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HomeMy WebLinkAbout25-0288Returnto: ll APR 1 4 2025 117 E StStreet, PO Box 58 Bayfie dt,Coupnty APlanning and Zoning Department Washburn, W154891 EffCIC1Gg INR 16 PLICATION County Use Only: Submission#: U. -DI£04 Permit p: Date: SECTION A: General Information Pro tcrts Oss ner Name: Authorised Agent Name(if applicable): The DBLk Trust David Asplund Telephone Number Telephone Number: 612.618.9242 8126'&9242 E -Mail Address: - - E -Mail Address: vangor©eomcast net vargor@comcssl not Mailing Address: %failing Address 14237 Staples Si NE 14237 Siasiea Si NE City. State. lip: (sty. Slate. /_ip. Ham Lake, MN 55304 Nam Lake I,'N 55704 Contractor: I dephone Number E -Mail Address: Sell 612.6+8-9747 wngnr@ eomcacl Act SECTION B: Property Information Project Address (if different from matbne addlc..) 14130 Warner Road. Mason Wi 54856 Legal Description (if additional space is needed attach a separate sheet): LOT 2 OF CSM 23451N Via CSIA P311 LOG IN SW SW (DBLX TRUST) IN DOG 2024R-604310 Section. Township. Range: secten28 Townof Delta Tax II) ':39718 Lot Si'e ACre Square I-Cat1. Iss SECTION C: Project Information (check all that apply) Project f 3c is JCResidential (-nmmercial [.I Municipal i'rnj'c1 Ij t is ._' \c11 ('onstruction ❑ Addition Al(cration (existing structure) O ('hange Use (existing structure) ❑ Relocate (existing structure) O R%' Placement 21 • days O Sign O Establishing a Business 9 Temporary (12 or less months) 0 Shorcland Grading, Class A O RV Placement •I • months. Class A ❑ Other (describe). required I total sq fti4jO A A0? ?0DO required SECTION D: Structure Infonnadon Does not apply to RVs and Signs. go to Section E) Slrunor; Ii)v ii J Residence C Principal Structure (describe): Cl Accessory Structure (describe); O Shorcland Exempt Structure (describe): O Mobile Home (provide manufactured date): O Shipping Container O Other (describe): T oaridation Type O Basement O Walkout Basement O Slab ❑ Crawlspace O Ground O Skids O Other (explain): Psrsiin Srruciure I.en Ih: Width' height Proposed Sinicturc I1'rm ice Sq 1•) lased an outside dintertur ns. wclud:ng w%tntsleil areal, anacli d garages abuse graik rkc/s orcl7es/ Basement Sq Ft: 1 • Floor Sq Ft: Loft Sq It 2'4 Floor Sq Ft: ° Floor Sq Ft: Garage Sq Ft: Porch Sq F( Deck Sq Ft Other Sq Ft (describe): Other Sq R (describe): Total Sq Ft: Overall Ileight (finished grade to peak): d of Scoria: Existing U of Bedrooms on property : Proposed N of Bedrooms in project: !SECTIQN E: RV and Sign Information (check all thatapply) Sign is Rigs O New a Replacement ❑ New O Replacement O On -premise O Off -premise O I -sided O 2 -sided Year: Vin a: O On -building O 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: O Driveways ❑ Frontage Roads (include name) ❑ Existing Structures O Well (W) O Septic Tank (ST) O Drain Field (DF) ❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain DWctlands ❑Slopes over 20% V L\ i) -irk T'\c t7CL 4�/ti�G� •1-V� 6 T�` J .S\;Now./ i1 i GS \�\ DII MAY 21 2025 Bayfield Co. Zoning Dept. Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline fl. ft. Notes/Comments: Front Lot Line/Right-of-Way ft. ft. Side Lot Line I 9 S ft. ft. ou (North Eas West. circle one) Side Lot Line 2 (North East SouthS, , circle one) ft. /d_C ft. Rear Lot Line ft. ft. Septic/Holding Tank ft. ft. Drainficld ft. ft. Privy ft, ft. Well ft. ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain fl. ft. Ordinary High-Waler Mark (OHWM) ft. ft. Other (describe) ft. ft. SECTION G: Additional Questions Ycs J No I las the location of the proposed project including caves arid overhangs and the sanitary system and well been staked? lire, what date will this he completed: 9 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. Ryes ❑ 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. '9 Yes ❑ No Is there an existing sanitary system on the property? If yes, what kind? $,Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe): ❑ Yes X No Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used to manage wastewater? O Drainfteld ❑ holding Tank ❑ Municipal/Public 0 Other (describe): ❑ Yes 'K No Will sleeping occur in the structure? If yes, contact local Uniform Dwelling Code (UDC) for approval and inspection requirements. is the project associated with any of the following: ❑ Rezone O Class A Special Use O Class B Special Use O Conditional Use O Variance Fee payment will be made via: ❑ Check (attached) ❑ Cash (attached) debit/credit/echeck (department to call once payment is ready to be taken) I low would you like to receive your permit card? ❑ Mail to: OR%Emailto: Nwh oC$i.GDmct & V%IJ ❑ Property Owner Address ❑ Agent Address O Contractor Address ❑ Other (provide Name and Email or Address): Section H: Acknowledgement and.Si 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 arc 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 Ass it}(oI You are responsible for complying with state and federal laws concerning construction near or on w n l''axx-es, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may It i{{��yy yim adtQt5 tbtp modification of construction that violates the law or other penalties or costs. For more information, U1t the ent of Natural Resources wetlands identification web page, dnr.wi.eov/tonic/wetlands, or contact a Department of Naturaj. �j rc 41ept. Bayttee 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 Hayfield County in determining whether to issue a permit. I (we) further accept liability which may be a result of Hayfield 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: b c ark I, Prs rPW Ml ^ Owner(s) or Authorized Agent Signature: g o..3' 4, Al\ L.Q----- Date: NOTES: I. If you arc signing on behalf of the owner(s) a letter of authorization must accompany this application. 2. Specific conditions/instructions maybe 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. k. i ,u15 Bayfield Co. Zoning Dept. + t7 r. 4 4 . )^ ��!► �' � >,•• �y� • , .. � _may-��•,yl F -.-ac •. AFFIDAVIT OF AUTHORITY (Trust) APR 1 42o35 BaNreld Co, zo&n PURPOSE. This Affidavit of Authority is used to certify the individual submitting an application is S Dep( authorized when the property is owned by a Trust STATE OF WISCONSIN ) ss. BAYFIELD COUNTY The undersigned affirms and states as follows. 1. Address of Subject Property I t -I (30 We rl\CS' Rk (y\o.son W. 2. The Subject Property is owned by 1'k_, c Q L Y. I - r (Name of Trust) 3. The name(s) of the current Trustee(s). ts0.��C1 S /t-sdJncA 4. I certify that the Trust named in paragraph 2 is valid and in effect on the date signed below I am the duly appointed agent of the Trust named above in paragraph 2. and I have the authority under the terms of said authorization to submit an application to the Bayfield County Zoning Department concerning the Property described in paragraph 1 I further certify that the information and statements made within this affidavit are true, accurate, and complete to the best of my knowledge. 5. I am authorized by the above -named Trust to apply for and bind the Trust to the terms and conditions of any decision or permit that may be issued by the Bayfield County Zoning Department 6. By signing this affidavit, I attest that I am unaware of any known or unknown person(s) who would contest this application. I agree to indemnify Bayfield County or such person or legal entity suffering a damage resulting from any illegalities of the application. Dated Subscribed and sworn to before me this 14 day of ftyrt I .21;� J Notary ,ir ' County, Wisconsin F! My commission (4 - au "a 1 PROCESSING INFORMATION PR q202U eaN0t r CO Zoning Dept INITIAL PROCESSING. Once the department receives your affidavit, the department will review it for completeness. It the information is not complete, the department may reject your affidavit and the application. REQUEST FOR MORE INFORMATION The department may request that you provide more information or evidence to support your affidavit. DECISION. The department will review all documents submitted as part of the application for registration and title, this form included, and may approve, deny or request more information. C Land Use Permit Application Review Checklist Submission #: flail What zoning district is the project located in? ER -2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C DIEM ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes P No Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: 21es ❑ 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 j�lo Is impervious surface required? (Required if riparian lot OR lot is entirely within 300 feet of OHWM of navigable waterway) ❑ Yes Eiio Is the project located in the Floodplain? Zone: ❑ Yes 6r Are there wetlands on the property? ❑ Yes d7j.No Is project associated with a nonconforming use or structure? ❑ Yes No Is project associated with a variance? Case #: ❑ Yes IA'I�o Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes No Is the project associated with a Special A Use Permit? ❑ Yes ❑1Nb Does the project require sanitary? ❑ Existing ❑ New O Intercept ❑ Reconnect O Non -Plumbing ❑ Public Sanitary Permit #: ❑ Yes -Pfo Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ YesE3410 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 p1 io Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? I]-R&idential ❑ Commercial ❑ Municipal Project type is? 2ic1w Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Business ❑ Temporary O Shoreland Grading ❑ Other, describe: Structure Type is: O Residence ❑ Principal Structure O Accessory Structure ❑ Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) ❑ Stairway to navigable waters ❑ Mobile Home 6 ❑ Shipping Container Other, describe �t/�vu.t Cd 64t .6'e led Total Sq. Ft. ofProject : Number of Stories: ...-0- Overall Height: Calculated Fee Category: ❑ Residential Principal Structures - $0.75/square foot (minimum $125) ❑ Habitable Residential Accessory Structures - $0.50/square foot (minimum $75) hlon-Habitable Residential Principal and Accessory Structures - $0.20/square foot (minimu $75 I❑ Commercial/Municipal Principal Structures - $0.75/square foot (minimum $125) ❑ Commercial/Municipal Accessory Structures - $0.20/square foot (minimum $75) Calculated Fee Amount: 75 Additional Fees: ❑ Return Inspection ❑ 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 2 ❑ Metallic Mine ATF Fee Amount: Inspected b2ffy Date of Inspection: Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed Approved Date of Approval: Condi ion(s): �8 Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. ❑ For personal residence only. ❑ Not for human habitation or sleeping purposes. wn/State/DNR/Federal may require permitting ❑ A Uniform Dwelling Code (UDC) Permit from the locally contracted UDC Inspection Agency must be obt fined 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). ❑ Use best management practices to limit and prevent erosion during construction. ❑ This permit cannot be transferred if property is sold. 0 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. be constructed per plan. ❑ Adhere to privy agreement. 0 Temporary permit allowing existing structure for a period of less than 1 year. 0 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) 0 Additional conditions may be placed and need to be adhered to at the time of permit issuance Other Conditions: $'FIELD 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: THE DBLK TRUST 14237 STAPLES ST NE HAM LAKE, MN 55304 Description Verified Fee Amount Non -Habitable Residential Principal and Accessory Structures - $0.20/ square foot (minimum $75) Payment Amount: Reference: 1942354985 Paid by: David Asplund Payment Type: Credit Card Transaction Date: undefined Submission Number: LU-01604 Transaction Number: LU-01604-2BA8F Amount $0.00 $75.00 $76.95 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 - No Floodplain - No / Wetlands - No Mitigation - No / Affidavit #: LAND USE - X SANITARY - SPECIAL A - SPECIAL B/CONDITIONAL — BOA — No. 25-0288 Tax ID: 39318 Issued To: THE DBLK TRUST Location: S29 - T46N - R07W Town of Delta BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: LOT 2 OF CSM 2345 IN V13 CSM P311 LOC IN SW SW (DBLK TRUST) IN DOC 2024R-604310 Residential Structure in R-1 zoning district For: New Construction Ground Geo Heat field [8000 Total sq. ft.] Height of 0' (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 May 21, 2025 Date Condition(s): Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. 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.