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HomeMy WebLinkAbout25-0863Return to: County Use Only: 117 15th Street, Po Box 58 Bayfield County Planning and Zoning Depljiut Submission #: LU-Oao63 Washburn, WI 54891 LAND USE PERMIT APPLICATI EU Permit #: aS- oO,63 permits@bayfieldcounty.wi.gov 1 ay Date: Ic%/SJ -Or-S SECTION A: General Informatt Property Owner Name: Ambulrv+ce Sevvtc•e Authorized gent Name (if applicable): R lcuw 13oard Presldev+ rea+'D,vtde n Telephone Number: Te hone Number: 1413 IV7q E -Mail Address: E -Mail Address: I � blevvn t" C_cV n Mailing Address:ecata 43555 I{w (p3 Mailing Address: Po P'ox II Ip Ciry, State, Zip: CZ6(P l V l City, State, Zip: '-,1rum tr OYJ I W ( 51-1832 Contractor: Telephone Number: E -Mail Address: ,,S Q-B:,Pro er : o m ti: n P o'ect Address (if different from mailing address): 511SZI SSS US i-Iw (p3 Ce,W , u11 Legal Description (if additional sp a is needed,attach a separatgg sheet); Lot I CSM 21(p2 IN V,12 R 3SI Located ,n iotS 7c3 (3LoclL (a Aysecsov5 plaE No, 2) Section, Township, Range: S IS — 143 N - i2 07 w Town of: Cab e Tax ID #: 38112G Lot Size (Acres/Square Feet): 41&90 s , SECTION C: Project Information check all that 1 ) Project Use is: ❑ Residential Commercial Municipal Project Type is: ❑ New Construction El Addition/Alteration (existing structure) El Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days SSign - ❑ Establishing a Business ❑ Temporary (12 or less months) ❑ Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe): rc uired (Total sq ft): required SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section E Structure Type is: El Residence ❑ Principal Structure (describe): ❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (prREOEJ JflJed date): ❑ Shipping Container ❑ Other (describe): N0V 242025 Foundation Type: planning and Zoning A;;ency El Basement El Walkout Basement ❑ Slab El Crawlspace ❑ Ground 0 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: I" Floor Sq Ft: Loft Sq Ft: 2 Floor Sq Ft: 3b 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: Existing # of Bedrooms on property: Proposed # of Bedrooms in project: SECTION E: RV and Sign Information (check all that apply) Sign is: is•: RVis: CI New ❑ Replacement ❑ New ❑ Replacement " On -premise El Off -premise ❑ 1 -sided lV2-sided Year: Vin #: ❑ On -building El Multi -Tenant Length: 5- t Width: 3 / Height: 5 / Make: Model: 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 requited to be provided on site plan) 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 ❑Pond ❑ Floodplain ❑Wetlands ❑ Slopes over 20% N EaLCE VE D NOV 2 4 2025 yap BaWeld Co. ,/ planning and Zoning Agency 7 J / /J� z X U v r Iji h 1 0 ^t� Setback or distance from furthest extent of structure County Use Only including eaves and overhangs to (include on site plan): Verified setbacks Road Centerline ft. ft. No s/Comments: Front Lot Line/Right-of-Way ft. ft. Side Lot Line 1 ft. (North ❑East❑South❑ West❑, check one) Side Lot Line 2 ft. (NorthDEastDSouthDWestD, check one) Rear Lot Line ft. ft. Septic/Holding Tank ft. ft. Drainfield ft. ft. Privy ft. ft. Well ft. ft. Existing Structure/Building ft. ft. Wetland ft. ft. Elevation of Floodplain ft. ft. Ordinary High -Water Mark (OHWM) ft. ft. Other (describe) ft. ft. Additional Questions ❑ Yes ❑ No Has the location of the proposed project including caves and overhangs and the sanitary system and well been staked? If no, what date will this be completed: ❑ 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. ❑ 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. ❑ Yes ❑ No 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 ❑ 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 O Conditional Use ❑ Variance Fee payment will be made via: ❑ Check (attached) ❑ Cash (attached) DO 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 �cl Agent Address ❑ Contractor Address ❑ Other (provide Name and Email or Address): Section H:Acknowled ementand.$' nature 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 starIf4ftEpgt9vithout a permit will result in penalties. P q dd 99�����r The local Town, Village, City, State or Federal agencies may also require permits. The new construction uuYle2I2J amily dwellings requires review and approval by the local Uniform Dwelling Code (UDC) authority. Additions an p9ns to one - and two-family dwellings may require review and approval by the UDC authority. All municipalities ets�segtxeddoi9r.'Qthjthe 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. YY1 Owner(s) or Authorized Agent Printed Name: th Owner(s) or Authorized Agent Signature: Date: I I 2z{ 2$J 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 pennit details & conditions and permit card must be posted on property prior to start of project. fiP CE2VED NOV 2 4 2025 AFFIDAVIT OF AUTHORITY Plannirn: ,.-.. (Corporation, LLC, etc.) cy PURPOSE. This Affidavit of Authority is used to certify the individual submitting an application is authorized when the property is owned by a corporate/business entity. STATE OF WISCONSIN ) ss. BAYFIELD COUNTY The undersigned affirms and states as follows: 1. Address of Subject Property: µ'?55S 05 1 iw (P3 Cabe 1&r\ 5y$Z I 2. The Subject Property is owned by: lown5 �f /rymmahC/)t Co L Q rand v iew I Nevi a Jc2on (Name of Company) 3. The name(s) of the current President or Managing Member: 1\� aeyl _ 4. I certify that the company named in paragraph 2 is valid and in effect on the date signed below. I am the duly appointed agent of the Company 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 Company to apply for and bind the Company to the terms and conditions of any decision or permit 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: l I I2 `a / 2S �) 2t&pen l3Lam, 4 Print Name Subscribed and sworn to before m this a( * day of A/nL4'M4/C, 20A. ` n Notary Public, jt 4&."County, Wisconsin My commission — r r.ECmVE© NOV 242025 IIIIIIIII III llllhIIIIIIIIIIIIIIIll hIIIII *2021R-586898 2* Bayfield Co. Planning and Zoning Agency BAYFIELD COUNTY CERTIFIED SURVEY MAP NO.0� LOTS 2 & 3, BLOCK 6, ASSESSOR'S PLAT NO. 2, RECORDED AS DOCUMENT # 306322 IN VOL. 6 OF PLATS, PG'S 10-19 WITHIN THE BAYFIELD COUNTY REGISTRY SECTION 18, TOWNSHIP 43 NORTH, RANGE 7 WEST, TOWN OF CABLE, BAYFIELD COUNTY, WI. LINE TABLE LINE BEARING DISTANCE LI N00°27'48'E 73.19' (N00'25'58'E) (72.94) L2 NOI-29-05-W 71.55' (NO1'48W-W (72.00) (S88°30'42"E) TAXID:10037 S88°25'47"E ---------- FD.1 & I.P. 302.32' LIGHT C4 j EDGE OF ASPHALT 21 POLE LOT1 ...................j............... 41,690 Sq.Ft..... FO. 2W C.I.P. 0.96 Acres i 110 -I31 FD.2WC.I.P.------------- BUILDING (S87°33'16"E 1II LOT1-CSM#1488 111III ------------- ti '. i(' TRICK ` MCKUEN S-2992 -_ ASHLAND, Wi "I-' SUR�1E ��•` 'IIIIIIII� LEGEND Q -SET 1 1/4"O.D. x 18" IRON PIPE WEIGHING 1.68 LEIS PER LIN. FOOT • -FD. MONUMENT AS NOTED I.P. -IRON PIPE C.I.P. -CAPPED IRON PIPE ( ) - PREVIOUSLY RECORDED AS 2021R-586898 DANIEL J. HEFFNER QAVCT❑n rn1 nITV I4T REGISTER OF DEEDS 02/03/2021 10:55AM TF EXEMPT #: RECORDING FEE: 30.00 PAGES: 2 GSM A•3) •352 .N 'W r S BEARINGS ARE GRID BA SED WCCS - BAYFIELO COUNTY WIiN THE NORTH LINE OF LOT 2, BLOCKS MEASURED TO BEAR SBEM25'47E FO, 1 X'I.P. N16'154TE-1.56' ) 307.51' 5.19' F0.1" LP. 260.99) - / FIELDWORK COMPLETED: 1/7/21 60' 0' 60' 120' 180' SCALE FEET 5o' l / I 45' I / / ( / I LINE ff^ti 3 J•/ !n t / °0°h / / 45 / 45, / /O /' Pine Ridge Land Surveying, LLC. Professional Land Surveying Services Value & Quo/jay in a Timely Manner... PATRICK A. MCKUEN, PIS 1424 1/2 Lake Shore Dr. W. Ashland, Wisconsin Phone (715) 682-2969 W W W. PINERIDGESURVEYING.COM PROJECT NO. GREATDIVIDE21-18-43-7 SHEET 1 OF 2 SHEETS W LA -E. rye=:.atr;A EDr NOV 2 4 2025 BAYFIELD COUNTY CERTIFIED SURVEY MAP NO. LOTS 2 & 3, BLOCK 6, ASSESSOR'S PLAT NO.2, RECORDED AS DOCUMENT # 306322 IN VOL. 6 OF PLATS, PG'S 10-19 WITHIN THE BAYFIELD COUNTY REGISTRY SECTION 18, TOWNSHIP 43 NORTH, RANGE 7 WEST, TOWN OF CABLE, BAYFIELD COUNTY, WI. Bayfield Co. Planning and Zoning Agency Surveyors Certificate I, Patrick A. McKuen, Professional Land Surveyor S-2992, hereby certify that I have surveyed and mapped; Lots 2 & 3, Block 6, Assessors Plat No. 2, recorded as Document #306322 in Vol. 6 of Plats, Pg's 10 -19 within the Bayfield County Registry, Section 18, Township 43 North, Range 7 West, Town of Cable, Bayfield County, W. That the above described parcel of land contains 41,690 square feet which is 0.96 acres. That I have made this map at the direction of Laura Bjork, AGENT for said lands. That said parcel is subject to any easements, restrictions and right-of-ways of record. That I have fully complied with the provisions of Section 236.34 of Wisconsin Statutes and with the subdivision regulations of the Town of Cable and Bayfield County in surveying, dividing and mapping said parcel. ,'If rr llr� That this map correctlyand accuietgty.degctsMfeAiderior boundaries of said parcel and the division thereof made. '. ti y 0f ICK A. 2o2/ da d thisda of r... A. S-2992 Pine Ridge bend Surveying t. C •. vv i :4 Patrick A. McKuen , 9.<j0 WI PLS S-2992 ",,O SU.R'ff ; rlrrnrrr� BAYFIELD COUNTY ZONING APPROVAL CERTIFICATE I, ROBERT SCHIERMAN, BAYFIELD COUNTY ZONING DIRECTOR, DO HEREBY APPROVE THI IEL UNTY CERTIFIED SURVEY MAP ROBERT SCHIERMAN rr) DATED THIS --- DAY OF --�"r _` 2021. Pine Ridge Land Surveying, LLC. Professional Land Surveying Services Value & Quality in a Timely Manner... PATRICK A. MCKUEN, PLS 1424 1/2 Lake Shore Dr. W. Ashland. Nsconsin Phone (715) 682-2969 Wt V.PINERIDGESURVEYING.COM PROJECT NO. GREATDIVIDE21 -18.43-7 SHEET 2 OF 2 SHEETS Land Use Permit Application Review Checklist Submission #:02063 What zoning district is the project located in? ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 ❑ R-RB DIEM ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M ❑ Yes Alo Is lot substandard (does not meet current zoning dimensional requirements)? Deed of record: ❑ Yes UNo 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..Ato ( 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: ❑ Yesto Are there wetlands on the property? ❑ Ye o Is project associated with a nonconforming use or structure? ❑ Yes o Is project associated with a variance? Case #: ❑ Yes o Is project associated with a Special B or Conditional Use Permit? Permit #: ❑ Yes Is the project associated with a Special A Use Permit? ❑ Yes E931e Does the project require sanitary? 0 Existing ❑ New 0 Intercept 0 Reconnect ❑ Non -Plumbing 0 Public Sanitary Permit #: # of Bedrooms: Does the project require mitigation? Implementation Deadline: Date of Compliance: ❑ Yes "T5,NQ ❑ Yes o 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 10 Did applicant/property owner mark lot line(s), if project is within 30 feet of required setback? Project use is? ❑ Residential ,Commercial 0 Municipal Project type is? 0 New Construction 0 Addition/Alteration ❑ Change Use 0 Relocate ❑ RV Placement theign ❑ Establishing a Business 0 Temporary ❑ Shoreland Grading ❑ Other, describe: Structure Type is: 0 Residence 0 Principal Structure 0 Accessory Structure 0 Boathouse (one story only) ❑ Open-sided/Screened Structure (gazebo, etc.) 0 Stairway to navigable waters ❑ Mobile Home ❑ Shipping Container ❑ Other, describe Total Sq. Ft. of Project: Number of Stories: Overall Height: Fee Type Calculation Fee Amount ❑ Dwelling Enclosed Areas — all enclosed areas within dwelling except attached non -habitable garages $0.75 x sq ft (minimum $125) $ 0 Dwelling Unenclosed Areas (decks, patios, etc.) or Attached Non -Habitable Garages $0.20 x sq ft (minimum $125) $ ❑ Habitable Residential Accessory Structures $0.50 x sq ft (minimum $75) ❑ Non -Habitable Residential Principal and Accessory Structures $0.20 x s ft q (minimum $75) $ ❑ Commercial/Municipal Principal Structures $250 + $0.005 x cost of construction (minimum $250) $ ❑ Commercial/Municipal Accessory Structures $150+$0.005 x cost of construction (minimum $150) $ ❑ Return Inspection 0 Land Use Revisions 0 Special Use Permit - Class A 0 Floodplain 0 Shoreland - Impervious Surface 0 Shoreland - Non -Conforming, etc. ❑ Tower Siting/Collocation 1 0 Tower Collocation 2 ❑ Metallic Mine ❑ After -the -Fact (ATE) $ Inspected by: Date of Inspection: I 'L Re -Inspected by: Date of Re -Inspection: Denied by: Date of Denial: Reason for Denial: Date Denial Letter Mailed: Approved by: 9 r Date of Approval: c Condition(s): ❑ 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. ❑ 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). cUse 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). ❑ 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 AYFIELD Bayfield County Planning & Zoning Department 117E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: GREAT DIVIDE AMBULANCE SERVICE 43555 US HIGHWAY 63 CABLE, WI 54821 Description Sign Submission Number. LU-02063 Transaction Number LU-02063-392C8 Amount $100.00 Total: $100.00 Payment Amount: $100.00 Reference: 9336 Paid by: Great Divide Ambulance Service Payment Type: Check Transaction Date: 12/5/2025 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 I Wetlands — No Mitigation — No / Affidavit #: LAND USE -X SANITARY — SPECIAL A — SPECIAL B/CONDITIONAL — BOA — No. 25-0863 Tax ID: 38429 Issued To: GREAT DIVIDE AMBULANCE SERVICE Location: S18 - T43N - R07W Town of Cable BAYFIELD COUNTY PERMIT WEATHERIZE AND POST THIS PERMIT ON THE PREMISES DURING CONSTRUCTION Legal Description: LOT I CSM #2162 IN V.12 P.351 (LOCATED IN LOTS 2 & 3 BLOCK 6 ASSESSORS PLAT NO. 2) For: Sign in C zoning district New, On -Premise, 2 -sided (5 x 3) Height of 5' (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. December 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): Use best management practices to limit and prevent erosion during construction. To be constructed per plan.