HomeMy WebLinkAbout26-0060Return to:
117 g 5t^ Street, PO Box 58
Washburn, WI 54891
Perm itsia)bayfieldcou nty.wi.gov
Bayfield County Planning and Zoning Department
LAND USE PERMIT APPLICATION
County Use Only:
Submission #: _____ 46
Permit #: - __ 6
Date: Ia-0 _
SECTION A; General Information
Properfty Owner N e:
Authorized Agent Name appli le):
ft r .e JackSwt
cs
Telephon umber:
Telephone Number:
cots
RECEIVED
E -Mail Address:
E -Mail Address:
�J�
�-
Mailing Address:
Mailing Address:
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Bayfield Co.
City, State, Zip: a/ S3v
City, State, Zip: nnmg and Zoning Agency
Contractor:/7
:E
Teleplyt/�Nu 12Y
-Mail Add pes. /
126
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SECTION B: Pi1operty Information
Project Address (if differ t fr m ling addre ):
/�
��
sr a j
e al De ipt sp ce s neede attach a separate sheet):
��additional
CC t /15
Section, Township, Range: 3 2 Oi Town of: C/al & 'L
Tax ID # "'' ' Q, TJ1 O Lot Size (Acres/Square Feet): w s
SECTION c: •tro ect Information (check all that iply)
Project Use is: 2 esidential ❑ Commercial ❑ Municipal If Commercial, estimated cost of construction: $
Project Type is: O'New Construction ❑ Addition/Alteration (existing structure)
❑ Change Use (existing structure) El Relocate (existing structure) ❑ RV Placement 21+ days
❑ Sign ❑ Establishing a Business ❑ Temporary (12 or less months)
❑ Shoreland Grading, Class A El RV Placement 4+ months, Class A ❑ Other (describe):
required Total sq ft): required
SECTION 1): Structure Information. oes_not apply to RVs and Signs, go to Section E)
Structure Type is: Residence /�jj' )& El Principal Structure (describe):
❑ Accessory Structure (describe): ❑ Shoreland Exempt Structure (describe): ❑ Mobile Home (provide manufactured
date):
❑ Shipping Container El Other (describe):
Foundation Type: S
❑ Basement ❑ Walkout Basement El Slab aCrawlspace 0 Ground ❑ Skids ❑ Other (explain):
tructure. (Z Length: 32' Width: ?ES' Height:
Proposed Structure (Provide Sq Ft based on outside dimensions, including unfinished areas, attached garages/above grade
decks/porches):
Basement Sq Ft:
1" Floor Sq Ft:��
Loft Sq Ft:_
2°a Floor Sq
3'' Floor S�:
Garage Sq Ft:
Porch Sq Ft: /
IJ6r
Deck Sq Ft:
Other Sq Ft (d�nbe):
Other Sq F(describe):
Total Sq Ft: 13$ ON
Overall Height (finished grade to peak): /7'
# of Stories:
Existing # of Bedrooms on property: 0
Proposed # of Bedrooms in project: (z) e.g.
SECTION E: RV and Sign Information (check all that apply)
Sign is:
RV is:
❑ New ❑ Replacement
❑ New El Replacement
❑ On -premise ❑ Off -premise
❑ I -sided El 2 -sided
Year: Vin#:
❑ On -building ❑ Multi -Tenant
Length: Width: Height:
Make: Model:
:RED
Application Page 1
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 O Frontage Roads (include name) O Existing Structures ❑ Well (W) 0 Septic Tank (ST) O Drain Field (DF)
❑ Holding Tank (HT) ❑ Privy (P) ❑ Lake ❑ River ❑Stream/Creek ❑Pond ❑Floodplain OWetlands OSlopes over 20%
N
RECEIVED
JAN 14 2026
Bayfield Co.
Planning and Zoning Agency
Setback or distance from furthest extent of structure
including eaves and overhangs to (include on site plan):
County Use Only
Verified setbacks
Road Centerline
ft.
ft.
Notes/Comments:
t U%
<� iJf�t
U
Front Lot Line/Right-of-Way
5rbrp ft.
SOt. ft.
Side Lot Line l
North as outh West, circle one)
�ft.
R.
Side Lot the 2
(North East South West, circle one)
17 ft.
i ft.
Rear Lot Line
53ft.
ft.
Septic/Holding Tank
I ft.
5* ft.
Drainfield
ft.
ft.
Privy 2
%p ft.
ft.
Well
Ckn2 'ft.
ft.
Existing Structure/Building
i ft.
ft.
Wetland
i ft.
ft.
Elevation of Floodplain
i ft.
ft.
Ordinary High -Water Mark (OHWM)
.— ft.
ft.
Other (describe)
— ft.
ft.
Application Page 2
Z_ 2�i�u3z
Ql eQ1--'
2 -
t 4?
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((9 ;I
s� �
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4tSV RECEIVED
��j JAN 14 2026
`� Hayfield Co.
planning and Zoning Agency
32� 2` day
SECTION G: Additional 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
N. 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.
19 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.
IN Yes
❑ No
Is there an existing sanitary system on the property? If yes, what kind?
LIN Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
RYes
0 No
Will pressurized water be installed in the structure? If yes, what kind of sanitary system will be installed or used
to manage wastewater?
N,Drainfield ❑ Holding Tank ❑ Municipal/Public ❑ Other (describe):
Yes
O 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 ❑ Conditional Use ❑ Variance
Fee payment will be made via:
Is Check (attached) O Cash (attached) 0 debit/credit/echeck (department to call once payment is ready to be taken)
How would you like to receive your permit card? '�tiii
I ,
❑ Mail to: OR' Email to: C0ry l'; 3 at-ioG 1 p I k .
❑ Property Owner Address O Agent Address O Contractor Address O Other (provide name and email or address):
Section H:.Acknowledgement andSi nature
All Land Use Permits expire Two (2) Years from the date of issuance if constriction 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 on
dwellings requires review and approval by the local Uniform Dwelling Code (UDC) authority. Additions and a teratiions to one -
and two-family dwellings may require review and approval by the UDC authority. All municipalities are requiretJdp,enlfo4ct
UDC. ddMuVV
Bayfield Co.
If subject property is part of a Condominium Plat, applicant hereby certifies and represents that applicant hap&k&*�4Wing Agency
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/tonic/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 reaso able time f2theurpose of inspection.
Owner(s) or Authorized Agent Printed Name:
Owner(s) or Authorized Agent Signature: Date: //Y ?
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 pennit details & conditions and permit card must be posted on property prior to start of project.
Application Page 3
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RECEIVED
I .
JAN 142026
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4 Bayfield Co.
Planning and Zoning Agency t
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-5'h'• . 'h' 25r 65'M
16-0'
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1/13/26, 5:26 PM
3d2.jpg
a)
RECEIVED
JAN .142026
13ayfield Co.
Planning and Zoning Agency
https://mall.google.com/mail/u/0/?tab=rm&ogbl#lnbox/FMfcgzQBGjMfnRmgwhJQWfpnrNHMGrR?projector=l &messagePartld=0.3 1/1
1/13/26, 5:25 PM
3dl .jpg
RECEIVED
JAN 14 2026
Bayfield Co.
Planning and Zoning Agency
https://mail.google.mm/mall/u/0/?tab=rrn&ogbl#inbox/FMfcgzQfBGjMfnRmgwhJQWfpnrNHMGrR?projector-1&messagePartld=0.2 1/1
Letter of Authorization
Bayfield County Planning & Zoning Department
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, IIYIlet. J 1 rope owner), authorize CC,Y`/ ✓ QL�✓1
(authorized agent) to submit a R vr l r Se (Example: land use, special
use, conditional use, rezone/map amendment, appeal, variance, text amendment, etc.) for the
following described project (Example: constructipn of residence or other structure, short-term
rental or other use change, etc.) Yes j {*ytep application on my behalf for
the following described property:
Legal description of subject property: kLE Cti%' /98O %&. '/'<'I114) Vi 53f /SY/zoy
Address of subject property: /1O&C /So//L
Signature
Dated
RECEIVED
JAN 141U16
Bayfield Co.
planning and Zoning Ajer1Gy
Land Use Permit Application Review Checklist
Submission #:
What zoning district is the project I9�ated in?
❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4 -RB ❑ C ❑ 1 ❑ M ❑ A-1 ❑ A-2 ❑ F-1 ❑ F-2 ❑ W ❑ M -M
❑ Yes DJMo
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 R214o
Are there wetlands on the property?
❑ Yes tMo
Is project associated with a nonconforming use or structure?
❑ Yes [WNo
Is project associated with a variance? Case #:
❑ Yes EVo
Is project associated with a Special B or Conditional Use Permit? Permit #:
❑ Y No
Is the project associated with a Special A Use Permit?
Yes ❑ No
Does the project require nitary?CS-ac ) y (p A -p0S
❑ Existing O New Intercept ❑ Reconnect ❑ Non -Plumbing ❑ Public
SanitaryPermit #: q— (a # of Bedrooms:
❑ Yes No
Does the project require mitigation?
Implementation Deadline: Date of Compliance:
❑ 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 ❑ No
Did plicant/property owner mark lot line(s), if project is within 30 feet of required setback?
Project use is? R dential O Commercial O Municipal
Project type is? EVNew Construction ❑ Addition/Alteration O Change Use ❑ Relocate ❑ RV Placement ❑ Sign
❑ Establishing a Busine s ❑ Temporary ❑ Shoreland Grading O Other, describe:
Structure Type is: esidence ❑ Principal Structure ❑ Accessory Structure O 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:
Fee Type
Calculation
Fee Amount
O Dwelling Enclosed Areas — all enclosed areas within
dwelling except attached non -habitable garages
$0.75 xci sq ft
(minimum $125)
$ (0 a
❑ Dwelling Unenclosed Areas (decks, patios, etc.) or
Attached Non -Habitable Garages
I,T (0
$0.20 x sq ft
(minimum $125)
$ /I
❑ 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 O Land Use Revisions ❑ Special Use Permit - Class A O Floodplain ❑ Shoreland - Impervious
Surface ❑ Shoreland - Non -Conforming, etc. O Tower Siting/Collocation 1 ❑ Tower Collocation 2 ❑ Metallic
Mine
❑ After -the -Fact (ATF)
$
�3x
Inspected by:
Date of Inspection:
Re -Inspected by: U
Date of Re -Inspection:
Denied by:
Date of Denial:
Reason for Denial:
Date Denial Letter Mailed:
Approved by: q in
'I
Date of Approval:
l r I
/
Cond)tion(s):
ust meet and maintain setbacks from furtest extension of structure including eaves and
overhangs.
❑ For personal storage only.
❑ For personal residence only.
❑l Not for human habitation or sleeping purposes.
n/State/DNR/Federal may require permitting
LUUniform
niform 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).
0 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.
❑ Sjgt1 must meet the requirements of Article E of the Bayfield County Zoning Ordinance.
B'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.
0 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:
Iz 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: Submission Number.
JACKSON, CORY & JESSICA LU-02096
30684 JOHNSON LAKE DR
DANBURY, WI 54830 Transaction Number.
JACKSON ,ANDREW & KRISTIN LU-02096-3B85E
27979 LEE RD
WEBSTER, WI 54893
Description Amount
Habitable Residential Principal Structures - enclosed $672.00
areas $0.75/square foot (minimum $125)
Habitable Residential Principal Structure - $91.20
unenclosed area or non -habitable garage
$0.20/square foot (minimum $125)
Total: $763.20
Payment Amount: $763.20
Reference: 1825
Paid by: A -Jackson Concrete LLC
Payment Type: Check
Transaction Date: 2/18/ 2026
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 — Intercept 26-0058 & 24-122S
SPECIAL A -
SPECIAL B/CONDITIONAL -
BOA -
BAYFIELD COUNTY
PERMIT
WEATHERIZE AND POST THIS PERMIT
ON THE PREMISES DURING CONSTRUCTION
No. 26-0060 Tax ID: 12177
Issued To: JACKSON, CORY & JESSICA & JACKSON , ANDREW & KRISTIN
Location: S35 -T51N - R07W
Town of Clover
Legal Description: LOT 15 CSM #1080 (LOCATED IN W 1/2 NW NW) IN DOC 2024R-603363
Residential Structure in R-RB zoning district
For: New Construction [1 - Story ], Residence [Cabin — B] on a Slab [1352 Total sq. ft. ] Height of 17'
(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.
Emily Macgillivray
Authorized Issuing Official
February 18, 2026
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.
To be constructed per plan.