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Home My WebLink About25-0105i i�urn to: 117 E 5" Street, PO Box 58 Bayfield County Planning and Zoning Department Washburn, WI 54891 LAND USE PERMIT APPLICATff permits@bayfieldcountv.wi.gov IlD �E n County Use Only: r' Submissio l ermit I ate: ` I Z& -cralInformation . _ - Property Owner Name: Authorized Agent Name (if applicable): za'r'WA-- L Bayfield Co. Zoning Dept Telephone Number: Telephone Number: a6d�i3 - — ®S E- ail Address: Cat E-Mail Address: M ling Address: Mailing Address: Ci Stale, Zip: City, State, Zip: Contractor: Telephone Number: E-Mail Address: SECTION B: Pro erty Information _ Project Address (ifdilicrcnt from mailing address): 5 531�z S A3/>2_evy Ntf01- Legal Description (if additional space is needed attach a separate sheet): �� Section, Township, Range: rj. T LEI &,,V D 7 jt/ Town of: Tax ID H: /y/0 O Lot Size (Acres/Square Feet): �20 - .SECTION C:Project Information check all that a t •--,_.:. _ _- ._ Project Use is: Residential ❑ Commercial ❑ Municipal Project Type is: XNew Construction ❑ Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 2 1 + days ❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe): re uired Total sq ft): required SECTION D: Structure Information Does not apply to RVs and Signs, *o to SectionE) Stntclure 7ype is: ❑ Residence ❑ Principal Structure (describe): Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured date): ❑ Shipping Container ❑ Other (describe): Foundation Type: ❑ Basement ❑ Walkout Basement 1 <Slab ❑ Crawlspace ❑ Ground ❑ Skids ❑ Other (explain): Existing Structure: Length: Width: Height: Proposed Structure (Provide Sg Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/ orches): Basement Sq Ft: 1" Floor Sq Ft: Loft Sq Ft: 2nd Floor Sq Ft: 3" Floor Sq Ft: Gaye S I. / Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): O Total Sq Ft: b O / Overall Height (finished grade to peak): t # of Stories- Fxisting # of Bedrooms on property: Proposed # of Bedrooms in project: SECTION E: RV and Sign Information check all that apply) Sion is: RV is: ❑ New C Replacement ❑ New ❑ Replacement ❑ On -premise ❑ Off -premise ❑ 1-sided ❑ 2-sided Year: Vin #: ❑ On -building ❑ Multi -Tenant Length: Width: Height: Make: Model: oESEoVE FEB 062025 D SECTION F: Site Flan — attach a site plan or draw site plan in box below (See pages 1 & 2 of Lan Information for information that is required to be provided on siteplan) Show location of: ❑ Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF) ❑ Holding Tank (1-1T) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20% N 5 C&7 4-7-04�,t1C—� Setback or distance from furthest extent of structure including eaves and overhangs to (include on site plan): County Use Only Verified setbacks Road Centerline a Q ft. ft. Notes/Comments: Front Lot Line/Right-of-Way 0 6 ft. ft. Side Lotjipe I orth s outh West, circle one it!O O Side Lot Line 2 (North East South es circle one 7-0 0 ft. ft. Rear Lot Line to o p t ft. ft. Septic/Holding Tank /?f / ft. ft. Drainfield ft. ft. Privy ft. ft. Well ft. ft. Existing Structure/Building /3 ft. ft Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ft. ft. Other (describe) ft. ft. I� FEB 0 6 2025 `dditioual Questions ❑ No Has the location of the proposed project including eaves and overhangs and the sanity e es staked? If no, what date will this be completed: Yes ❑ No Did a licensed surveyor mark lot line(s) if project is within 10 feet of required setback? See page 2 of Land Use Application Information for required setbacks. ❑ Yes ❑ No Did property owner or applicant mark lot line(s) if project is within 30 feet of required setback? See page 2 of Land Use Application Information for required setbacks. Yes ❑ No Is there an existing sanitary system on the property? If yes, what kind? 2Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes RINo Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used to manage wastewater? ❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and inspection ruluirements. Is the project associated with any of the following: ❑ Rezone ❑ Class A Special Use ❑ Class B Special Use ❑ Conditional Use ❑ Variance Fe344yment will be made via: El Check (attached) ❑ Cash (attached) ❑ debit/credit/echeck (department to call once payment is ready to be taken) How would you like to receive your permit card? n ❑ Mail to: OR ail to: 10r QS/Y1"(P—A-4 r I-O GI�-r,.t/ &( Le C D rw✓ ❑ Property Owner Address ❑ Agent Address ❑ Contractor Address ❑ Other (provide Name and Email or Address): ;'SectionH: Acknowledgement and Signature All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has not begun. Sanitary Permit issuance, if required, needs to occur prior to Land Use Permit issuance. Failure to obtain a permit or starting construction without a permit will result in penalties. The local Town, Village, City, State or Federal agencies may also require permits. The new construction of one- & two-family dwellings requires review and approval by the local Uniform Dwelling Code (UDC) authority. Additions and alterations to one - and two-family dwellings may require.review and approval by the UDC authority. All municipalities are required to enforce the UDC. If subject property is part of a Condominium Plat, applicant hereby certifies and represents that applicant has all necessary approvals and recorded documents required to complete the project for which this permit is sought including requirements set forth in Wisconsin statutes pertaining to condominium associations, the Declaration of the Condominium Association in which the property is located, and all other rules, regulations and requirements pertaining to that Condominium Association. You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. 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, dtir.wi.gov/topic/wetlands, or contact a Department of Natural Resources service center(715)685-2900. 1(we) 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. I (we) acknowledge that I (we) am (are) responsible for the detail and accuracy of all information that I (we) are providing and that will be relied upon by Bayfield County in determining whether to issue a permit. I (we) further accept liability which may be a result of Bayfield County relying on this information I (we) are providing 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 re unable time for the purpose of inspection. 4J-� 40� Owner(s) or Authorized Agent Printed Name: Owner(s) or Authorized Agent Signature: Date: a b _lZo 2 NOTES: 1. If you are signing on behalf of the owner(s) a let er of authorization must accompany this application. 2. Specific conditions/instructions may be stated on the face of the issued Land Use Permits. Owners, agents, & contractors must all be aware of permit details & conditions and permit card must be posted on property prior to start of project. FEH 0 b�025 \\\ p\\\ n" \m \ \\%°y \\ PARCE \ N \ 848, 000 s 19.47Acn `pG \ (INCLUDING RO. N 7 0 0 SEPTIC SHED Z `VFIJTi] J [A�O CA IN l \\ =VTIC 40 532.2p�� BELLEVUE 664.45' 2,617.90' '.Ye CORNER 1,308.95'�`-`N EASTy CORNER SEC. 29, T46N, R7W �? PD. 2Y¢'B.C.LP. c 3F-\1 R.O.W.) 0 W 2oc r m N ^ AO f N 0 o SEE GUAVA" N L1 CyeEE CORNER l APPROXIMATE J ORDINARY HIGH \` WATERMARK Tracy Pooler From: Tracy Pooler Sent: Thursday, February 13, 2025 2:37 PM To: pjrosman@ra.rockwell.com Subject: FW: 59325 Birch Nest Cove Attachments: Impervious Surface Form $25.00 fee.pdf Paul, In looking into your project, a couple more items will be needed. • Impervious Surface Calculation Form & $25.00 fee • Provide an elevational drawing accurately showing the height of the proposed structure (13-1-22(h)) Tracy Pooler - AZA Planning and Zoning Department 117 E 5th Street, PO Box 58 Washburn, WI 54891 Phone: 715-373-3512 Fax: 715-373-0114 Email: track. op oler@—b ieldc�a �c,v�ri: v 1 Bayfield County . Impervious Surface Calculations s } These calculations are REQUIRED per WI Admin Code NR 115.05(1)(e) and Section 13-1-32(g) and 13-1- 40(h) of the Bayfield County Code of Ordinances. The undersigned hereby makes application for construction, reconstruction, expansion, replacement or relocation of any impervious surface within 300 feet of the ordinary high water mark and agrees that all activities shall be in accordance with the requirements of the Bayfield County Code of Ordinances and all other applicable ordinances and the laws of the State of Wisconsin. Pursuant to Chapter 1, Title 13, Section 13-1-106(d) of the Bayfield County Zoning Ordinance(s), Planning and Zoning Department employees assigned to inspect properties shall have access to said properties to make inspections. Property Owner(s): Pof 414- A os 04-Itl Matting Address: �G� 7f eA- 60rag -T Property Address �rgs'6 Z o -dr9*?0?3" 6 a ell /Ver-sr eev 1/6 ljv"fsoA , iw-r Legal Description: Section, Township, Range 1/4, 1/4, Sec Township 216 N, Range l2-7—w Authorized Agent/Contractor Gov't Lot Lot # CSM# Vol & Page Lot(s) # Block(s) # Subdivision Town of: P 6L T/1 Parcel 1D # (PIN #) Tax ID # Date: Impervious Surface: An area that releases as runoff all or a majority of the precipitation that falls on it. "Impervious surface" excludes frozen soil but includes rooftops, sidewalks, driveways, parking lots and streets unless specifically designed, constructed and maintained to be pervious. Calculation of Impervious Surface: Percentage of impervious surface shall be calculated by dividing the surface area of existing and proposed impervious surfaces on the portion of a lot or parcel that is within 300 feet -of the ordinary high water mark by the total surface area of the lot or parcel, multiplied by 100. Impervious Surface Standard: Allow up to 15% impervious surface but not more than 30% impervious surface on the portion of a lot or parcel that is within 300 feet of the ordinary high water mark. A permit can be issued for development that exceeds 15% impervious surface but not more than 30% impervious surfaces with a mitigation plan that meets the requirements of the Bayfield County Ordinance(s). Existing Impervious Surfaces: For existing impervious surfaces that were lawfully placed when constructed but that do not comply with the standards in Section(s) 13-1-32(g) and Section 13-1-40(h), the property owner may do any of the following: a. Maintenance and repair of all impervious surfaces: b. Replacement of existing impervious surfaces with similar surfaces within the existing building footprint; c. Relocation or modification of existing impervious surfaces with similar or different impervious surfaces, provided that the relocation or modification does not result in an Increase In the percentage that existed on the effective date of the county shoreland ordinance, and meets the applicable setback requirements In Section 13-1-32. Impervious Surface Item Dimension Area (Square Footage) Existing House �72t a�a i9y3 - o — Existing Accessory Building/Garage 7✓FX �S Existing Sidewalk(s), Patio(s) & Deck(s) Existing Covered Porch(es), Driveway & Other Structures 0 Proposed Addition/House Proposed Accessory Building/Garage 1Va x (o /Z Proposed Sidewalk(s) & Patio(s) Proposed Covered Porch(es) & Deck(s) Proposed Driveway �C d ,1 -2 a ,2000 Proposed Other Structures Total: 9 70 a. Total square footage of lot: 571 .,Z OO b. Total impervious surface area: 13 %' 70 c. Percentage of impervious surface area: 100 x (b)/a /✓' WIS 7/,7 00 If the proposed impervious surface area is greater than 15% mitigation is required. Total square footage of additional impervious surface allowed: @ 15% @ 30% Issuance Information (County Use Only) Date of Inspection: / ZL Inspection Record: Zoning District Lakes Classification ( 1 Condition(s): Stormwater Management Plan Required: 0 Yes VNo Signature of Inspector: Date of Approva z u/forms/impervioussurface Created: May 2012 (®Apr 2016; Sept 2020) Proofed by: LA(D USE - INFORMATION NEEDED q 1 • e. DATE: : I / III. \ , TO: RUTH ' "FRANKI TRAC J MCKENZIE ALESSANDRO DATE CONTACTED: DEB ❑ PHONED ❑ IN -PERSON ❑ ANSWERING MACHINE ❑ MAIL SPOKE WITH: OWNER ❑ AGENT ❑ CONTRACTOR ❑ OTHER NEED: ❑ AFFIDAVIT ❑ BLUEPRINTS ❑ CONDITION(S) ❑ DEED (Type) ❑ FEE ❑ INSPECTOR NOTES/SIGNATURE ❑ PLOT PLAN ❑ LAND USE APP ❑ LEGAL DESCRIPTION ❑ LETTER ❑ LETTER OF AUTH ❑ SANITARY, ❑ SOILTEST ❑ SQ. FOOTAGE ❑ ZONING DISTRICT IT OTHER ❑ STORM WATER PLAN ❑ ❑ FLOOR PLAN ❑ MITIGATION ❑ TAX STATEMENT ❑ IMPERVIOUS SURFACE SHEET ❑ PARCEL ID# ❑ TBA ❑ veme�aevevvvvvvem emevvvveeeveveevveevemvmm am evveev a emmvevveveeemeem see evvvraeevevee evevvvee� Cl NON -CONFORMING STRUCTURE: FOOTPRINT OF EXISTING BLDG FOOTPRINT ALLOWED FOOTPRINT PREVIOUSLY FOOTPRINT REQUESTED FOOTPRINT REMAINING COMMENTS: DWELLING SPACE of EXISTING BLDG DWELLING SPACE ALLOWED DWELLING SPACE PREVIOUSLY DWELLING SPACE REQUESTED DWELLING SPACE REMAINING OVER HANG OF EXISTING BLDG OVER HANG ALLOWED OVER HANG PREVIOUSLY OVERHANG REQUESTED OVER HANG REMAINING Bayfield County, WI 2/1012025, 2:08:08 PM 1:688 Wetlands Road Type Intermediate o 0.01 0.. 0... m1 —tee y Rivers Town 0 0.01 0.03 0.05 km Lakes Building Footprint 2015 bayfeld_gis.SDE.T_Delta Approximate Parcel Boundary • Building — Index eayfieM county Land Record: eepartrnant eayfield County imNny Applloefion hfl efinuot bayfieMcourdy m, wMnnniiWAV [� 110/25, 2:13 PM Novus-Wisconsin Access rev. 12.0206 /"' Real Estate Bayfield County Property Listing Property Status: Current Today's Date: 2/10/2025 Created On: 3/15/2006 1:15:16 PM S Description Updated: 11/13/2023 S Ownership Updated: 11/13/2023 Tax ID: 13100 PAUL 3 ROSMAN GREENFIELD WI PIN: 04-016-2-46-07-29-4 02-000-10000 Legacy PIN: 016106106000 Billing Address: Mailing Address: Map ID: PAUL 3 ROSMAN PAUL 3 ROSMAN Municipality: (016) TOWN OF DELTA 4868 S 79TH ST 4868 S 79TH ST STR: S29 T46N R07W GREENFIELD WI 53220 GREENFIELD WI 53220 Description: PAR IN NW SE IN V1123 P.552 500A 2023R-601119 f1t a ' Site Address * indicates Private Road Recorded Acres: 20.040 59325 BIRCH NEST COVE RD MASON 54856 Calculated Acres: 19.437 Lottery Claims: 0 Property Assessment Updated: 8/29/2011 First Dollar: Yes Zoning: (R-1) Residential-1 2025 Assessment Detail ESN: 110 Code Acres Land Imp. G1-RESIDENTIAL 2.040 83,000 112,600 Tax Districts Updated: 3/15/2006 G6-PRODUCTIVE FOREST 18.000 28,800 0 1 STATE 2-Year Comparison 2024 2025 Change 04 COUNTY Land: 111,800 111,800 0.0% 016 TOWN OF DELTA Improved: 112,600 112,600 0.0% 041491 SCHL-DRUMMOND Total: 224,400 224,400 0.0% 001700 TECHNICAL COLLEGE Recorded Documents Updated: 3/15/2006 If Property History 0 WARRANTY DEED Date Recorded: 11/6/2023 202311-601119 N/A o 0 QUITCLAIM DEED n ��/ Date Recorded: 4/10/2014 2014R-553892 1123-552 Y 0 CONVERSION Date Recorded: 404-275 https:Hnovus.bayfleldcountywi.gov/access/master.asp?paprpid=13100 1/1 Land Use Permit Application Review Checklist Submission #: t zoning district is the project located in? 7Wh R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M-M ❑ Yes ❑ o Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: Yes 3 No Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR • landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)? Yes ❑ No Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes KNo Is the project located in the Floodplain? Zone: ❑ Yes No Are there wetlands on the property? ❑ Yes No Is project associated with a nonconforming use or structure? ❑ Yes p'No Is project associated with a variance? Case #: ❑ Yes 06 Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes o Is the project associated with a Special A Use Permit? ❑ Yes No Does the project require sanitary? ❑ Existing ❑ New ❑ Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public Sanitary Permit #: ❑ Yes o Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes No Does the project require an affidavit? Affidavit #: ❑ Yes pKN9 Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback? ❑ Yes No I Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? esidential ❑ Commercial ❑ Municipal Project type is? New Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Business ❑ Temporary ❑Shoreland Grading ❑ Other, describe: Structure Type is: ❑ Residence ❑ Principal Structure Accessory Structure ❑ Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) ❑ Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container ❑ Other, describe Total Sq. Ft. of Project: ;, 49Number of Stories: Overall Height: Calculated Fee Category: ❑ Residential Principal Structures - $0.75/square foot (minimum $125) ❑ abitable Residential Accessory Structures - $0.50/square foot (minimum $75) Non -Habitable Residential Principal and Accessory Structures - $0.20/square foot (minimum $75) ❑ Commercial/Municipal Principal Structures - $0.75/square foot (minimum $125) ❑ Commercial/Municipal Accessory Structures - $0.20/square, foot (minimum $75) Calculated Fee Amount: Additional Fees: ❑ Return Inspection ❑ Land Use Revisions ❑ Special Use Permit -Class A ❑ After -the -Fact (ATF) ❑ Floodplain /horeland -Impervious Surface ❑ Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic Mine ATF Fee Amount: Inspected by: Date of Inspection: �i Re -Inspected by: Date of Re-Inspe by: Reason for Denial: Letter Mailed: Approved Date of Approval: Condition(s): OF - ❑ Must meet and maintain setbacks from furthest extension of structure including eaves and For personal storage only. personal residence only. t for human habitation or sleeping purposes. Town/State/DNR/Federal may require permitting ❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained prior to the start of construction. )2 A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained prior to the start of construction (if applicable). ❑ Use best management practices to limit and prevent erosion during construction. ❑ This permit cannot be transferred if property is sold. ❑ A Bayfield County Health Dept permit is required. ❑ Check with Town regarding room tax. ❑ Short -Term Rental is for a maximum occupancy of persons. k❑ Sign must meet the requirements of Article E of the Bayfield County Zoning Ordinance. To be constructed per plan. ❑ Adhere to privy agreement. ❑ Temporary permit allowing existing structure for a period of less than 1 year. ❑ RV may not be used for permanent residence or storage. ❑ RV allowed for ❑ RV must be removed by ❑ No sewer and pressurized water allowed in the structure. ❑ No plumbing or plumbing fixtures allowed. ❑ No additional sleeping areas allowed without obtaining necessary sanitary permit(s). ❑ Land use permits shall be required for any new residence, any building or structure erected, relocated, rebuilt, or structurally altered ❑ Land use permits shall be obtained prior to the initiation of construction or a change in land use ❑ Requirements (e.g., permits/licensing/tax) of Local Town, Village, City, State or Federal agencies are required ❑ Sanitation requirements must be met (if applicable) ❑ Additional conditions may be placed and need to be adhered to at the time of permit issuance Other Conditions: B�YFIELD Bayfield County Planning & Zoning Department 117 E 5thStreet P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: ROSMAN, PAUL J 4868 S 79TH ST GREENFIELD, WI 53220 Description Verified Fee Amount Non -Habitable Residential Principal and Accessory Structures - $0.20/square foot (minimum $75) Submission Number. LU-01494 Transaction Number: LU-01494-25C54 Amount $0.00 $576.00 Total: $576.00 Payment Amount: $576.00 Reference:1215 Paid by: PAUL ROSMAN, 4868 S 79TH ST, GREENFIELD, WI 53220 Payment Type: Check Transaction Date: undefined Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit. S A-YFIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number. ROSMAN, PAUL J AP-00018 4868 S 79TH ST GREENFIELD, WI 53220 Transaction Number: AP-00018-25A25 Description Amount Additional Fee Amount $25.00 Total: $25.00 Payment Amount: $26.95 Reference:4395847175 Paid by: Paul Rosman Payment Type: Credit Card Transaction Date: undefined Receipt of payment does not guarantee approval. Town, City, Village, State or Federal Permits May Also Be Required Substandard — No / Nonconforming — No Shoreland — Yes / Impervious Surface — Yes Floodplain — No / Wetlands — No Mitigation — No / Affidavit #: LAND USE —X SANITARY — SPECIAL A — SPECIAL B/CONDITIONAL — BOA — No. 25-0105 Tax ID: 13100 Issued To: ROSMAN, PAUL J Location: S29 - T46N - R07W Town of Delta BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: PAR IN NW SE IN V.1123 P.552 500A 2023R-601119 Residential Structure in R-1 zoning district For: New Construction [1 - Story ], Accessory Structure on a Slab [2880 Total sq. ft. ] Height of 34' (Disclaimer): You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Any future expansions or development would require additional permitting. Condition(s): See back of card NOTE: This permit expires two years from date of issuance if the authorized construction work or land use has not begun. Changes in plans or specifications shall not be made without obtaining approval. This permit may be void or revoked if any of the application information is found to have been misrepresented, erroneous, or incomplete. This permit may be void or revoked if any performance conditions are not completed or if any prohibitory conditions are violated. Tracy Pooler Authorized Issuing Official March 26, 2025 Date Condition(s): For personal storage only. Not for human habitation or sleeping purposes. Town/State/DNR/Federal may require permitting A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained prior to the start of construction (if applicable). To be constructed per plan.