HomeMy WebLinkAbout25-0823RECEIVED
SEP 262015
Bayfield Co.
Return to: Planning and Zoning Ana,,;; County Use Only:
117 E 5t° Street, PO Box 58 Bayfield County Planning and Zoning Department Submission S: L U-01977
Washburn, WI 54891 LAND USE PERMIT APPLICATION Permit it: d'S- o-3
permitsh yfieldmunty.wi.yov Date: 11 /S boas
Property Qivner N3rne:. ` Authorized Agent Name (if applicable):
fY
Telephone Number. Telephone Number:
715 78/
E-MailAddress: QTv. (� E -Mail Address: 9/ dS
Mailing Address: Y� T Mailing Address:
City State, Zip: ` w/ fJ tfo / 3 City, State, Zip:
Contractor: Telephone Number: E -Mail Address:
a
I Section, Township, Range: Sec .3'l`, 7,%4 l4pAiR9ji/ I Town of: (f/yioC2/q
Tax ID #: 3 '/ 51/// ��zrLot Size (Acres/Square Feet): : `ft
Project Type is:
O Change Use (existing structure)
❑ Sign
❑ Shoreland Grading, Class A
❑ New Construction
❑ Relocate (existing structure)
❑ Establishing a Business
❑ RV Placement 4+ months, Class A
❑ Addition/Alteration (existing structure)
RrRV Placement 21+ days
❑ Temporary (12 or less months)
❑ Other (describe):
Structure Type is: O Residence O Principal Structure (describe):
❑ Accessory Structure (describe): O Shoreland Exempt Structure (describe): O Mobile Home (provide manufactured
date):
❑ Shipping Container O Other (describe):
Foundation Type:
❑ Basement O Walkout Basement O Slab O Crawlspace O Ground O Skids O Other (explain):
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/porches):
Basement Sq Ft:
10 Floor Sq Ft:
Loft Sq Ft:
2o°Floor Sq Ft:
3`° Floor Sq Ft:
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
Total Sq Ft:
Overall Height (finished grade to peak):
# of Stories: J
Existing # of Bedrooms on property:
Proposed # of Bedrooms in project:
SECTION E: RV and Sign Information (check all that apply)
Sign is:
R V is:
❑ New
O Replacement
0 New ifiteplacemeut
❑ On -premise
O Off -premise
❑ 1 -sided
❑ 2 -sided
Year: / %9'LJ Vin #: 1CAL92L'( a
❑ On -building
❑ Multi -Tenant
J 00.330/
Length:
Width: Height
Make: rr6l, e Model:c(
Cep. e.Z
RECEIVED
SEP 26 2025
Bavfield Co.
znq
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 site plan
Show location of;
❑ Driveways ❑ Frontage Roads (include name) ❑ Existing Structures 0 Well (W) 0 Septic Tank (ST) 0 Drain Field (Dl')
❑ Holding Tank(HT) ❑ Privy(P) 0 Lake 0 River ❑Stream/Creek ❑Pond ❑Flood lain ❑Wetlands ❑Sloes over 20%
N
Lifi f
kaa kf7MV n�
r � aih
of i2 �
`t
cc
--a
frive-
7a5.f/'
o71'!dcq.c_VSTr_6o�L-
'7
4 u!a !
Dw�rX-- f�rr'e+ert tF2rurl�n
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
Road Centerline
-5p
R
Front Lot Line/Right-of-Way
5
ft.
Side Lot ' e I
orth t❑South❑West❑ check one)
`& c
ft.
Side Lot Line
orth EastkSouth❑West❑ check one)
a C
ft.
Rear Lot Line
�pp
ft.
Septic/Holding Tank
/y,Q
ft.
Drainfield
/yq.
ft.
Privy
/VA
ft.
Existing Structure/Building I /VA
Wetland ,1.'w rem 9'a
ft.
Use
fft- LIJJiv;
7 a1ca�o.,
ft.
c,\ ✓ cud
7fft.
cl
ft.
ft. tq1d ehf7<.✓ wv�Sf — �r5✓� 1
ft. 4o b w I A 525/!4 s J/4 (
-5 A &5 ',�l4eQ ,7 dr et -c rc-
7 74c rd►s)r%jr_eC {7//e /Aq/
SySTr�c In,7//,c? V
a u cC- Wge, /,.4dv- /�- P/ec//n'Ye-a/ $rrt4'k t�
a o' c// Iris C OC/r/ /f.T' 4- -5e
RECEWED
SEP 26 2025
hayfield Co.
Planning and Zoninn
SECTIONGtAdditional
Questions
❑ Yes
No
Has the location of the proposed project including eaves and overhangs and the sanitary system and well been
staked? If no, what date will this be completed:
❑ Yes
O No
Did a licensed surveyor mark lot line(s) if project is within 10 feet of required setback? See page 2 of Land Use
Application Information for required setbacks.
❑ Yes
O No
Did property owner or applicant mark lot line(s) if project is within 30 feet of required setback? See page 2 of
Land Use Application Information for required setbacks.
❑ Yes
o
Is there an existing sanitary system on the property? If yes, what kind?
❑ Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
Yes
❑ No
Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used
to manage wastewater? •
❑ Drainfield WHoldin Tank ❑ Mumici blic ❑ Other describe):
es
O No
Will sleeping occur in the structure? If yes, contact local Uniform Dwelling bode (UDC) for approval and
inspection requirements.
Is the project associated with any of the following:
❑ Rezone O Class A Special Use 0 Class B Special Use O Conditional Use O Variance
Fee payment will be made via:
❑ Check (attached) O Cash (attached) Vdebit/credit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card?
Mail to: OR O Email to:
lfiProperty Owner Address ❑ Agent Address O Contractor Address O Other (provide Name and Email or Address):
Section H: Acknowledgement and Signature
All Land Use Permits expire Two (2) Years from the date of issuance if construction or use has not begun.$anitary 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, dncwi.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 Qf' on.
C r6!
Owner(s) or Authorized Agent Printed Name: ✓ / / /tom t/
Owner(s) or Authorized Agent Signature: Date: a3 ._9X5
NOTES:
I. 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.
AFFIDAVIT OF AUTHORITY
(Trust)
IRPOSE. This Affidavit of Authority is used to certify the individual submitting an application is L.u-o19 71
thorized when the property is owned by a Trust
'ATE OF WISCONSIN ) RECEIVED
) ss.
LYFIELD COUNTY ) OCT 10 2025
Bayfield co.
e undersigned affirms and states as follows: planning and Zoning Agency
1. Address of Subject Property: 2 3 yfLry —4'f 4 5cr 14 ?iur 9't'I% /fQy% �G'�!
/ter IJ�
2. The Subject Property is owned by: 75tA c*it'P
(Name of rust) J o/9
3. The name(s) of the current Trustee(s): , /K/cr 2 t/ #/%r
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 Bayfleld County or such person or legal entity
suffering a damage resulting from any illegalities of the application.
rted:
ibscribed and sworn to before pie this 1O
y of Q&F' , 20ILJ'.
`.D. wl /V1. _.LJA
Lary Public, (' Mi_o,_d _ _ County, Wisconsin
My commission: �P, i. I L.1, 2.O1-1
PROCESSING INFORMATION
INITIAL PROCESSING. Once the department receives your affidavit, the department will review it for
completeness. If 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.
RECEIVED
OCT 10 2025
Bayfield Co.
Planning and Zoning Agency
Land Use Permit Application Review Checklist
,it _i—
Submission #:
What zoning district is the prdjed 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
❑ Yes ?lo
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 o
Is the project located in the Floodplain? Zone:
es ❑ No
Are there wetlands on the property?
❑ Yes WNo
Is project associated with a nonconforming use or structure?
❑ Yes o
Is project associated with a variance? Case #:
❑ Yes No
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes No
Is the project associated with a Special A Use Permit?
"Wes ❑ No
Does the project require sanitary?
t
❑ Existingew 0 Intercept ❑ Reconnect 0 Non -Plumbing O Public
Sanitary Pe it #: 2 - (p � # of Bedrooms:
❑ Yes J0
_
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes J0
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?
❑ Ye o
Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Proje use is? esidential O Commercial O Municipal
Project typ G? ❑ New Construction O Addition/Alteration O Change Use ❑ Relocate . V Placement O Sign
❑ Establishing a Business O Temporary O Shoreland Grading ❑ Other, describe:
Structure Type is,Residence O Principal Structure ❑ Accessory Structure ❑ Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container Other, describe A
Total Sq. Ft. of Proje : Number of Stories: Overall Height:
Fee Type
Calculation
Fee Amount
❑ Dwelling Enclosed Areas — all enclosed areas within
$0.75 x sq ft
(minimum $125)
dwelling except attached non -habitable garages
$
❑ Dwelling Unenclosed Areas (decks, patios, etc.) or
$0.20 x sq ft
(minimum $125)
Attached Non -Habitable Garages
$
❑ Habitable Residential Accessory Structures
$0.50 x sq ft
(minimum $75)
❑ Non -Habitable Residential Principal and Accessory
$0.20 x s ft
q
(minimum $75)
Structures
$
❑ Commercial/Municipal Principal Structures
$250 + $0.005 x
(minimum $250)
cost of construction
$
❑ Commercial/Municipal Accessory Structures
$150 + $0.005 x
(minimum $150)
cost of construction
$
❑ Return Inspection O Land Use Revisions ❑ Special Use Permit - Class A ❑ Floodplain ❑ Shoreland - Impervious
Surface O Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic
Mine
❑ After -the -Fact (ATF)
$
Inspected by: Date of Inspection:/
5co�j �eks� / /�7LC
Re -Inspected by: Date of Re -Inspection:
Denied by: Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: c5
E t€S Date of Approval:
1 2 "
Condition(s):
rMust meet and maintain setbacks from furthest extension of structure including eaves and
(overhangs.
❑ For personal storage only.
or personal residence only.
❑ Not for human habitation or sleeping purposes.
(Fbwn/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).
Jse best management practices to limit and prevent erosion during construction.
( T}his 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.
'flTo be constructed per plan.
,Adhere to privy agreement.
0 Temporary permit allowing existing structure for a period of less than 1 year.
RV may not be used for permanent residence or storage.
2 -RV allowed for 'Z f dK S — Y
❑ 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
s°anitation 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:
AGREEMENT OF RICHARD MILLER
TRUST
1496 310TH ST
GLENWOOD CITY, WI 54013
Description
Recreational Vehicle (RV) Placement
Submission Number:
LU-01977
Transaction Number.
LU-01977-37D35
Amount
$75.00
Total: $75.00
Payment Amount: $76.95
Reference: 8661916885
Paid by: Richard Miller
Payment Type: Credit Card
Transaction Date: 11/5/2025
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 - Yes
Mitigation - No I Affidavit #:
LAND USE - X
SANITARY — New 25-150S
SPECIAL A -
SPECIAL B/CONDITIONAL -
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 25-0823 Tax ID: 34914
Issued To: TRUST AGREEMENT OF RICHARD MILLER
Location: S34 - T49N - R09W
Town of Orienta
Legal Description: LOT 3 CSM #1509 IN V.9 P.88 (LOCATED IN NE NE SEC 34 & NW NW SEC 35) IN 2023R-598148 (TRUST
AGREEMENT OF RICHARD MILLER DTD 6/29/2018)
For: Recreational Vehicle (RV) in A-1 zoning district
Make: Cobra Model: Corsica VIN #: 1CALG26W2SJD03301 Year: 1995
(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. November 05, 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.
Town/State/DNR/Federal may require permitting
Use best management practices to limit and prevent erosion during construction.
This permit cannot be transferred if property is sold.
To be constructed per plan.
RV may not be used for permanent residence or storage.
RV allowed for 21 days -4 months.
Sanitation requirements must be met (if applicable)