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HomeMy WebLinkAbout002-940-15-1405-LUP-2010-108�3 Application for Land Use Permit (*Non-shoreland*i o County of Sawyer PO Box 676 - Hayward WI 54843 715/634-8288 lake or pond ,Property that is not Located within 300' of a creep river or stream or within 1000' of a flowage, or does not have any oFtlie above waterbodies located within the property's boundaries. CONSTRUCTION SHALL NOT BEGIiV UNTIL ALL REQi7IItED PERNIITS HAVE BEEN ISSUED. SIGNATURE OF PROPERTY OWNER IS REQUIRM. USE BLACK I�NK� /OR PENCIL $yam lU ��� v c��i" /t/e•�1tiiC�' Owner < Builder vC,:VT M ling Address M ' ' .g�jdrss City, State, Zip City, State, Zip �z- 3-7 -71 Daytime Phone' ,p Daytime Phone L!D 5 �o� 1 cs44 vo1'Jr /YS `�/�`t7 �Z `9'�!D -/�- Site address: 'ugZ ��q!?�� `� �� (Number -and name of road) Proposed construction (check one): building. Number of bedrooms: (New or replacement dwelling/primarY ( )New or replacement accessory building ( )Addition or alteration to dwelling/primary building. Total number of bedrooms:_ ( )Addition or alteration to accessory building ( )New business or use of existing building ( )Use of land (such as mining, grading, filling) Additional information: Construction Cost: Primary Structure $ �' Accessory Building: $ Addition: $ Describe what you are building. List each project s parately. ft 1 Z �� sq ft. project#1.Size of footprint: Z'$ ft.x • A p Total sq ft: .24 769 Height from grade to peak: z ,(This total includes additional stories or lofts.) ft 7 ft. Project#2. Size of footprint: � � ft - sq Y e- Total sq ft: Height from grade to peak:.T ;7 ft = sq ft. Project#3. Size of footprint: ft.x Total sq ft: Height from grade to peak: (rear lot line) Show lot dimensions and indicate north. Draw the location, size, and dimensions of of each structure on the property. indicate new structure. Show driveway access. Draw the location of the septic system and distance to Structure. Show location of any wetland. Show the distance from the structure to N road centerline, lot lines, wetland, septic system (drainfield and/or tank). Z,6 ZIT Notice: -- Land use permits expire one year from issue date. K� The undersigned certifies that the listed Information and inten- cv lions are true and correct, that all work shall be performed In compliance with the requirements of the sawyer county Zoning Ordinance and the laws and regulations of the State of YYisconsin. The undersigned person(sspheererebby give permission access for to the property for Mile Q 1 D ✓@� � l J /�0 Signature of property owner (or agent with Permit Fee Power of Attorney). 0-0 1 OQ co R I I A Real Estate Sawyer County Property Listing Today's Date: 5/5/2010 Page A of 1 Property Status: Next Year Created On: 3/31/2010 10:10:55 AM „i mr uescri Llo Updated: 3/31/2010 Tax ID: 40722 PIN: 57-002-24"9-15-104-000-000050 Legacy PIN: 002940151405 Map ID: .4.5 Municipality: (002) TOWN OF BASS LAKE STR: S15 T40N R09W Description: PRT SENE LOT i CSM 28/96 #7212 Recorded Acres: 5.000 Calculated Acres: 0.000 Lottery Claims: 0 Flrst Dollar: No Zoning: (RRl) Residentlal/Recreatlonal One I Tax Districts Updated: 3/31/2010 1 State of Wisconsin 57 Sawyer County 002 Town of Bass Lake 2478 Hayward Community School District 17 Technical College A''Recorded Documents Updated: 3/31/2010 © WARRANTY DEED Date Recorded: 1/6/1993 232979 500/207 Ownership Updated: 3/31/2010 ROBERT W & JANIS K BERGUM HAYWARD WI Billing Address: Mailing Address: ROBERT W & JANIS K ROBERT W & JANIS K BERGUM BERGUM 11901N EATON ROAD 11901N EATON ROAD HAYWARD WI 54843 HAYWARD WI 54843 T Site Address N/A 0 Pronerty Assessment Updated: N/A 2010 Assessment Detail Code Acres Land Imp, N/A 2-Year Comparison 2009 2010 Change Land: 0 0 0.0% Improved: 0 0 0.0% Total: 0 0 0.0% [5 Property History Parent Properties Tax ID 57-002-2-40-09-15-1 04-000-000030 40256 5/5/2010 STATE BAR OF WISCONSIN FORM 3 - 2000 Document Number QUIT CLAIM DEED This Deed, made between ROBERT W. BERGUM AND JANIS K. BERGUM, husband and wife Grantor, and BRIAN G. BERGUM, an adult single man Grantor quit claims to Grantee the following described real estate in Sawyer County, Stine of Wisconsin (if more space is needed, please attach addendum): Lot Three (3), Block Five (5), Fox Run Subdivision iiii oiii s 3 6 6 3 3 11 1 s 366331 PAULA CHISSER REGISTER OF DEEDS SAWYER COUNTY, HI 05/03/2010 02:25PH REC FEE: 11.00 IF ESENPr 08 PAGES I ALSO: Part of the Southeast Quarter of the Northeast Quarter(S11KNE'/.ore ), Name and Return Ad, Section Fifteen (15),w Tanship Forty (40) North, Range Meals) Wesq mRobertW. Bargain particularly described as Lot One as recorded in volume 31 or Certified P.O. Be. 241 Survey Maps, Pages 96-97, Survey No. 7689. Hayward, WI 54843 Description provided by Grantor Together with all appurtenant rights, title and interests 236-12845-0300a 002-940-15-1405 Parcel Identification Number (PIN) This is not homestead property. OW (is not) Datedthis 6th day of April . 2010 • Rithert W. Ber um K. Berinum AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Signatures) — - SAWYER County I Personally came before me this 'Vol day of authenticated this day of April ,2010 the above named TITLE: MEMBER STATE BAR OF authorized by 4 706.06, W is. Sees I THIS INSTRUMENT WAS De HAYWARD, WI 54843 (Slanaluna may be amhentimed or acknowkdgod. QUIT CLAIM DEED p�BLIC STATE BAR OF WISCO FORM No. 3-2000 ate of WISCONSIN is permanent. (If not, state expiration date: INFOPRO (0001a55-2021 wwx eiraprolaemcom �esaa1 1011 W[1ww .SSK W3-Ob-10 J101 1 _ tnr n p 1011, e p 0!R-Bb-IS 1103 OOR-H10-15 110] 001-Hb-IS 1102 LW 00R-M-15 .10, W3-Bb-15 1301 1➢r 1 ,-1YC I Ste' IOiI.K i6G,G I IfiFC {pf 16 L5i IB O O W1-Bfi0-I5 31W p1R-H{0-1] 3106 fi,YC _ 6915G NE —NW � NE—NE _Ilol NW —NE p o 5 _IIDS Wz-Hfio-m 1101 2 I.Br a w u Lm n LHr 11 J 3 � o5z-wo-ls 3103 W3-H0-IS pn-B"-IS 01R-OW-IS 1 �9 L SR1K RiN Rlw 2t05 Lq_Bb-I51R01 11]K yy,K i1YC _2 > ID! p w p LIT , O pIl-Bb-15 RL01 S9BK F- M-Hb-15 1J05 YI Wra ]b.c $gam C \ 003-Hb-153bR 33� 3 I.. SW —NE SE —NE O LIT,SE—NW W, iB W3-H.0-r!1]01 C0:-HW-13iN1� K y 2ba JB.fiS,G O C01-Bb-IS y 1 ssuc LOr a e ,WK � �d� ° aol-Bb-ts 14w iBSK 3 aax=sw u�l mz—Hw—le sw1 ,� WyB�ls-<me _ �i�i Wi-9b 1 tl02 NW —SE iuA, 357576 REGISTER OFRAULA DEEDSCHISSER SAWYER COUNTY, WI 01/07/2009 00:15AN SEE FEE: 15.00 PAGES 3 SAWYER COUNTY CERTIFIED SURVEY MAP LOCATED IN THE SOUTHEAST OUARTER OF THE NORTHEAST QUARTER, SECTION 15, TOWNSHIP 40 NORTH, RANGE 9 WEST, TOWN OF BASS LAKE, SAWYER COUNTY, WISCONSIN. INCLUDING ALL OF LOT 1 OF C.S.M. No.7212 RECORDED IN VOLUME 28 PAGES 96-97. LINE TAB&£ L1 Na9'40'48'W 33.05' L2 = S89'39'24"E 33.05' (L2) v (S89'55'013"E 33.05') Lag 9 Lom 9 I LZjW-Ak ZLRA I ESN-NaZtsa (SBPBS',5p'E 4]4.89') ( (SOP35'OB�) NE 1/ie cORNER 89'39'48"E 474.8 S89'39'24"E 841.21' sE0.15-40-1 BOBJ a' (BJ3,B9') OR O •`II W IR � LOT 1 QI w 1,692.510 SQFT. 38.85 ACRES hz CE 1/IB CORNER ]84.58'-19].37' _ (113a4- SEC.15- M I16,J4' N89'40'48'YY 1310.3 r >r 'PEEP.I Lag aI 4a.Z 3 / dN2 1 }9474B�Et23 1 E3J�G_Xa. Z37s I t.S..1L-Hn Zy7¢ TJ I GS!,.(L-N2. ZiG3 FOUND 5{8' SQUARE IRON BM .41 SOURI OF INC.L JOB p 06808 Prepared by Jesse Suzan. LaTEd Suruey'ing LLC Phone No. (718) 634-0774 13731 W S)ostrom Circle O' 300' 600' Hayward, WE 54843 Sheet i of 3 Sheets SCALE IN FEET i" = 300' Certified Survey No. 7 6 O 4 NOPS IS! CORNER p SEC.ts-�o-s i ��F WARD $VINEY MARKER NIIL I �1 Q � , �I 4I�j1I INpATH 1/l8 CORNEN ON E.IJNE : SEC.15-b-B 1 al i �I s C; N it G yl +>YI CIUU 1/5 CORNER SEC.15-b-9 FOUND 3-1/4- ALUM. WON. LEGEND 0 P, L.S. S. Corner Monument of Record as noted. • Found Mag. P.K. Nail 0" Found 1-1/4" O.D. Iron Pipe ® Found 1" O.D. Iron Pipe ■ Found 5/8" Square Iron Bar It Approx. Undelineated Wetland (xxxx) Recorded Data VOL 3 0 PG 2 4 8