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117 E 5th Street, PO Box 58
Washburn, WI 54891
perm is Ca bdvflel drounty.wov
County Use Only:
Bayfield County Planning and Zoning Department Submission #: W -0 J
LAND USE PERMIT APPLICATION Permit #: 25"
Date:
Owner Name: I Authorized Agent Name
E -Mail Address: E -Mail Address: Il II APR 302025 Li
Jeff(oleverettfsher es am
Mailing Address: Mailing Address: Bayfield Co. Zoning De'
91075 Morrison Rd.
Contractor: Telephone Number: I E -Mail Address:
LSection,
dress (if different from mailing address):
cription (if additional space is needed attach a separate sheet):
661' OF SE SE IN V.1021 P.548 117A
ownship, Range: SO4 T49N R08W Town of: Port Wing
27896 Lot Size (Acres/Square Feet):N C: Project Information check allProect Use is: El Residential ❑ Commercial ❑ Municipal
Project Type is: O New Construction ❑ Addition/Alteration (existing structure)
❑ Change Use (existing structure) 0 Relocate (existing structure) 0 RV Placement 2l+ days
❑ Sign 0 Establishing a Business 0 Temporary (12 or less months)
❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A 0 Other (describe):
Structure Type is: ❑ Residence ❑ Principal Structure (describe):
O Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured
Pole building barn date):
❑ Shipping Container 0 Other (describe):
Foundation Type:
❑ Basement ❑ Walkout Basement 0 Slab ❑ Crawlspace ID Ground 0 Skids 0 Other (explain):
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/porches):
Basement Sq Ft:
l u Floor Sq Ft:
Loft Sq Ft:
2"d Floor Sq Ft:
3r° Floor Sq Ft:
0
1872
0
0
0
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
0
0
0
0
0
Total Sq Ft: 1872
Overall Height (finished grade to peak): 16'
# of Stories: 1
Existing # of Bedrooms on propertv:4
Proposed # of Bedrooms in project: 0
SECTION E: RV and Sign Information (check all that apply)
Sign is
RI is:
❑ New
❑ Replacement
❑ New ❑ Replacement
❑ On -premise
0 Off -premise
❑ I -sided
❑ 2 -sided
Year: Vin #:
0 On -building
0 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 plan)
Show location of:
❑ Driveways 0 Frontage Roads (include name) O Existing Structures O Well (W) O Septic Tank (ST) O Drain Field (DF)
❑ Holding Tank (HT) O Privy (P) 0 Lake O River ❑Stream/Creek OPond ❑Flood lain ❑Wetlands ❑Slopes over 20%
N
'1111APR 302025
Bayfield Co. Zoning Dept.
5E 2V
we -
Setback or distance from furthest extent of structure
County Use Only
including eaves and overhangs to (include on site plan):
Verified setbacks
Road Centerline
75 ft.
') S ft.
Notes/Comments:
Front Lot Line/Right-of-Way
195 ft.
7 7 ft.
Side Lot Line 1
ft.
ft.
% 1 f
North❑East❑South❑ West❑, check one)
Side Lot Line 2
ft.
ft.
North❑East❑South❑West❑ check one)
7!�
j
Rear Lot Line
ft.
ft.
Septic/Holding Tank
172 ft.
ft.
Drainfield
ft.
ft.
Privy
ft.
ft.
Well
20 ft.
- ft.
Existing Structure/Building
75 ft.
1 ' ft.
Wetland
ft.
ft.
Elevation of Floodplain
ft.
ft.
Ordinary High -Water Mark (OHWM)
ft.
ft.
Other (describe)
ft.
ft.
If11 APR 302025 U
SECTION
0 Yes
G:. Additional
O No
Questions
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
O 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.
O Yes
O No
Is there an existing sanitary system on the property? If yes, what kind?
❑ Drainfield O Holdin Tank ❑ Munici aVPublic ❑ Other (describe):
❑ Yes
O 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 ❑ Holdin Tank ❑ Munici al/Public ❑ Other (describe):
❑ Yes
0 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 O Class A Special Use O Class B Special Use O Conditional Use O Variance
Fee payment will be made via:
E Check (attached) ❑ Cash (attached) O 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 O Email to:
❑ Property Owner Address O Agent Address O Contractor Address ❑ Other (provide Name and Email or Address):
Section II: .Acknowledgement andSi ature
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 o i.ea% topic endands, or contact a Department of Natural Resources service
center (715)685-2900.
I (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 reasonable time for the purpose of inspection.
_e f tin
Owner(s) or Authorized Agent Printed Name: vt
Owner(s) or Authorized Agent Signature: Date: `3 0 -25
NOTES:
1. If you are signing on behalf of the wner(s) a letter o 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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APR 3070Z5
202511
Bayfield Co. Zoning Dept.
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Land Use Permit Application Review Checklist
Submission #:
What zoning district is the project located in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ I ❑ M -1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ YesIo Is lot substandard (does not meet curren zoning dimensional requirements)?
Deed of record:
❑ Yes l cNo 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
p -No
/
Is the project located in the Floodplain?
Zone:
Are there wetlands on the property?
Is project associated with a nonconforming use or structure?
JYesMNO
Is project associated with a variance?
Case #:
Is project associated with a Special B or Conditional Use Permit?
Permit #:
❑ Yes
o
Is the project associated with a Special A Use Permit?
Does the project require sanitary?
0 Existing ❑ New ❑ Intercept ❑ Reconnect O Non -Plumbing ❑ Public
Sanitary Permit #:
❑ Yes No
❑ Yes
No
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes
T- o
tt
Does the project require an affidavit?
Affidavit #:
❑ Yes
rNo
Did licensed surveyor mark lot line(s), if project is within 10 feet of required setback?
❑ Yes
No
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? -Residential O Commercial O Municipal
Project type is?ONew Construction ❑ Addition/Alteration O Change Use O Relocate O RV Placement O Sign
❑ Establishing a Business O Temporary ❑ Shoreland Grading ❑ Other, describe:
Structure Type is: O Residence ❑ Principal Structure Accessory Structure ❑ Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container O 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 cygssory Structures - $0.20/square foot (minimum $75)
Calculated Fee Amount: I
Additional Fees: O Return Inspection O Land Use Revisions ❑ Special Use Permit - Class A ❑ After -the -Fact (ATF)
❑ Floodplain O Shoreland - Impervious Surface ❑ Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1
❑ Tower Collocation 0 Metallic Mine
ATF Fee Amount:
Inspected by: , n Date of Inspection:
Coo �K o In
I Re -Inspected by: I Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: GSc Date of Ap royal-
Condition(s):
]'Must meet and maintain setbacks from furthest extension of structure Including eaves and
ForFor personal storage only.
❑ For personal residence only.
'I lot 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).
MUse 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.
o 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
wand use permits shall be obtained prior to the initiation of construction or a change in land use
L/J 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 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner: Submission Number.
JOHNSON, JEFFRY P LU-01641
81075 MORRISON RD
PORT WING, WI 54865 Transaction Number:
LU-01641-2ABB7
Description Amount
Verified Fee Amount $0.00
Non -Habitable Residential Principal and Accessory
Structures - $0.20/square foot (minimum $75)
$374.40
Total: $374.40
Payment Amount: $374.40
Reference: 2434
Paid by: JEFFRY & BRITTANY JOHNSON, 81075 MORRISON RD, PORT WING, WI
54865
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 - No / Impervious Surface - No
Floodplain - No I Wetlands - No
Mitigation - No / Affidavit #:
LAND USE - X
SANITARY -
SPECIAL A -
SPECIAL B/CONDITIONAL -
BOA -
RAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0253 Tax ID: 27896
Issued To: JOHNSON, JEFFRY P
Location: S04 - T49N - R08W
Town of Port Wing
Legal Description: E 330' OF S 661' OF SE SE IN V.1021 P.548 117A
Residential Structure in A-1 zoning district
For: New Construction [1 - Story], Accessory Structure on a Ground [1872 Total sq. ft.] Height of 16'
(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 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. May 09, 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.
No plumbing or plumbing fixtures allowed.
No sewer and pressurized water allowed in the structure.
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