Aecessory Strueture(e.Pia��) ( � 7 X �� �
❑ Agrieultural �e«a�n�eea,a.�.,�nee.,boa�no�,..,.��� � ' � Ft.
U52 Temporary Guest Quarters or eunkhouse(circie rype� ( X �
Ft.
� Commercial/ oeck/Porch/Patio ( x �
Ft.
Industrial Use � X �
(2n°)Deck/Porch/Patio Ft.
C Municipal Use � x �
OChEr(explain)
Ft.
� Other ( X )
Principal StruCture(Agrimltural,Commertlal,Muniupal,Etc.) Ft.
( X )
Addition/Aiteration(expia�n) F�
7otal habitabie square feet: Tatai Non-habitable square feet: �y �`
(decks,paeios,Barages,sheds,storage area&other structures) ( j1,�
M 4-�
Originai Applicatian MUST be �submitteci
Attach a Plan or Sketch your Property on 8.5" x 11"or 8.5" x 14"paper. 'Must• Include location and seMack of proposed and existing strudures,roads, I
� driveway,sanitary components,well,lake,river,stream,and wetlands. ! -
L __�_._._ .—�._—_
—._—._ _...T..._ _....._._'�__ _' '_
Descriptfon Setback I Descrlption Setback
� Measurements Meawrements
______� __ ..—.. . , -
� Setback from the Centerline of Platted Road and/or � 7 Leet i Setback from the Lake(o�d��.ry n�gn-wac�.ma.t) ��� ` feet i
Setback from the Established Right-of-Way Feet I Setback from the Rfver,Stream,Creek ' '- v Feet i
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I � � Setback from the Bluff if applicable F00t '
Setback from the North Lot Line U Feet
---.._ �. ----
Setback from thc South Lot Line � U G Feet ( Setback from Wetland ', � Feet
�_..__...__ _�.._..T � ---..,. .�
Setback from the West Lot Cine Feet Slope wi[hin area of constructlon/disturbance %Slope .
,.— - --- --...._. __..�
Seiback from the East Lot Line Q Feet Elevation of Floodptain Feet !
Setback to Septic 7ank or Holding Tank �� Feet ' Setback to Wel� i �,l;) Feet
...._ ._.._.....- --
Setback to Droin Field Feet ��
Setback to Privy(Portable, Composting) feet �
... i �t. � '.:e� i i _ ,. t .rtnFd[ „_ . �z�^t ��p,y� f^ ini7i r cP�:S . ^.iY._ , ua§ �,"Y-'h. , .n�'.' .nu_G �'r� . _.f,r • �'..4r�
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. _ ,�c. . � .,�.i .. ,^.S?`t , - _� _. .. .. �. _ . . ' i"�',. . . ___ :h ,. . �.,.ti � , '�:1C .,. .__
CC . (. . ��� .., . , , „ ,.. i , . . . . .. �_ � . ._, i ... . . .�... � .
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�G� Calculate Impervious surfaces.(Roofed,concrete, paved,and other wrfaces that water cannot penetrate.The ZoNng Office can help you determine ii a
( surface is considered impervious)
i
� , -�
,/�.� Lalculate lot area: � / l � .� J
� / /� Indicate lot size from CSM �NOVU �cirde one): � �.� Acres; Multiply by 43,560= Lot area: / �' �� Square Footage
, (%U y �
Calculate impervious surface area: '
1 �✓t � � L � `
�� p���«�� ' Determine the total size,in square feet, of your projects IisteA above (inctude eavesj: � `� sq ft. � � � U C, �� � � i /
p � �, � [
�(/� V�K,�` ����'- Determine the total size, in square feet, of all existing roofed strudures(indude eaves): - % `—V sq ft. �
�O� � � .� � r�<5
Determine the total size,in square feet, of all existing paved/bricked/blocked surfaces ( ` ' � sq ft. Z e I �
/` ,.I i..{' L1 �
f _ � ��p' � I�J ��� �� �~���_�������Add these measurements to determine total impervious surfaces: � tv .___sq ft. I� �� ��P�^�-'i �� t' L
✓/w �� ( J �
,� x t�j'} 7 �� Calculate impervious lot percentage /'7 x � �-/ �
ZG � �( � � ��c ��� � f� ��S\
C ��(, v`�� Total impervious surface: � = Lot area: 7U�'v Sq ft. X 100=impervious surface U % 1
(M¢Igation Is required if total exceedi IS%� �
•"Notice a separate grading permit needs to be obtained if dizturbed area is within the Shoreland district as indicated on previout page and meets criteria below•" �...
---- —......._.._ i
Gradin on a slope greater than 20% �T Grading of more than 1,000 Sq. Ft. on 12Yo-20`Yo slopes ��.
. Grading of more than 2,000 Sq. Ft.on Slopes less than 12% Grading is in excess of 10,000 Sq. Ft. __
� � . ;;z . ., . - ., .. .. ., . . . „ .tr,F... ....
i(we)tledare that Ihis applitation(induding any accompanying informat�on)�has been examined by me(us)and to the best of my(our) knowledge and belie(i[is true,�orrect and
complete. I(we1 acknowledge that I (we)am(are) responsible for the detail antl accuracy of all information I (we)am(are) provlding 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 resuk of Sawyer County relying on this information!(we�am(are�providing in or
. with his application.I (we)consent m�ounty off�cials charged with administering county orAir.ances m have access to the above described property at any reasonable time for the
, purpose of inspection.Additionally,the undersigned person�s�hereby glve permission for acress to the property for onsite inspection by Municipal Officials. �
� i
' Owner �y'���`�_Y � ro .r Owner � ' .-. . � � i�� ;�� � � � �' �
( Signature Prir.tcd name � �� � � �� � �" ���� '�• Date � �� � ���
� � .n „
R:U IfF .� ._. . r fr^. �`( „tcB Wnr:i� �
n _
�.:'.i. ' :nr, � 'd���: , ; '-.,:E� . ;):_:� . ,. �.:�,. ..,I .nr: i ... .��. . . �ir. . . ..,,., . .
"_ i( , .._lili.,v .`.L i'_ ^. t _ ... . ir � �.��h �. . i ..Fa....it5. ..
You are responsi6le for complying with the requirements of the Sawyer Counting Zoning Ordinancez and law and regulations of the Sta[e of Wisconsin.Vou are aiso responsibie for �
complying wrth State and Federal laws conceming consVuction near or on wetlands,lakes,and rireams.Pailure to r.omply may result in removal or modi'ication of mnstruction
thac violates the law a other penalties or msts. Por more information,visit the department oi natural resources wetlands identification web page or con�act a department of
naturai resources servite center(608)2673125
Issuance Information (County Use On{y) Sanitary Number: � p of bedrooms: �
Permit Denied(Date): Reason for Denial: �
-------
Permit N: issuing agent Date
� —�— --- q�3�a�
�
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Is Parcel a Sub-Standard lot ' -. Yes (Deed ot aemrd� �NO Mitigation Required .Yes o
Is Parcel in Common Ownership �Yes (Fused/Contiguous�ot(sl) �'. ' No Mi[igation Attached �Yes ! � Vo ��
is SVacture Non-Conforming � Yes ^�No '��,
Gronted by Variance(B.O.A.) 6rented by Conditional Use
�� Yes No Case p: "�,Yes o Case p:
Was Parcel Legally Created �Yes No ' Were Property Lines Represented by Owner .Yes �.�.� No
Was Proposed Building Site Delineated ves No . Was Property5urveyed Yes I: No
Offite Comments: � Z e Dis[rict: Fee:
� � �� � � � ��
� Hold For Saritary: FiolA Far TBA: � � Nold f-Ur fif[a�.vit� ......_---,__- � Hold Far Feis . �
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