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25-0360
Return to: County Use Only: 117 E 5th Street, PO Box ayfield County Planning and Zoning Department Submission #: LU -Q y�y Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit #: permits anbayfieldcountv.wi.gov Date: Property Owner Name: Authorized Agent Name (if applicable): LAUREL HOLM William Erickson - Extreme Measures Bldg. Svcs.LLC Telephone Number: Telephone Number: 715-209-3977 E -Mail Address: E -Mail Address: 1111 IA JZ5 Bill @ExtremeMeasuresPlans.com 2 Mailing Address: N3409 830TH ST Mailing Address: 71470 State Hwy 13 Bayfleld Co. Zoning De City, State, Zip: City, State, Zip: HAGER CITY WI 54014 Ashland, WI 54806 Contractor: Telephone Number: E -Mail Address: Cory Holsclaw- Holsclaw Const. 218-428-5123 Holsclawconst@chegnet.net SECT EON B: Property Information — - ' Project Address (ifdifierent from mailing address): 2990 SOUTH SHORE RD BARNES 54873 Legal Description (if additional space is needed attach a separate sheet): PAR IN NE SE IN V.549 P.269 (LOT 1 OF CSM V.2 P.172) 729B Section, Township, Range: S20 T44N R09W Town of: TOWN OF BARNES Tax ID #: 2234 Lot Size (Acres/Square Feet): 2.113 nfortdatiun yak al) that a 1: Project Use is: Residential ❑ Commercial ❑ Municipal Project Type is: E New Construction ❑ Addition/Alteration (existing structure) ❑ Change Use (existing structure) ❑ Relocate (existing structure) O RV Placement 21+ days ❑ Sign ❑ Establishing a Business O Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe): required (Total sft): required SECT1CN D: Structure Information (Does not apply to RVs and Signs, go to Section Structure Type is: E 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 E Slab ❑ Crawlspace O Ground ❑ Skids ❑ Other (explain): Existing Structure: Length: Width: Height: Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade decks/porches): Basement Sq Ft: Pt Floor Sq Ft: Loft Sq Ft: 2n"Floor Sq Ft: 3" Floor Sq Ft: 960 Garage Sq Ft: Porch Sq Ft: Deck Sq Ft: Other Sq Ft (describe): Other Sq Ft (describe): Total Sq Ft: soo Overall Height (finished grade to peak): 14'-0" # of S--aories: 1 Existing # of Bedrooms on property: 0 Proposed # of Bedrooms in project: 2 SECTION E: RV and Sign Information (check all that a 1 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: ufofl 0 liii JAN 22 Z025 Show location of: ❑ Driveways ❑ Frontage Roads (include name) O Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (DF) ❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond [1 Floodplain ❑ Wetlands ❑Slopes over 20% P2 &t\ Setback or distance from furthest extent of structure including eaves and overhangs to (include on site plan): County Use Only Verified setbacks Road Centerline +or- 146 ft. ft. Notes/Comments: Front Lot Line/Right-of-Way +or- 113 ft. ft. Side Lot Line I (North East South West, circle one) +or- 44.5 ft. ft. Side Lot Line 2 (North East South West, circle one) +or- 322 ft. ft. Rear Lot Line +or- 113 ft. ft. Septic/Holding Tank tbd ft. ft. Drainfield tbd ft. ft. Privy — ft. ft. Well tbd ft. ft. Existing Structure/Building 35 ft. ft. Wetland — ft. ft. Elevation of Floodplain ---- ft. ft. Ordinary High -Water Mark (OHWM) -- ft. ft. Other (describe) — ft. ft. EC!!v JAN 2l 2025 SECTION G: Additional Questions - _.A.- O(Ilfl ❑ Yes ❑ No Ilas 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 E 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 E 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 E No Is there an existing sanitary system on the property? If yes, what kind? ❑ Drainfield ❑ Holdin Tank ❑ Munici al/Public ❑ Other (describe): E 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 O Other (describe): E 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 O Class A Special Use ❑ Class B Special Use ❑ Conditional Use O Variance Fee payment will be made via: E 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? \ s.e\ •he\ ❑ Mail to: ORE Email to: � �SC�0..t,..o C�S'C C\e c , O Property Owner Address O Agent Address ❑ Contractor Address O Other (provide Name and Email or Address): ection H: Ac,15nuwi 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. 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. Owner(s) or Authorized Agent Printed Name: (_C)t\�.cet. rl c Owner(s) or Authorized Agent Signature: Date: _'ate- ar 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. 160.0' m fD 0 N 373.19' BP � Z m Line of Existing Proposed r4torage Shed San. Lo Owner Name: LAUREL HOLM Owner Address: N3409 830TH ST :__._........__: HAGER CITY WI 54014 Site Address: 2990 SOUTH SHORE RD Pro o5ed !` Proposed BARNES 54873 Well Lao. • Rome Loc. 322-0" Tax ID: 2234 I 4r-0 PIN: 04-004-2-44-09-20-401-000-10000 1'AJMJnAV Legacy PIN: 004113008000�I<MFr{�.., Municipality: TOWN OF BARNES S S STR: S20 T44N R09W Description: PAR IN NE SE IN V.549 P.269 arc. (LOT 1 OF CSM V.2 P.172) 729B•��,sry- Recorded Acres: 2.113 Calculated Acres: 2.113 265.17' m Zoning: (R-1) Residential -1 -- h & - - - - - - - - - - - N i-c o 113.09 Center of South Shore - v tl] J. f i - m R.O. 1'-6" x 4'-0" R.O. 3'-3" NOTE: Contractor to verity exact window specifications and o R.O.'s prior to framing. 9 Living Rm I N '-or---------------------------------- 0 0 z 0 NC yo r Dining Area R.O.4'-0" x 5'-0" •-------- R.4. 2'-0" x 2-6" �emp gl. a Fr Bath '^ I r wio J I N • 2'-8" ur N ' F6'-1 1-3r 5'-51/z' O Kitchen Exact cabinet plan layout to be provided by supplier HHE R.O. 3'-W x 3'-0" R.O.4'-0" x 5'-0" u � 00 __ 0o Bedroom 2 8'-0" Ceiling Bedroom 1 8'-0" Ceiling access above r 00 n HO. 4-0" x 5'-0" Unless noted, All dimensions are to rough framing. 1111 Letter of Authorization JAN 2 L 2025 Bayfield County Planning & Zoning Department Bayfield Co. Zoning Dept. 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, Laurel Holm (propertyowner),authorize William R Erickson (authorized agent) to submit a I and Lice Appiiratinn (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.) New Residence application on my behalf for the following described property: Legal description of subject property: PAR IN NE SE IN V.549 P.269 (Lot 1 of CSM V.2 P.172) 729B Address of subject property: 2990 South Shore Rd Barnes, WI 54873 ature /r / ,25^ Dated Tracy Pooler From: Tracy Pooler Sent: Friday, January31, 2025 11:25 AM To: bill@ExtreMemeasuresPlans.com Subject: Holm - 2990 south shore rd -2234 I do not see any septic plans that are required for issuance of this project. ? 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: t1a,pooler@ba ieldco11ntywi.,gQy Bayfield County, WI 1/22/2025, 10:12:02AM 1:618 . Approximate Parcel Boundary Road Type — Town Private Building Footprint 2015 Building 0.01 0.01 0.01 0.02 0.04 km BayfeId county Land Records oepa,unent 0.03 ml aaylei County Zang Appnafon nnps'/mapa.Lavrerdmunlywi gavaonngWABI \\A 1/22/25. 10:12 AM Novus-Wisconsin Access rev. 12.0206 y`v: Real Estate Bayfield County Property Listing Property Status: Current r� Today's Date: 1/22/2025 Created On: 3/15/2006 1:14:47 PM Z Description Updated: 1/9/2024 Tax ID: 2234 PIN: 04-004-2-44-09-20-4 01-000-10000 Legacy PIN: 004113008000 Map ID: Municipality: (004) TOWN OF BARNES STR: S20 T44N R09W Description: PAR IN NE SE IN V.549 P.269 (LOT 1 OF CSM V.2 R172) 729B Recorded Acres: 2.113 Calculated Acres: 2.113 Lottery Claims: 0 First Dollar: Yes Zoning: (R-1) Residential -1 ESN: 104 I Tax Districts Updated: 3/15/2006 1 STATE 04 COUNTY 004 TOWN OF BARNES 041491 SCHL-DRUMMOND 001700 TECHNICAL COLLEGE 4 Recorded Documents Updated: 3/15/2006 © QUIT CLAIM DEED SO Ownership Updated: 1/9/2024 LAUREL HOLM HAGER CITY WI Billing Address: Mailing Address: LAUREL HOLM LAUREL HOLM N3409 830TH ST N3409 830TH ST HAGER CITY WI 54014 HAGER CITY WI 54014 11 Site Address * indicates Private Road 2990 SOUTH SHORE RD BARNES 54873 ® Property Assessment Updated: 10/4/2016 2025 Assessment Detail Code Acres Land Imp. G1 -RESIDENTIAL 2.130 8,400 2,600 2 -Year Comparison 2024 2025 Change Land: 8,400 8,400 0.0% Improved: 2,600 2,600 0.0% Total: 11,000 11,000 0.0% Property History N/A Date Recorded: 1/2/2024 2024R-601717 2 © CONVERSION 1/� 4' /// / Date Recorded: 7 286-419;549-269 ✓( g577 ;rgoc 6710r&8' https://novus.bayfieldcounty.wi.gov/access/master.asp?paprpid=2234 1/1 Land Use Permit Application Review Checklist Submission #: Wh oning district is the project located in? R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB ❑ C ❑ I ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes 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 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 No 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 7t'No Is project associated with a variance? Case #: ❑ Yes No Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes �a1io Is the project associated with a Special A Use Permit? es ❑ No Does the project require sanitary? 0 Existing j214ew 0 Intercept ❑ jeconnect 0 Non -Plumbing ❑ Public Sanitary Permit #: Z j - 3 ❑ Yes o Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes No 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? ❑ Yes 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? aiciw Construction ❑ Addition/Alteration ❑ Change Use ❑ Relocate ❑ RV Placement ❑ Sign ❑ Establishing a Busipess ❑ 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: Number of Stories: Overall Height: Calcul ted Fee Category: esidential 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: Additional Fees: ❑ Return Inspection ❑ Land Use Revisions ❑ Special Use Permit - Class A ❑ After -the -Fact (ATF) ❑ Floodplain 0 Shoreland - Impervious Surface ❑ Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic Mine ATF Fee Amount: Inspected by: Date of Inspection: 5 - Re -Inspected by: Date of Re -Inspection. Denied by: Date of Denial: Reason for Denial: Date Denial Letter Maile Approved by Date of Approval: ,C/� c Condition(s): ❑ Must meet and maintain setbacks from furthest extension of structure including eaves and overhangs. ❑ For personal storage only. ,ior personal residence only. ❑ Not for human habitation or sleeping purposes. 2_.,'fown/State/DNR/federal may require permitting 2,v 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). ❑ 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. 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 5w Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: HOLM, LAUREL N3409 830TH ST HAGER CITY, WI 54014 Description Verified Fee Amount Residential Principal Structures - $0.75/square foot (minimum $125) Submission Number: LU-01474 Transaction Number: LU-01474-2D056 Amount $0.00 $720.00 Total: $720.00 Payment Amount: $720.00 Reference: 3780 Paid by: EXTREME MEASURES BUILDING SERVICES, LLC, WILLIAM R ERICKSON, 71470 STATE HWY 13, ASHLAND, WI 54806 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 / Wetlands - No Mitigation - No / Affidavit #: LAND USE - X SANITARY — New 25-40S SPECIAL A — SPECIAL B/CONDITIONAL — BOA — No. 25-0360 Tax ID: 2234 Issued To: HOLM, LAUREL BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Location: S20 - T44N - R09W Town of Barnes Legal Description: PAR IN NE SE IN V.549 P.269 (LOT 1 OF CSM V.2 P.172) 729B Residential Structure in R-1 zoning district For: New Construction [1 - Story], Residence on a Slab [960 Total sq. ft.] Height of 14' (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 June 05, 2025 Date Condition(s): For personal residence only. 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. To be constructed per plan.