HomeMy WebLinkAbout25-0176Return to:
117 E 5" Street, PO Box*LAND
yfield County Planning and Zoning Department
WasFiburn, Wl 54891 USE PERMIT APPLICATION
permits@bayfieldcounty.wi.gov
County Use Only:
Submission#: UJ-01
Permit #:'1(o
Date:
SECTION A: General Information
Pro rty Own r Name:
Auth
i Agent Name (if applicable):
Telephone Number
Telephone Number:
` — 1
't
�—� — 1�645
E-Mail Address:
E-Mail Ad ess:
0. nSl Com
Mailing Address:
( ' 'rig Ad Vss Cb�K Gordon �� S �F83g
City, State, Zip:
ity, S te, Zip: 4139
(�Orl
Contractor:
Telephone Number:
E-Mail Address:
SECTION B: Property Information
Project Addre (if differe t from mailin address):
�ct..
4'F 3o t.c+l,
Legal Description Lif additional space is needed attach a separate sheet) -
Zed 09 Trt43 Ole LiA A CSh1 *=7 Y.S P.a(oa �ee J t n 60V 6 bf 3 ;n V.77X P. iqs" 35SB
Section, Township, Range:
Town of: NhrAdLk , p n
Tax ID #: p'(4�'1rj D34
Lot Size (Acres/SquareFeet): $• 7CO
SECTION C: Project Information check all that apply)
Project Use is: X Residential ❑ Commercial ❑ Municipal
Project Type is. ❑ New Construction Addition/Alteration (existing structure)
. Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days
❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A IKOther (describe'):
re uired Totals ft : re uircd ?tokq & W
SECTION D: Structure Information(Does not apply to RVs and Signs, go to Section E
Structure Type is: IS Residence ❑ Principal Structure (describe):
® Accessory Structure (descTibe). ❑ Shoreland Exempt Structure (describe): El Mobile Home (P dt fired
�ei� �NG bif
I� tudate):
❑ Shipping Container ❑ Other (describe): April ,'
BdYfi' !U2
Foundation Type: Lo. 7
"log
❑ Basement ❑ Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground P9 Skids ❑ Other (explain): 0s',bl
Existing Structure: Lea Width: Height:
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/ orehes):
Basement Sq Ft:
11 F'-- Qq Ft:
Loft Sq Ft:
Deck Ca Ft:
2nd Floor Sq Ft:
Other Sq Ft (describe):
Yd Floor Sq Ft:
Other Sq Ft (describe):
Garage Sq It
Porch Sq Ft:
Total Sq Ft:
Overall Height (finished grade to peak):
# of Stories: Existing # of Bedrooms on property:
Proposed # of Bedrooms in project:
SECTION E: RV and Sign Information check all that apply)
Sign is:
RV is:
❑ New ❑ Replacement
❑ New ❑ Replacement
❑ On -premise ❑ Off -premise
❑ 1-sided ❑ 2-sided
Year: Vin#:
❑ On -building ❑ Multi -Tenant
Length: Width: Height:
Make: Model:
SECTION F: Site Plan — attach a site plan or draw site plan in box below (See pages 1 & 2 of Land Use Permit Application
Information for information that is required to be provided on site Ian
Show location of:
❑ Driveways ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF)
❑ Holding Tank (HT) ❑ Privy ) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain ❑Wetlands ❑Slopes over 20%
N
ECE§YE
APR .:-
LOt,�
"meld Co. Zoning Dept
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerline
Z0
ft.
7 &
Notes/Comments:
Front Lot Line/Right-of-Way
ft.
ft.
Side Lot Line I
Northeast❑South❑West❑, check one
Z s
ft.
Z5.1 ft.
Side Lot Line 2
orth❑East South❑West❑,checkone
r Zd
ft.
/D ft.
Rear Lot Line
Septic/Holding Tank
ft.
C% ft.
Drainfield
'�(f r
ft.
y ft.
Privy
ft.
ft.
Well
Existing Structure/Building
Wetland
ft.
ft.
Elevation of Floodplain
ft.
&
Ordinary High -Water Mark (OHWM)
ft.
&
Other (describe)
ft.
ft.
- �y
a
O G -
S
"J4k
bO q j. sr m
"D ZOnln9OL,pt
SECTION G: Additional Questions
❑ Yes
C& No
Has the location of the proposed project including eaves and overhangs and the sanitary system and well been
staked? If no, what date will this be completed: 14 - 19 — o
❑ 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
bficno
'/(Land
Use Application Information for required setbacks.
Yes
❑ No
s there an existing sanitary system on the property? If yes, what kind?
Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
❑ Yes
No
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 requirements.
Is the project associated with any of the following: <
❑ Rezone ❑ Class A Special Use ❑ Class B Special Use ❑ Conditional Use ❑ Variance
Fee payment will be made via:
® Check (attached) ❑ Cash (attached) ❑ debit/credit/echeck (department to call once payment is read e taken) j
How would you like to receive your permit card? ryCp
95 Mail to: OR ❑ Email to:
9 Address ❑ Contractor Address ❑ Other (provide Name and Email or
❑ Property Owner Address Agent
Section H: Acknowled ement 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, dnr.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 (arc) 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 reasonable time for the purpose of inspection.
Owner(s) or Authorized Agent Printed Name: O7 #Q� t � 61\)(kl o n
Owner(s) or Authorized Agent Signature: D YI Date: �% 7 9
NOTES:
1. If you are signing on behalf of the owner(s) a letter 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.
Impervious Surface Item Dimension Area (Square Footage)
Existing House
�D, X 1/0 r
O d
Existing Accessory
Building/Garage
Existing Sidewalk(s), Patios) &
Deck(s)
Existing Covered Porch(es),
Driveway & Other Structures
Proposed Addition/House
_
rG .
I i r x 9w t
ZY C)
Proposed Accessory
Building/Garage
Proposed Sidewalk(s) & Patio(s)
Proposed Covered Porch(es) &
Deck(s)
Vic,
Proposed Driveway
Proposed Other Structures
Total:
a. Total square footage of lot:_ l i
b. Total impervious surface area: t VI If
c. Percentage of impervious surface area: 100 x (b)/a =/y
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:
Inspection Record:
Zoning District ( 1
Lakes Classification ( 1
Condition(s):
Stormwater
Management Plan Required:
❑ Yes ❑ No
Signature of Inspector.
Date of Approval:
ulforms(mpervioussurface
Created: May 2012 (®Apr 2016; Sept 2020) Proofed by:
Letter of Authorization
Bayfield County Planning & Zoning Department
PURPOSE. This Letter of Authorization is used to authorize a single property owner to act on
behalf of multiple property owners or a designated agent to act on behalf of the propertyowner/s.
If multiple property owners, each property owner must submit this signed letter.
(property owner), authorize !�°/�i/-4)1746n
(authorized agent) to submit aje iA.J tc,* (Example: land use special
use, conditional use, rezone/map amendment, appeal, variance, text amendment,etc. � P
following described project ) for the
p (Example: construction o residence or other structure, short-term
rental or other use change, etc.) , CpnS%&F&Std!n6�
the following described property: application on my behalf for
Legal description of subject property ,z #$47 1/, s'/? aGa
�Zveau.4A Cif �Lof3j 1/. 7
Address of
subject subJjproperty: 4147.3D `ej3�A�
Signature
Dated -
Letter of Authorization
Bayfield County Planning & Zoning Department
PURPOSE. This Letter of Authorization is used to authorize a single property owner to act on
behalf of multiple property owners or a designated agent to act on behalf of the property owner/s.
If multiple property owners, each property owner must submit this signed letter.
I, 2 r (property owner), authorize �ff / ,L &/ ,g
(authorized ent) to sub 't a t&nd_use, S hea, I «mencsL.► (Example: land use, special
use, conditional use, rezone/map amendment, appeal, variance, text amendment, etc.) for the
following described project (Example: construction of residence or other structure, short-term
rental or other use change, etc.) JCAn4 Ae Sldehu, application on my behalf for
the following described property:
Legal description of subject property&A 09 IN 43 R% 610 L-ot A CS M -'Qo-Iy
(L&eG,%A tau GO\J L.o+4 IN v. Z W. t?. l q5 3 6"S i3
Address of subject property: 44130 GALA i'&Lr\-t Kd RQtfY a V(Q 440 _ W)-
Signature
Dated _
j-
^ Land Use Permit Application Review Checklist
Submi ion#:
LU —
! Ot
Wha zoning district is the project located in?
-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M-M
❑ Yes ;PhNo
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
Yes ❑ No
Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR
landward side offloodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)?
[des El No
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
t
navigable waterway)
❑ Yes P"o
Is the project located in the Floodplain?
Zone:
es ❑ No
Are there wetlands on the property?
❑ Yes eENo
Is project associated with a nonconforming use or structure?
❑ Yes 0
Is project associated with a variance?
(
Case #:
❑ Yes kNo
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 o
Does the project require sanitary?
❑ Existing ❑ New ❑ Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public
Sanitary Permit #:
❑ Yes pMo
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes A&
Does the project require an affidavit?
Affidavit #:
❑ Yes No
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
[]Yes 2]*o
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 Ekhange Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Business ❑ Temporary ❑ Shoreland Grading EI Other, describe: 4 C $'lei{
Structure Type is: ❑ Residence ❑ Principal StructureI>r-qccessory 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: Z ye Number of Stories: Overall Height:
Calculated Fee Category:
❑ Residential Principal Structures -$0.75/square foot (minimum $125)
❑ Habitable Residential Accessory Structures - $0.50/square foot (minimum $75)
,EKNon-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 ❑ Shoreland -Impervious Surface ❑ Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1
❑ Tower Collocation 2 ❑ Metallic Mine
ATF Fee Amount:
Inspected by: S
Date of Inspection: ��
C ,
Z�
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Reason for Denial:
Approved by:
Date of Approval:
Condition(s): - '
9must meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
� or personal storage only.
❑ For personal residence only.
211Not 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.
❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
�Plse 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.
❑ 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:
R -'FIELD
Bayfield County
Planning & Zoning
Department
117 E 5w Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner.
Submission Number:
WHALEN, GAIL M
LU-01569
13986 S ST CROIX RD
GORDON, WI 54838
Transaction Number:
LIDMILA,BEVERLY A
LU-01569-29552
W4214 HEEVTOWN RD
LOYAL, WI 54446
MARTY,MARY J
S70 W34400 RD X
EAGLE, WI 53119
Description Amount
Shoreland - Impervious Surface $25.00
Verified Fee Amount $0.00
Non -Habitable Residential Principal and Accessory $75.00
Structures -$0.20/squarefoot (minimum $75)
Total: $100.00
Payment Amount: $100.00
Reference:1630
Paid by: DANIEL W & GAIL M WHALEN,13986 S ST CROIX RD, GORDON, WI
54838
Payment Type: Check
Transaction Date: undefined
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.
Town, City, Village, State or Federal
Permits May Also Be Required
Substandard — No / Nonconforming — No
Shoreland — Yes / Impervious Surface — Yes
Floodplain — No / Wetlands — Yes
Mitigation — No / Affidavit #:
LAND USE —X
SANITARY —
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0176 Tax ID: 24475
Issued To: WHALEN, GAIL M; LIDMILA, BEVERLY A; MARTY, MARY J
Location: S09 - T43N - R06W
Town of Namakagon
Legal Description: LOT 2 CSM #807 V.5 P.262 (LOCATED IN GOVT LOT 3) IN V.736 P.195 355B
Residential Structure in R-1 zoning district
For: Relocate [1 - Story], Accessory Structure on Skids [240 Total sq. ft.]
(irisclaimer) 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 Scott Roush
work or land use has not begun.
Authorized Issuing Official
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. April 22, 2025
This permit may be void or revoked if any performance conditions are not Date
completed or if any prohibitory conditions are violated.
Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs.
For personal storage only.
Not for human habitation or sleeping purposes.
Use best management practices to limit and prevent erosion during construction.
To be constructed per plan.
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