HomeMy WebLinkAbout25-0177. ENiEBEo
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117 E 511 Street, PO Box 58 Bayfield County Planning and Zoning Department
Washburn, WI 54891 LAND USE PERMIT APPLICATION
perm its (n@ bavfi eldco u ntv.wi.gov
County Use Only:
Submission #: w-6%
Permit#: '
Date:
SECTION A: General Information
Property Owner Name: .p s Aq, „ riz Agent a f licable):
!I-td
Telephone Numbe :
Telephone Number:
1.06(- A L - 8-1"
V ld(Zt4t -.87=-
E-Mail Address:
E-Mail Add es_ sb ;I01 ' s COm
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Mailing Address:
M3ailing S rVSrfrl6. V41T J
ts6
City, State, Zip:
Di te, Zip: ).x 4?3�
�' ion W�.
Contractor:
Telephone Number: E-Mail Address:
SECTION B: Pro' ri y nformation
Project Address (if diCferen from m ilina address): '
�(Lk73D h etn F� Ly\ama.Ka n LJ'U
Legal Desorption (if additional space is needed attach a separatesheet):
w. Gouf lo�'3itxt�l. �3V P.IRS 3
04 lrl¢3 04 a CSm go7 �,5 �. at�diWanl�d
Section, Township, Ra ge:
Town of. -
Tax ID #: aU4-(
Lot Size (Acres/Square Feet):
EC - N.C: Project Information (check all t atL . 6
Project Use is: EA Residential ❑ Commercial ❑ Municipal
Project Type is: ❑ New Construction :W 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):
required (Total sq ft): required
.SECTION D:.Structure Information Does not a I to RVs and Signs, go to Section E
Structure hype 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 ❑ Slab V Crawlspace ❑ Ground ❑ Skids ❑ Other (explain):
Existing Structure: Length: 40 Width: -A0 Height: 1'A
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/ orches):
Basement Sq Ft:
I g Floor Sq Ft:
Loft Sq Ft:
2n' Floor Sq Ft:
3b Floor Sq Ft:
Garage Sq Ft:
Porch Sq Ft:
Deck Sq R44
Other Sq t (describe):
Other Sq Ft (describe):
Total Sq Ft: xP
Overall Height (finished grade to peak):
# of Stories:
Existing # of Bedrooms on property: Proposed # of Bedrooms in project:
'SECTION E: RV and Sin Information check all that a 1 r) '
Sign is:
R I is:
❑ New ❑ Replacement
❑ New ❑ Replacement
❑ On -premise ❑ Off -premise
❑1-sided 02-sided
Year: Vin#:
❑ On -building ❑ Multi -Tenant
Length: Width: Height:
Make: Model:
-3
SECTION F: Site Plan — attach a site plan or draw site plan in box below (See pages I & 2 of Land Use Permit Application
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 (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑P000,nnJd; ❑lloodplain ❑Wetlands ❑Slopes over20%
N
APR 1(�
Ba�eld co 7 �d j5
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
aco
ft.
ft.
Notes/Comments:
0w 15
9^N
�F2W M
Ti r
g �, )a
..., the tC
Front Lot Line/Right-of-Way
ft.
ft.
Side Lot Line 1
(North ❑East❑South❑West❑, check one
Side Lot Line 2
orth❑East❑South❑West❑,check one
[ )
Nj
ftf
Rear Lot Line
ft.
ft.
Septic/Holding Tank
fl.
ft.,pVo�eC�L
Drainfield
fl.
ft.
Privy
fl.
ft.
Well
ft.
ft.
Existing Structure/Building
ft.
ft.
Wetland
fl.
ft.
Elevation of Floodplain
ft.
ft.
Ordinary High -Water Mark (OHWM)
Other (describe)
ft.
ft.
' SECT QN G, Additional Questions
Yes
❑ 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:
❑ Yes
W No
Did a licensed surveyor mark lot line(s) if project is within 10 feet of re re etback? Seepage 2 of Land Use
Application Information for required setbacks.
Yes
❑ No
Did property owner or applicant mark lot line(s) if project is within 3 et of re ui d e c&? S page 2 of
Land Use Application Information for required setbacks. CS
19 Yes
❑ No
Is there an existing sanitary system on the property? If yes, what kind? I %
® Drainfield ❑ Holding Tank ❑ Municipal/Public El Other (des
❑ Yes
Ili No
Will pressurized water be installed in the structure? If yes, what kind of sanita 8 se4q w II be installed or used
�ept.
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 ready to be taken)
How would you like to receive your permit card?
❑ Mail to: OR ❑ Email to:
❑ Property Owner Address ❑ Agent Address ❑ Contractor Address ❑ Other (provide Name and Email or Address):
Section .H:.A.cknowled ement,andaS1 ature All
I 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 (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 Bayfreld County relying on this information I (we) are
providing in or with this application. 1 (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.
�!Q-t ha � r
Owner(s) or Authorized Agent Printed Name:
Owner(s) or Authorized Agent Signature: n Date: ! �tat
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.
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Impervious Surface Item Dimension Area (Square Footage)
Existing House
_
Existing Accessory
Building/Garage
Existing Sidewalk(s), Patio(s) &
Deck(s)
Existing Covered Porch(es),
Driveway & Other Structures
/ = lc 2 y
Proposed Addition/House
_
) Z r X
Proposed Accessory
Building/Garage
Proposed Sidewalk(s) & Patio(s)
Proposed Covered Porch(es) &
Deck(s)
6 rx fr.'
G
Proposed Driveway
Proposed Other Structures
Total:
a. Total square footage of lot: �_ l 3 1 " 9 i
b. Total impervious surface area: 2 N q
c. Percentage of impervious surface area: 100 x (b)/a = d
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 Rewrd:
Zoning District l 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
Bayfdd County Pluming & Zoning Department
PURPOSL 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
If multiple property owners, each property owner must submit this signed letterover/s.
I, 10tYCrt
(property owner), authorize 6AZ •"46n
(authorized agent) to submit a vW%U.!Pesidtn (Example: land use, special
use, conditional use, rezone/map amenament appeal, variance, text amendment,etc.
following described project (Example: } for the
p 'construction o residence or other structure, short-term
rental or other use change, etc.) .
the following described property:application on my behalf for
Legal description of subject Property' Ca 'f^t *P a?Ga
�ZO,*44d -4A G&*&f "IS) Mow y, 73d
Address of subject property: '�%'��%30 a�k� /M��4 e/
-&-Ar
Signature
Dated
PJOG
i
Letter of Authorization
BayWd 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 owners.
If multiple property owners, each property owner must submit this signed letter.
--.A�g ge r(property owner), authorize ,G &//�
(authorized ) to . ' a UnA u6e.
Sh i R dCnA le• land use, special
use, conditional • use, rezonehnap amendment, appeal, variance, text am�ent, etc.) for the
following descrbed project (Example: construction of residence or other strucl ue, short-term
rental or other use change, etc.} application on my behalf for
the following described property;
Legal description of subject properly:]ed 69 rN 43 Rg 610 L-ot a, CS M -'go1y. b'' F. a (f a
(L&M%A im Govt LA IN V. 1110 F.1 16 tire i3
Address of subject property:
10 �7,
�'w
Land Use Permit Application Review Checklist
Submission #: I LA
What zoning district is the project located in?
111 R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ I ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M-M
❑ Yes Imo
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
'!es ❑ No
Is the project located in the Shorelands (Shorelands are lands within 300 feet of a river/stream OR
t
landward side of floodplain OR 1000 feet of a lake/pond/flowage, whichever is greater)?
es []No
Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of
navigable waterway)
❑ Yes ,Poo
Is the project located in the Floodplain?
Zone:
es ❑ No
Are there wetlands on the property?
❑ Yes 4TNo
is project associated with a nonconforming use or structure?
❑ Yes JR:No
Is project associated with a variance?
Case #:
❑ Yes C;IrNo
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 J o
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 459do
Does the project require an affidavit?
Affidavit #:
❑ Yes o
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
es ❑ No
Did applicant/property owner mark lot line(s), If project is within 30 feet of required setback?
Project use is?`Residential []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 ise'='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: 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)
❑ 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: `t
Additional Fees: ❑ Return Inspection ❑ Land Use Revisions ❑ Special Use Permit- Class A ❑ After-the-Fact(ATF)
❑ Floodplainhoreland -Impervious Surface ❑ Shoreland - Non -Conforming, etc. El Tower Siting/Collocation 1
El Tower Col ocation 2 f] Metallic Mine f
ATF Fee Amount:
Inspected by: Date of Inspection:
Lela � N 2 f
CO 9 ie
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Reason for Denial:
Letter Mailed:
Approved by:
Date of Approval:
Condition(s): 01
�5 Must meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
❑ For personal storage only.
Wor personal residence 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.
� Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be
obtained prior to the start of construction (if applicable).
C07--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.
❑ 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).
,.and use permits shall be required for any new residence, any building or structure erected,
rr�e,.l,ocated, rebuilt, or structurally altered
k Land use permits shall be obtained priorto 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:
P A,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:
Submission Number:
WHALEN, GAIL M
LU-01592
13986 S ST CROIX RD
GORDON, WI 54838
Transaction Number:
LIDMILA,BEVERLY A
LU-01592-28E28
W4214 HEEsITOWN RD
LOYAL, WI 54446
MARTY,MARY I
S70 W34400 RD X
EAGLE, WI 53119
Description Amount
Verified Fee Amount $0.00
Residential Principal Structures - $0.75/square foot $252.00
(minimum $125)
Total: $252.00
Payment Amount: $225.00
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.
B�'FIELD
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:
Submission Number:
WHALEN, GAIL M
AP-00021
13986 S ST CROIX RD
GORDON, WI 54838
Transaction Number:
LIDMILA,BEVERLY A
AP-00021-294C9
W4214 HEINTOWN RD
LOYAL, W154446
MARTY,MARY J
S70 W34400 RD X
EAGLE, WI 53119
Description
Amount
Additional Fee Amount
$27.00
Total:
$27.00
Pavment Amount:
$28.95
Reference:3422208555
Paid by: Gail Whalen
Payment Type: Debit
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 — Yes
Mitigation — No / Affidavit #:
LAND USE — X
SANITARY —
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
BAYFIELD COUNTY
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0177 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: Addition/Alteration, Residence on a Crawlspace [336 Total sq. ft.]
Qti laimer) You are respouaible 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 residence only.
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
A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obtained
prior to the start of construction (if applicable).