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002-840-18-5110-LUP-2024-158
SUBMITCOMPLETED 0.PVUCATION AND Fee ro: APPLICATION FOR LAND USE PERMIT SawyerCounty SAWYERCOUNIY,WISCONSIN �a.�e �j I S a� Zoning&Conservatioe Depart. F � � � � 4 1\ // O�y �� n \ 10610 Main St Suite 49 � i [� o' E�F,l� �^�.� h k# ���-3 ----�- .� Hayward,WI 54843 ---F � (715)634-8288 � �; � , ,�: MAR 1 2 2024 c���_ �`� �° �� — ��� ���� No perm'rts will be issued until all fees are paid. ( ^ [heckz are made payable to:Sawyer County Zoning Departmenc v; — t <'i5i F.c s�i�m..itt�d FILLOUTtNINK � . .�.��`..� : . __ sawY�:� c�� �,-j-., - � � Owner(s)Name: � Contnctm�s)Name I �c � � �u��ft-n 1`�l 1�oF� I' 4.Q-na,n l:��l S�c�`a-,� L-L.cr MailingAdd ss: I MailingAddress: ` 1 \ ��OL��'X7u"L uS �- r�y �1t1 'j5tj�1 i��%�}� �iL Ft- �✓Yic�3 �'J' `�Z-j�3 rPhone: �-l� �5�"��,3�13 Phorre: ���' ��`7� 1FS�.I.`� 7 J Email: ��O :.D� C� L�'��,CN'✓� Emaii:�i�(1 cL �\Qe� C M �e Ct�. . �./)!r\ � Site address: !�ZV� � O��- �I'�� Or Date applied tor. ' � �egxy PIN p � �/(..i L— ��l�.. �� S�I� Town ot: .SS �;-�C..z i. Dermit delivery Method c Call Owner c Mail Owner �all Contractor �^Mail Contrector I — ��. Is ProDerty/Land wkhin 300 feet of River,SVeam Unci. Distance Structure is from Shoreline: Is ruu>CrouF�n r . �m<,mrn�oq � feet . . _..a�n �. Creek or landward side of Floodpiain? '� �Shorela�d �Is Property/Land within 1000 feet of Lake,Pond or Flowage Distance SWcture is from Shorelirte: � x � `�-�p feet '�C ���.;Non-Shorcbnd ____ peKryy� Project 7otal#of Value at Time of project type Faundation What Type&Capacity is the Completio� Number bedrooms (House,garage,shed,deck, (Basement, Sewer/Sanitary System�s) nddition,etc..) of Stories Crawlspace, List separately Slah) S?g-1 wc.u:. �,� � S�� � ���� Tr�.�—yo�� � Dwellin5 $ Accessary eld5 5 nddKion/Altera�ion Height: TotalSquare Lowest Pro ed Use � Proposed Structure Dimens{ons Footage Grode to p� (multiply per Highest story) Peak �/ Residence '��' X l� ' /�00 Ft. ij , with 2nd story or loft � 3� x �l 7� , �y O b Ft. �� � X ) with Basement Ft. � X 1 �Residential Use Attached Garege Ft. Aecessory Strueture le.via��) � x � -� �a�ea�nea ga.�¢:.,�nea:,no,e no�s.:,em) F�' _ Agricultural ( X � Use Temporary Guest Quarters or Bunkhouse(c.de ryve) Ft. ( X ., ) � Commercial/ ✓ Detk/Porchj� �V �= ,��O FL ��J Industrial Use ( x 1 ✓ (2"d)Dec�/Patio \0 � t�u Ft. 1� 1 � Municipal Use ( x ► Other�exPia��1 Ft. � Other ( x � Prineipal Strueture�aqdc�ic�rei,comme�c�ai.M���c�oai,ecc.) Ft. � x 1 Additioo/Alteretion Iexpia��1 Ft. Tatal Non-habitable square feet: ��� Total habitable square feet: 2'��� (decks,patios,garages,sheds,storage area&other struaures) Attac�h a- or your Properry on 8.5"x 11"or 8.5"x 14"paper.'MusN Indude loation and setback of proposed and existing structures,roads, ; j ddveway,sanitary componeMs,well,lake,rfver,stream,and wetlands. . ,____ —�_.�J l p���� -- 5etback ���n Setbadc MeasuremeMs Meawremenis _-- I - � Setback from the Centerline of Platted Road and/or � p� � Feet Setback from the Wke(o�m�ary n��gn-w,ie�m,�) \ Feet Setback from the Established Rightof-Way eet ' Setback from the River,Stream,Creek feet � I Setbackfrom the Bluff�e,Ppr<aa� Feet ' Setback from the North Lot Line i (,L+ feet Setback from the South Lot Line � �'�(} Feet Setback from Wetland Feet �� Setback from the West Lot Line ' Feet Slope within area of construction/disturbance U %Slope � . Setback from the East Loc Line �, Feet Elevation of Floodplain Peet Setback to Septic iank or Holding Tank �U Peet Setback to Well Feet Setback to Orain Kield i Feet 4 Setback to Privy(Portable,Compos[ing) Feet I � � _�.v�thin f:�.�-. � � .. . . ,...�eye�. . . � � .... �. . . -.. .. . . . ....,,e;; . . . . ,_�.,�:. � ,�.��- .'.�i�.p,�.i ,_.:,.,,. ,., .,,... .-_-.';�:�.. . � �:;r.'..., ., . .::• � by.�'.e�cPa t �, .. . .._., c t ._o.-ue5s . , .,�.... . � ... .,.... . ,. .�. .. ,�...Of.e.:. _� _��s'ec"�e,i �..' ' ' ' v _'i. _,_- - . . ... � . '__—._. _.._. __ � � Cakulate impervfous wrfaces.(Roofed,concrete,paved,and other wrfacez that water cannot penetrete.The Zoning Office can help you determine if a wnc�e Is considered impervious� Calculate lot area: Z (� Indicate lot size from CSM or NOVUS(circle one): J Acres;Multiply by 43,560=Lot area:��� �,-1 Square Footage Caicufate impervious surface area: I Determine the rotal size,in square feet,of your projects listed above(indude eaves): \��.t3 a'� sq ft. j Determine the total size,in square feet,of a�i ezisting roofed structures(indude eaves�: ��`L zq ft. i Determine the to[al size,in square feet,of all existing paved/britked/blocked surfaces: sq ft. Add these measurements to determine total impervious surfaces: sq ft. Calcu�ate impervious lot percentage ITotal impervious surface:���� +Lot area:�� ��'�q ft.X 100=impervious surface � % ; �Miiigatbn is required if ro[al eKceeds 15%) � j '••Notice a sepa2te gradfng permit rreeds to be obtained'rf disturbed area is wRhln the Shorela�d distrid az indkated on previous page and meets criteria bebw•'• � Gradin on a slope greater than 20% Grading of more than 1,000 Sq.Ft.on 12%-20Y slopes Grading of more than 2,000 Sq.Ft.on Slopes less than 12Y Grading is in excess of 10,000 Sq.ft. II(we)declare that this application(inciuding any acmmpanying information)has been examined by me(us�and m the best of my(our)knowledge and belief it is true,wrreR and � complete.I(we)ar.knowledge that I(we)am(are)responsible for the detail and accurecy of all intormation 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 Counq relying on this inkrmation I(we)am(are)providing in or I with th-is apptication.i(we)consen[to counry off�cials charged with administering county ordinances to have aaess to the above descri6ed property at any reasonable time tor the ipurpose e°inspec� .Additionall underzigned person(s�hereby give permission for access to the property for onsite inspection by Municipal Officials. IOwner Owner �� .[ �y ' Signature Printednam�V��S ' 6��'�kr� Date� �Z' �Z \ Vou are respons�ble for mmplying with the requiremenLs of the Sawyer Counting Zoning Ordinances and law and regulations of the State of Wisconsio.Vou are also responsible for complying with State and Federal laws concerning construciion near or on wetlands,lakes,and streams.fa�lure to wmply may result in removal or modiFlcation of construction that violates the law-or othei penalties or costs.For more information,visit the department of na[urel resources wetlands identification web page or contact a department of natural resourc ervice tenter(608�267- 5 � 1`"e�1t7 6'1 YIQ,� � Issuance Information(County Use Only! Sanitary Number. �U _ �G I a of nearooms: —� a Fermit Deoied(Date): Reason for Denial: � Permitlt: � Issuingagent Date: � a�l-�Sa ;�� ��s 3`( I Is Parcel a SutrStandard Lot i f Yes (Deed of Remrd) _ �(No Mitigation Required �.'Yes ,y/���,-, 15 Parcel in Common Ownership �Yes (FusedlConeiguous loclsp � No MRigation Attached :. Yes F No Is Strutture Non-Conforming Yes �'No � Granted by Variance(B.O.A.) Granted by Conditional Use ��I Yes No Case p: ��'.Yes�No tase N: i Was Parcel Legalry Created rYes .-'No � Were Property Lines Represented by Owner XYes No Was Proposed Building Site Delineated �Yes _'No Wat Property Surveyed �=Yes No Office Commentr. - � Zone DistriCt: ! Fee: � � �\C.�,t o-����^�� �'7R^Cut�+�-rrt�� ) � I I ��� I��x\'.-.� �yZ. �S ��� � ►J c t1�"'y�- -.-�c.��=� ' ; � --- _ _ ------- �F¢62071 Redl EStdte Sawyer County Property Listing PropertyStatus: Current Today's Date:3/20/2024 Created On:2/6/2007 7:55:05 AM �Description Updated:1/6/2001 '�Ownership Updated:2/6/2007 TaxID: 2206 GARY W&SUSAN M NOFF RUSHFORD MN PIN: 57-002-2-40-08-18-5 OS-001-OOD100 Legacy PIN: 002840185110 Billing Address: Mailing Address: Map ID: :1.10 GARY W&SUSAN M HOFF GARY W&SUSAN M HOFF Municipality: (002)TOWN OF BASS LAKE PO BOX 702 PO BOX 702 STR: 518 T40N R08W RUSHFORD MN 55971-0702 RUSHFORD MN 55971-0702 Description: PRT GOVT LOT 1 Recorded Acres: 0.821 w Site Address *indicates Priva[e Road Cakulated A�res: 0.806 14206W OMAJIK LN ' HAYWARD 54843 Lottery Claims: 0 First Dollar: Yes �-.�Property Assessment Updated:10/10/2023 Waterbody: Grindstone Lake 2024 Assessment Detail Zoning: (RRl)Residential/Recreational One Code Acres Land Imp. ESN: 445 GI-RESIDENTIAL 0.821 252,000 76,700 �Tax Districts Updated:2/6/2007 2-Year Comparison 2023 2024 Change 1 State of Wisconsin Land: 252,000 252,000 0.0% 57 Sawyer County Improved: 76,700 76,700 0.0% 002 Town of Bass�ake Total: 328,700 328,700 0.0% 572478 Hayward Community School District 001700 Technical College � ��tlJ Property History +� Recorded Documents Updated:1/17/2011 N�q WARRANTY DEED Date Recorded:12/2/1996 258080 592/203 PLAT OP SURVEY Date Recorded:2/16/2030 18408-20 . I �3�`��: ,_y. �{��. :k. . ' 3 � �' r � _ k � . � � � << � � �. � ` f � �b� .. . . ... �. I ' � �''�j� 1[. � �� �� t��� �� � !: � �� z ��. �. i �.� � � �� � �� ,�. � � aar t� � � �. ;' �" "' � ,. : ,-., . ar,y�� y� � + .�" r:: — � �. ;5 � . �. � � �"''"°�j�h ��n�dF. . 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M �..�1 �7 �_. �.1� *t�` '� a.�' �� � .Y�T .�,�.: �• � _1 9���.J,#� a Ia f• •�� F � �r � .1� - � ����t � * a . �t� �� ... k y� }�,� �a�..� � ^ '�'�F !��-+ .���.r1 ,,��� � +d�� }A k�• T.r rr S 4 �.. �'q; Ll�_ S�. '� :�j� ti�a. .��'� F�:. ��`A ..`��n, �.� POWER OF ATTORNEY Kno�v ta all �1en by these gres�nts, that �z-�, �ar;:T �ti' I�off�. Susart �1 Hc�ff, prc�p�rt� owners, Tou�n of Bass Lake, Sa�tiyer County�, Sec 18 Tn 4Q Rg Q8 part of Gov't Lot 1, State of Wisconsin, have made, constituted and appointed Justus Keenan of Keenan Construction, in the County of Sawyer, State of Wisconsin, my true and lawful agent for me and in my name, place and stead to do any and all things necessary for the application for, nebatiati�n of, or obtaining of state, county and local perri�its with the County of Sawyer, Wiscansin, gi�ring and granting hereby unto said agent full power and authorize to do so and perform all and every act and things whatsoever required and necessary to be done in about said premises, as fully to all intent and purposes as I might and could do if personally present, reserving full power of substitution and revocation, hereby ratifying all that my said agent of his substitute shall lawfuily do or cause to be done by virtue thereof. In witness whereof, I have hereunto set my hand and seal this 1 S'° day, of March, 2024. �, � �� � Hoff, Own � � i, � ��,ti�� ��� ; Susan M Hoff, Own � �', Not � �a ' G �1���d � :%2� �� r �� State o£ ,/�i�J/�e�`�� County of: ��u.�`�+ r\ �� Personally c,ame before me this �/ day of �G��'� �` , 2024 The above named �c�f�l 1,(� . (�d F� and ��r �• � F to me to , �e t�e p�rsc�rs w-�o exe�uie� t�e for�a�fr�g ins�.~�z�nz�t an� acl�nowledged the same. q,..:�,��-���. ��;u� n /f?�J �°'`. '`;�` TERRY A GHIGLO ''��'; f�'''=' Notary Public County State ���.;�°���; NOTARY PUBLIC �:�'��'� MINNESOTA �K�^ h�iy cammission exp.Jan 31, 2025 • • /.—?> % —�7�5 My Commission �xpir�s: , + ��,� � . ' � �� ; 4 ��� •. � �>� �x� ' _ . v ;�.ti "� ..:. =.t . � �. ��� � � ;+-� `.i:�'.., ..,. �� , ., .. .. `n. �. ' :rd?^";�'� :� azi•,�� R♦ i'�� \�� �v �' w :. 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'- � .." y� �Y .. y'�•,,c v, •. ^ � � . /� d ,+• ♦" < � , � . ,`. � � . ♦ �" ., / � �� � .'�:" �� • " • ��;� ,•''`• �! �y,� .`` �S� �y� ,+�`i �, . �.' `.✓ ♦'' , � ,, t ` � V `z, 1' y.� , ` �' I : � '- .�� ��>> >^� i�� �i. ;`� �'�� �i-., : '� /�1 �` �.: �� �.M :t ,� • ~� �y�♦ �' �� ��� �� �� ;'Y�� i�� ���� ,•'Y�, i� ���� �;. ''', •�:�'`` �•i�V�y�., �=t�� ��•.�i��. '��` �/S�v�/` � ''��` ��t� �y�� ��x�`.�., �. �r��� .�~�y����,��r�• .���` � ��•.:'�� ���� -':•�' <�,t` 'y` �s.`,i�l, '- > ♦ .^. �� �♦ '�. %� . �� %� ;c` j�` �� 1f1 �_ �;' ., . . . ,. ; . �� :t� f�: �x� :C` �� ;�!; �!: .�' i<� i� .'` �S� 1�-_ `x ti _ . . • .v .. � .` .� v ., � ` � v/ , \�-r. \yi _c__�`� -♦�! ' �,i � � ��y��.`�� .'�`y��`��"��.i'��y����,� %`•� �•�� ��•� %:�•i�� �,�� �)� .i�,� ,� i Y Y 1 K � � � '' � Jesse Suzan Land Surveying LLC 13731W Sjostrom Circle Hayward, WI 54843 715-558-4668 May 13, 2024 Determine elevations at the existing cabin and detached gazage at 14206W Omajik Lane, Haywazd, WI 54843. Located in part of Government Lot 1, of Section 18, Township 40 North, Range 8 West, in the Town of Bass Lake, Sawyer County, Wisconsin. Ground elevation at the southwest corner of the cabin= 1292.50' Ground elevation at the southeast comer of the cabin = 1292.52' Garage slab elevation = 1292.71' Regional flood elevation of Grindstone Lake = 1289.51' All elevations listed aze based on NGVD29 datum. . Jesse B. Suzan Wisconsin Professional Land Surveyor No.2635 `���i1111t1��� ���,�\SC�Ns�ti��i : 'JESSE B.�~•ti �� ��•• S-2635N � ' 's NAYWARD � �(t WISCONSIN f�� i,9,y•., yp`,. '/�SURVE �� ����►1111���� wiswnsinoepanmentolindustry. PRIVATESEWAGESYSTEM ounty: " ! �e LaborandHumanRelatlons INSPECTIONREPORT Sql.!) Ga2 ' Satety and Buildings Division (ATTACH TO PERMIT) 5anrtaryverm�tNo.: GENERALINFORMATION _L/ � . PermftHolder'sName: �City Viage � Towno : StatePanlDNo.: (�aun � Gl+a.�s 1�1�Aurz f3a-ss Lr�k� S9(n- a►� 8 CS7 BM E ev.: Insp.BM E ev.: � 9M Descripfion: Parce 7ax No.: ioe• 'T o� T�ez. ����DesrA��NvrCS'rm ooa- Syo- �g-s�� sr�� TANK INfORMATION ELEVATION DATA � TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1 O U� Dosing Aeration Bldg.Sewer Holding U��G�,�,�j^ S,�C I.InOU 'St�Ht Inlet .� � TANK SETBACK INFORMATION St/Ht Outlet --- TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Airintake Septic NA Dt Bottom Dosing NA Header/Man. J Aeration NA Dist.Pipe Holding �o '� 5p� aD�f 2D'3 �j ' Bot.System � PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand �� �j'�/.33� Model Number GPM TDH Lift Friction S�s[em TDH ft Forcemain Length Dia. o�rt.roweu SOIL ABSORPTION SYSTEM BED/TRENCH Width lengtb NOAfTrenches PIT No.OfPrts Inside0ia. liquidDepth $YSTEMTO P/L BLDG WELI LAKE/STREAM LEAGHING Manuacturer: SETBACK CHAMBER INFORMATION iype neo e Num er: S stem: OR UNIT DISTRIBUTION SYSTEM Heade�/Marn old DistribuGonP�pe(s x HoeSue x HoeSpacing VeneTOAirinta e Lenglh _ D�a Length _ Dla. Spacmg _ $011 COVER x Pressure Systems Only zx Mound Or At-Grede Systems Only DepthOver DepthOver .x Depih0l xx SeededlSodded xx Mulched Bed/7renchCencer 9edrtrenchEdges Topsod ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies,persons present,etc.) RE�4}CE»��.VT ND�Dr�v4 TRulG l5 Go.v�ve�'�D 7a 7'K� (J!-cTLtr-T D� /lN �'ks577KL �05� Ar�i.bK, Plan revision required? ❑ Yes � No Use other side for additional information. 12 � � ��G��'�" � � S 8 � SBD-6710(R 0591) Oate InspeRor's5lgnature Cert.No. � - - - Y � ADDITIONAL COMMENTS AND SKETCH .,� _ SANITARY PERMIT NUMBER: ��- � y � " ;� ��x�D srnu� L�ec— ,_` . � ._.�; .r-,.�:, _-.�._ �,r----� - ,..�_- - �--- .--� . . 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