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WrO1pi
117E 5" Street, PO Bffi5811ayfielld County Planning and Zoning Department
Washburn, WI 54891 LAND USE PERMIT APPLICATION
permits@bayfieldcounty.wi.gov
County Use Only:
Submission #:
Permit #:
Da
te: t
SECTION A: General Information
Property Owner Name:
Authorized Agent Name (if applicable):
Stephen P. and Julie K. Maciosek Revocable Trust
Telephone Number:
Telephone Number:
612-770-3288
E -Mail Address:
E -Mail Address:
steve@maciosek.coin
Mailing Address:
Mailing Address:
P.O. Box 566
City, State, Zip:
City, State, Zip:
Cable. WI, 54821
Contractor:
Telephone Number:
E -Mail Address:
SECTION B: Property Information
Project Address (if different from mailing address):
41885 Valhalla Townhouse Rd
Legal Description (if additional space is needed attach a separate sheet):
Lot Two (2) of Certified Survey Map No. 2378 as recorded in Volume 13 of Certified Survey Maps on Page 393 as Document No. 2024R-605698
Section, Township, Range: T w,ag ftr ann Sea Twenyegm(28),Townof:Cable
Tax ID #: 39453 Lot Size (Acres/Square Feet): 7.1 acres
SECTION C: Project Information (check all that apply)
Project Use is: O Residential ❑ Commercial ❑ Municipal
Project Type is: ❑ New Construction El Addition/Alteration (existing structure)
❑ Change Use (existing structure) ❑ Relocate (existing structure) ❑ RV Placement 21+ days
❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months)
0 Shoreland Grading, Class A ❑ RV Placement 4+ months, Class A ❑ Other (describe):
required Total sq ft): required
SECTION D: Structure Information (Does not apply to RVs and Signs, go to Section E)
Structure Type is: O Residence ❑ Principal Structure (describe):
❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured
date):
❑ Shipping Container ❑ Other (describe):
Foundation Type:
O Basement ❑ Walkout Basement ❑ Slab ❑ Crawlspace ❑ Ground ❑ Skids 0 Other (explain):
Existing Structure: Length: 45 Width: 63 Height: 26.5
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/ arches):
Basement Sq Ft:
1" Floor Sq Ft:
Loft Sq Ft:
2nd Floor Sq Ft:
3.d Floor Sq Ft:
552
563
Garage Sq Ft:
Porch Sq Ft:
Deck Sq Ft:
Other Sq Ft (describe):
Other Sq Ft (describe):
1375
Total Sq Ft: 2,490
Overall Height (finished grade to peak): 26.5'
# of Stories: 2 Existing # of Bedrooms on property: 2
Proposed # of Bedrooms in project: 1
SECTION E: RV and Sign Information (check all that apply)
Sign is:
is:
RVis:
❑ New ❑ Replacement
❑ New ❑ Replacement
❑ On -premise ❑ Off -premise
❑ 1 -sided ❑ 2 -sided
Year: RECEIVED:
O On -building O Multi -Tenant
q�9
AUG 2 0 elyg5el:
Length: Width: Height:
Make:
Planning and Zoning Agency
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 ❑ Frontage Roads (include name) ❑ Existing Structures ❑ Well (W) ❑ Septic Tank (ST) ❑ Drain Field (OF)
❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain []Wetlands ❑Slopes over 20%
N See attached
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerline -. j/(' LO
125
ft.
' ' 4c ft.
Notes/Comments:
RECEIVED
Al IA 2 fl 2025
Front Lot Line/Right-of-Way
365 ft.
D ft.
Side Lot Line 1
(NorthDEastDSouthWestD, check one)
125 ft.
ft.
Side Lot Line 2
orthOEast❑South❑West❑ check one
300 ft.
Iv
Rear Lot Line
95 ft.
/ Qft.
Septic/Holding Tank
23 ft.
ft.
Drainfield
55 ft.
ft.
Privy
n/a ft.
ft.
Well
27 ft.
ft.
Existing Structure/Building
0 ft.
ft.
Wetland
n/a ft.
ft.
Elevation of Floodplain
n/a ft.
ft.
Ordinary High -Water Mark (OHWM)
n/a ft.
ft.
Other (describe)
n/a
ft.
ft.
nMp w.
Planning and Zoning Agency
SECTION G: Additional Questions
E 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
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
El 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.
El Yes
O No
Is there an existing sanitary system on the property? If yes. what kind?
E Drainfield ❑ Holding Tank El Municipal/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?
E Drainfield El Holding Tank unici al/Public ❑ Other (describe):
El Yes
O No
Will sleeping occur in the structure? f yes, contact local Uniform Dwelling Code (UDC) for approval and
inspection requirements.
Is the project associated with any of the following:
El Rezone ❑ Class A Special Use O Class B Special Use El Conditional Use ❑ Variance
Fee payment will be made via:
El Check (attached) El Cash (attached) ❑ 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 El Email to:
El Property Owner Address ❑ Agent Address ❑ Contractor Address ❑ 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. 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, takes, 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: Stephen P. Maciosek
Owner(s) or Authorized Agent Signatur • Q Date: ��
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 agenntts {{ppctors
must all be aware of permit details & conditions and permit card must be posted on property riorR� btu
AUG 202025
BavfieM on.
EXISTING
7.134 ACRES
RECEIVED
AUG 202025
BaYFeld Co.
Planning and Zoning Agency
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PROPOSED
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AUG 2 0 2025
Bayfield Co.
Planning and Zoning Agency
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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 ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ YesJo
Is lot substandard (does not meet current zoning dimensional requirements)?
Deed of record:
❑ Yes %o
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 Jo
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 Flood plain? Zone:
❑ Yes 10
Are there wetlands on the property?
❑ Yes No
Is project associated with a nonconforming use or structure?
❑ Yes No
Is project associated with a variance? Case #:
❑ Yes No
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Yes 10
Is the project associated with a Special A Use Permit?
Yes O No
Does the project require sanitary?
❑ Existing ❑ New O Intercept O Reconnect ❑ Non -Plumbing O Public
Sanitary Permit #: A 4# of Bedrooms:
❑ Yes,�No
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ Yes j 'No
Does the project require an affidavit? Affidavit It:
❑ Yes o
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 is7
esidential O Commercial ❑ Municipal
Project type ist O New Constructioddition/Alterationhange Use ❑ Relocate O RV Placement ❑ Sign
❑ Establishing a Business O Temporary ❑ Shoreland Grading ❑ Other, describe:
Structure Type is Residence ❑ Principal Structure O Accessory Structure O Boathouse (one story only)
❑ Open-sided/Screened Structure (gazebo, etc.) O Stairway to navigable waters ❑ Mobile Home
❑ Shipping Container ❑ Other, describe
Total Sq. Ft. of Project: Z 0 Number of Stories: Z Overall Height:
Fee Type
Calculation
Fee Amount
Dwelling Enclosed Areas — all enclosed areas within
dwelling except attached non -habitable garages
q ft
(minimum $125)
$
,B Dwelling Unenclosed Areas (decks, patios, etc.) or
Attached Non -Habitable Garages
$0.20 x s ft
q
(minimum $125)
$
❑ Habitable Residential Accessory Structures
$0.50 x sq ft
(minimum $75)
❑ Non -Habitable Residential Principal and Accessory
Structures
$0.20 x sq ft
(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 O Land Use Revisions O Special Use Permit- Class A ❑ Floodplain ❑ Shoreland - Impervious
Surface ❑ Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 O Tower Collocation 2 ❑ Metallic
Mine
❑ After -the -Fact (ATE)
$
Inspected by: '/J c
Date of Insp in o
�C— ® 7
Z Z
Re -Inspected by:
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter M ' d:
Approved by:
Date of Approval:
/ /
Condition(s):
Must meet and maintain setbacks from furthest extension of structure including eaves and
overhangs.
❑ For personal storage only.
P'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.
7,A Uniform Dwelling Code (UDC) Permitfrom 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.
❑ 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).
,ZI 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:
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:
MACIOSEK REV TRUST, STEPHEN P &
JULIE K
5695 NORTH SHORE DR
EAU CLAIRE, WI 54703
Description
Habitable Residential Principal Structures - enclosed
areas $0.75/square foot (minimum $125)
Habitable Residential Principal Structure -
unenclosed area or non -habitable garage
$0.20/square foot (minimum $125)
Submission Number:
LU-01897
Transaction Number:
LU-01897-33701
Amount
$836.25
$275.00
Total: $1,111.25
Payment Amount: $1,111.25
Reference: 1345
Paid by: Julie K Maciosek, Stephen Maciosek, 5695 North Shore Drive Eau Clair, WI
54703
Payment Type: Check
Transaction Date: 8/21/2025
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 I Nonconforming - No
Shoreland — No I Impervious Surface — No
Floodplain — No / Wetlands — No
Mitigation — No / Affidavit #:
LAND USE -X
SANITARY — Existing 259794
SPECIAL A —
SPECIAL B/CONDITIONAL —
BOA —
0re> *71[I*Ii f7III&PLf+ ?
Issued To: MACIOSEK REV TRUST, STEPHEN P & JULIE K
Location: S28 - T43N - R07W
Town of Cable
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
Legal Description: LOT 2 CSM 2378 IN DOC 2024R-605698 487 IM 2025R-607994 (STEPHEN P & JULIE K MACIOSEK REV
TRUST)
Residential Structure in R-RB zoning district
For: Addition/Alteration [2 - Story], Residence on a Basement [2490 Total sq. ft.] Height of 26.5'
(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
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.
Scott Roush
Authorized Issuing Official
August 21, 2025
Date
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
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.
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)