HomeMy WebLinkAbout024-741-06-2307-LUP-2023-040 SUBMITCOMYIEfED FVVLICATION AND -
FEE T0: ���A�I'I(7N FOR LAYJfJ�U¢E PE IT �J
SawyerCounty I .. �YL�:CO[�NTY,.WIStUi�1��1� `�j
2oning&Conservation Depart. � � �,
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Hayward,W154843 �.,..-'�-� �.... ..�..�.
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(715)634-8288 �'r�S �� �3� S
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ZONWG AU�A(hISTRATION su�� W,,r\� ,�-����'�(p�j �i
irvtiRiiflltlNS:Nopermitswillbelssued�ntilallfeesarepaid. :'�'�.�'`��-_�_._..--.. ._.__.._
[hecks are maEe paYable to:Sawyer County Zoning Departmen[. /��,����
DO NOi SIARTCONSiRUCTION tlNTll Atl FERMITS NAVE BEEN ISSUED TO PFPIICANT. O�igindl ApO���aFon MUST bP SubmittCd FILL OUT IN INK (NO PENCIL)
Su�mittal o(tAis applicatlon or.ecei0�o!le��Joe�not conslitu�e permit issuance.
owneq�rvame: l� [ontncm�{s1 Name
�`������a�ad�5 24l�n Dus�2ina-�2
Nf�a`.\�Z �.\�,.� S
Mailing Address: Malling Address:
��1/..7�� G� �r/�T�L7
Phone: Phone:
7i5-S�.S�-�5�.5-/_�
Ema��:�u 5�2mQ� �S`S4� m4�/eCom Ema��:
Site address: � /Y'�/ '1� or Date a Iletl for:
LB atyPlN# �� / Q '�� / Townof: K�OIlV�C, LLC
PermltdellveryMethod �CallOwner '�YlailOwner oCallContractor -.MailContrecmr
_Is ProOerty/Land within 30U feet of River,Stream����i. Distance Structure is from Shoreline: is your vroperty
�^°P1^�<,e^,� ND c%6 � nrewevana:
� �reek or Landward side of Floodplaln? If yes--continue �e1 m����� Fresent?
'rf5horeland ���--� ZO"B' ves
�Is Property/�and within 3000 feet of Lake,Pond or Flowage Distance Structure is from Shoreline: �es N
n ycs—mntinue� y'�7:! feet Na
/ 7
'�..I Non-Shoreland
Describe Projec[
Value at Tme of Total#ot
Project type Foundation What Type&Capacity is the
completion Number bedrooms
'include donated (House,yarage,shed,deck, (Basement, Sewer/Sanitary System�s)
Addition,etc...) of Stories Crawlspace, Post
cime&mater�al �ist separately Slab wnstruction
)
5 — C)— - ��
J(C(� G..__.cf�?i�=a /l ��<z� _ .
DwellinG /
5 3`���st7
A[[e�szary Bldg
S
Additlon/Allere[lon
Height:
To[al Square LoweSt
Proposed Use ✓ Proposed Structure Dlmensions Footage Grade to
(multlplyper Highest
story) Peak
Residence � x �
F[.
with 2n°s[ory or bft � X �
Ft.
with Basement ( x �
Ft.
Attathed Garage ( x �
�Residential Use Ft.
Accessory Structure(e.plain� ( ^,t�, X � ,U
❑Agritulturel �a.�,m.as.,.i<: «� J ��� /,�DU Ft. ��
Use Temporary Guest Quarters or Bunkhouse(arcierype� � x ' Ft.
❑ Commercial/ oeck/vorch/Patio � x �
Ft.
Indus[rial Use
(2"d)Deck/Porch/Pa[io � x �
Ft.
�Municipal Use
\ / x �
� Other�e,pia��l �cxC.� l�c-7 z.�v ��.� � 1 ��U Ft. �i-� ��
'�' Other .(�'
PflOe{paI StfuCluff(NgticulIDral,Commertlal,Munitlpal,Etc) , X , Ft.
Addition/Alteration(e.p�a��n� � X �
Ft.
Total habitable square feet: Total Non-habitable square feet:_�� �?j�D
�decks,patios,garages,sheds,storege a�ea&other structures)
Original Appiication MUST be 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, well, lake, river, stream, and wetiands.
Description Setback Sethack
Measurements Deuriptlon
— Measurements
Setback from the Centerline of Platted Road and/or 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 Biuff if applicable Feet
Setback from the North Lot Line Feet
Setback from the South Lot Li�e Feet Setback from Wetland Feet
Setback from the West Lot Line Feet Slope within area of construction/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, CompostingJ — Feet
Prior to iLe placement or construction of a strucYure within five (5)feet of the minirnum required setback, the boundary line from which the setback must be measured must be visible from one
previously surveyed corner to the other previously surveyed mrner or marked by a hcensed surveyor at the owner's ezpense.
Prior to the placement or construction of a structure more than five(5) feet but less[han ten (10)feet from the minimum reqwred sethack,the boundary line from which the setback musi be
measured musi be visible from one previously surveyed comer to the other prevlously surveyed corner, or verifiable by the Department by use nt a corrected compass from a known corner
within 500 feet of the proposed site of the structure, or must be marked by a licensed surveyor at the owner's expense.
. � • . . . • . • • • • • - .' • • . • • . - .
Calculate impervious surfaces. (Roofed, concrete, paved, and other surFaces that water cannot penetrate.The Zoning Office can help you determine if a
wrface is considered impervious}
Calculate lot area: L,� 7
Indicate lot size from CSM or NOVUS (circle one): � / �Acres; Multiply by 43,560 = Lot area: �/`� ��� �$quare Footage
Calculate impervious surface area:
Determine the total size, in square feet, of your projects listed above (indude eaves): �/�l sq ft.
Determine the tota! size, in square feet, of all existing roofed structures (include eavesM: d!��� 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 surfaws:_ �T\�� sq ft.
Calculate impervious lot percentage
l 'r �
Total impervious surface: 7 � � = Lot area: ������Sq ft. X 100= impervious surface`��/. �5�%
(Mitigation is requlred if total 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 below"•
Grading on a slope greater than 20% . Grading of more than 1,000 Sq, Ft. on 129'0-20% slopes
Grading of more than 2,0�0 Sq. Ft. on Slppes less than 12% . Grading is in excess of 10,000 Sq. Ft.
F;U W ftE IO 013TAIN A PtRMIT or STARI W G CONSTRUCTION WITHGUT A PERMIT WILL RESU�I-iN P[NA�71ES
I (we) declare that this application (including any accompanying informailon)has been examined by me (us)and to the best of my (our) knowledge and bellef(t is true, correct and
complete. I (we)acknowledge that I (we) am(are) responsible for the detail and accuracy of all information I (wej am(are) providing and that it will be relied upon by Sawyer
County in determining whether to issue a permit. I (we)further accept Ilability which may be a result of Sawyer County relying on this information I (we) am(are) provldfng 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
pu�se of inspection.Additionally, the undersigned person(s)hereby give permission for access to the property for onsite inspection by Municlpal Officlals.
�
Owner ��4����.,%""'�c-,-����� Owner � ,/�.��
Signature � Printed name ���� � /� �i�(G�L� ? �
- 1 Date -� �—
{Signa[ure and Pnnted Name required) '
NOTICE: All land Use Pennits Fxpire One (1� Year from the Da[e of Issuance
Fur ihe Construction Of New One &Two f�amily Dwelling: ALI.Municipalities Are Reyuired To Enfor�e The Uniform Dwelling Code.
1 he iocal?own, State or Federal agencie5 may also require 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 S[ate 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 Information (County Use Only) Sanitary Number: �of bedrooms:
Permit Denied (Date): Reason for Denial:
Permit tt: Issuing age� ' Date:
� � �- G�-/ U
�i� ^ ��--.____ _ � �.� a
Is Parcel a Sub-Standard Lot I i Yes (Deed of Record) �y(No
Is Parce) in Common Ownership Yes (Fused/Contiguous �ot�s�J ; i ryp Mitigation Required � Yes I_: No
Is Structure Non-Conforming +�Yes _�ti�,� `� I No
Mitigation Attached �Yes i.-: No
Granted by Variance(B.O.A.) Granted by Conditional Use
❑ Yes , ' No Case If: ' Yes No Case i►:
Was Parcel legally Created Yes _' No Were Property Lines Represented 6y Owner Yes No
Was Proposed Building Site Delineated '`��Yes IJ No Was Property Surveyed "�4`Yes No
�
o iceComments: �k c��,ti�� ��,�� �ti� ;�� `����� ���� �,�y Zone �istrict: Fee:
�:.: G.-,` �oC...^c� '�crc..� av`a�?.•> ?`�r..Sl 1'.�t. �.-�sa�.��� ��\.{ `
n t� G\J'7.`S �t4.er� @�� :�1 i-�� .�,t7 �e`�S� �ff. �:1-L. ` l� ' 1 � �V
Hold For Sanitary: I. , Hold For TBA: _.i Hold For AffidaviL• L_' Hold For Fees: i )
�Feb2021
Real Estate Sawyer County Property Listing Propertystatus: Current
Today's Date:3/17/2023 Created On:2/6/2007 7:55:41 AM
�Description Updated:7/7/2014 'u Ownership Updated:12/22/2017
- . . .. . .. . .... . ...
------ . .._ ._.___.
Tax ID: 24686 BUSHMAN REV TRUST �� �HAYWARD WI
PIN: 57-0242-41-07-06-2 03-000-000070
Legacy PIN: 024741062307 Billing Address: Mailing Address:
Map ID: .7.7 BUSHMAN REV TRUST BUSHMAN REV 7RU5T
Muni[ipality: (024)TOWN OF ROUND LAKE 12159W TART RD 12159W TART RD
STR: 506 T41N R07W HAYWARD WI54893 HAVWARD WI54843
Description: PRT SWNW lOT 4 CSM 9/158#1911
Recorded Acres: 0.490 �Site Address *indicates Private Road
.._..._----------_---- ---
Calculated Acres: 0.527 12159W TART RD HAYVJARD 54843
Lottery Claims: 1 I�l
First Dollar: Yes 1�.�Property Assessment Updated:7/16/2019
Waterbody: Mdlaine Lake 2023 Assessment Detail � �
Zoning: (RRl)Residential/Recreational One Code Acres Land Imp.
ESN: 404 G1-RESIDENTIAL 0.490 75,400 209,200
�Tax Districts Updated:2/6/2007 2-year Comparison 2022 2023 Change
1� �� � � �� � State of Wismnsin Land: 75,400 75,400 0.0%
57 Sawyer County Improved: 209,200 209,200 0.0%
024 Town of Round Lake Total: 284,600 284,600 0.0%
572478 Hayward Community S�hool District
001700 Technical College
�Property History
.. .. . . . _._.__...... .. . . .
�+ Recorded Documents Updated:12/22/2017 N�q
QUIT CLAIM DEED
___._ __._... . . . .
Date Recorded:12/21/2017 410347
SHORELAND RESTORATION/PRESERVATION AGREEMENT
Date Recorded:5/15/2014 390373
WARRANTY DEED
Date Recorded:4/1/2013 384284
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SHORELAND MfiT1GAT(ON AGREENfENT Cf�-yi�a;�������J .
ix:4�4392t
. �437�3
Ownets Name(s)as shown oci deed: �A4��.A CHISSE R �
' }2ECiISTER OF DEE[?S
����Mc,,� ��� ,���� �A1tVYER COUNTY, WI
Parcet tdentikc+6an Numbee �s3 f 2fl�I2023 1Q:31 AM
ct�o���D} ��. �I -�y 1 - o(�-..�� z:� ���O��aNG FEe ��.��
fttts Agreement�tnclude the fattowing exhlbft5: ���F'; �
fxhi�tt A:l.�a�oesaiatierri of the reaf�}afe tor vfikh lhis Agreemer�appfies CP�Feihr? •
EYhJbft 8: f�' a�ort ChedcF�i-Prcferre�ml!}9aGon praclitts mast b4 sel�ste4 al� .
doa,mtni fs rocctded
Extiltrit C: acat�nn flfsl—shoxrs an aaurate EocaiEon(s)of¢ach m8iga�cn pnctlsa(s) - .
seiedtd and setved by Ud5 Agreers�enL
Refum to: Sawyet County Zantnp and CanservalJon Depa�tmeai
S0b10 Mato SL Sutte 49,H3yward,WI 5d843
� �^�� hereb entet into an A
�—'�=a���-- ��u-� y greemen!for Sha�eifne Mitiga�on
on(date of agreementj �"���--� �� . �.���
forProAertY located af(addressj ���� �J -��"� � �
as despibed and aCachcd hereto. •
This agreemer�t,stgned by awner of property attaached�here�yyc�ettifies that ihe selecie�i m3ttgation psadices on said praperty
wiil be wmpJeied/maintainsd Mi�gation pradices sF�ti be sdeded try�gner of this agneetnertt and iru�rafed on foQowing Pa9�.
The owmer(s)hereby agrees t!�property subjest ia this Ag�eemsn(shap have aa selec�eed ml�gation campfeted s[x mantfis
afte�Land Use pertn�is issc�ed. The pmperty Is subject to thls Agreement in perpetuJty�re�ardless of owriership
transfer. .
She owner(sj furthec agrees to atiow authorized representaEives of the Govemmentaf Uait to es�ier onto the owne�s praperiy at
the above descripHon batwe�n ths h�w�s of 8:04AM and 6:OOPM,Monday ttuaugh Friday.[Section 9.13(1 j POWERS�Sawyet
Cotmiy Zening Qrdmancel!o detemiine ff selected mRlgaHan is complet�and that k ls beJng preserved. . .
Volation of th3s Agreemer�t�n71 authacize,In addition tQ othsr p�atpes and r�Gef requb�d under the Sawyer Caunty Zening
Ordsnance,tnjunc�ve reGet.restoratlan of sald property tidd idp�' sifyJng Perrnit App�rcattons. AU parttes agree that this
Agreement shatl be fifed with ttte Sawyer County �ls Department and recorded wittt 6�e Sawyer Caunty
Regtster of Oeecfs. .y ���.,��;•
. . �� C'' ��'�,..¢ °`.�f-�" , `
. �afr �� �
, m w
-On ona owner sF awro re ulted. � s�'' . ���'; ;�r,n' ACK@lOWLEDGMENT
� ��'s Signature; -✓' �� � �
L 1
, ;� .� �`�•., �� ��bfi _ l.��s c.v n s, •,.
�,: S.� '� ��' �• '° N `,�C1 ~.�,af: S
�WRP.r'S 8n1B(P � t):� �7 / r����� . w �'�'n •C w��,1 r
e�s �,�,� '�'�"ubscn'bed artd swom to trefore e ort th(s
�� ;�; J �,,�S f�i�-� .rl ��� �day of �'►'1 �r 20 .Z3
Date: � / .-� BY jOwnets hiame): i� w-�t rd� - u���r,�
/ Notary Pubiic Signabure: �.c� � f"� „�i
Drafted by:'� � Public Notary Name(Print): �::s y,Ncr�-I,;,��,i� �
�`- ` -���...�• My cammission expires or�_ f � -.,2��t S
iVotarial Officer by Wis. Stats
140.10 (1) {f) and (2) Countv C�er�
Persanal informatian you provide maybe used for secondaryPurpases(pmrac�Lzw,§t5.44(ry(m)I RBv.04lS4116
/'''
�
Mitigation points are required for developing Property owneropt(ons to eam mitigation points
property under the following conditions. include:
. Impervious surFace coverege is greater Removal of a stmcture within shoreland setback
than 15%but less than 20%-3 polnts ❑ ❑ 5100 Ft�-1 Pt.
❑ 101 FtZ—250 Ft�-2 Pts.
❑ 2251 Fl�—3 Pts.
• Impervious surface coverage is greaier�. �nstallation of a rain garden
than 20%but less than 309'o-4 points ❑ TreaG 0-250 Ft�-1 Pt
❑ Treats 251-500 Ft=-2 Pts.
❑ Treatr greater than 500 Ft�-3 PCs.
• 5 200 ftzLateral Expansion of ❑Passive Restoretion(Natural Recovery)of a
Nonconforming princ3pal structure within compiiant shoreland buffer-1 poiM
the shoreland set-back-2 points ❑ �Reducing width of allowable view and
access torridor(s)-1 point for every 10
foot reduction
• Relocation of Nonconforming prinapal ��ncreasing depth of an existing compiiant
strvcture within tfie shoreland setback- shorefand buffer4 point for every 10 feet of
depth
1 point ❑ �
❑Eiiminate shoreline Iighting 5 35'from lake
shore-1 point(Must submit before and after
• Open sided struciure requiring at least photographs) �`
70%ofthehalfoftheshorelandsetbadc ���ng compliant shoreland buffe�2points
area that is nearest to the water is covered ` �
by a vegetative buffer zone as per ❑Active Restoretion{Accelerated Reco�y)of a
5.59.692(Sv),Stats. 35'shoreland buffer-2 points
� ❑Sea Wall Removal and Bank Stabilization-2
points fDNR permits may be requiredJ
❑Replacement of steel septic tank-2 point5
(Tank must be installed before SMA is
recordedj
❑Instaliation of a Storm water Infiltration
Sysiem•3 poinu
❑Increasing Shoreland Setback-1 point for
every 15 foot increase beyond required.
(max(mum of 3 points)
#024-741-06-2307
That part of the Southwest Quarter of the Northwest Quarter (SWl/4NW1/4), Section Six
(6), Township Forty-one (41) North, Range Seven (7) West, described as Lot Four (4)
recorded in Volume Nine (9) of Certified Survey Maps, page 158, Survey No. 1911.
doc #184934
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